Government determined to increase population to 7 mil in 2030.

[Temperament]

It's an irony isn't it? Our G plan far, far ahead for Singapore's economy to survive in this harsh world but not so much for the betterment of the welfare of all Singaporeans in general.

What does this means? Only benefits most of the "ELITES" if not all? Scholars are scholars. Workers are workers. In other words, workers also benefit but compare to our "Elites" it's really peanuts. As one of the ELITES had used peanuts to compare in the past about remunerations or something like that.
So we are really peanuts to them?

[candy188]

Our government needs to learn the rope from China Premier to EMPHASIZE on WELL-BEING of the PEOPLE rather than solely pursuing Economic Growth.
[Image: jbzmvljxUdm3m3.png]

"This GDP needs to ensure Fairly full employment and help INCREASE PEOPLE's INCOME.
We AREN'T PREOCCUPIED with the GDP Growth.

The GDP growth we want is one that
~~ brings REAL BENEFITS to our PEOPLE,
~~~ helps raise the quality and efficiency of economic development
~~~~ and contributes to energy conversation and environmental protection."

- China Premier Li Keqiang

[Image: jbbcAqjp7LuNoz.png]

http://www.cnbc.com/id/101489798

It's an irony isn't it? Our G plan far, far ahead for Singapore's economy to survive in this harsh world but not so much for the betterment of the welfare of all Singaporeans in general.

What does this means? Only benefits most of the "ELITES" if not all?

Scholars are scholars. Workers are workers. In other words, workers also benefit but compare to our "Elites" it's really peanuts.
[Image: jtC7uFwMWFYOF.png]
As one of the ELITES had used peanuts to compare in the past about remunerations or something like that.
So we are really peanuts to them?

[safetyfirst]

haha quite funny... Give them some time la, i think they have changed; they seem more willing to help the lower income people now, read the newspapers today... Recently they also give more medical benefits to the pioneer generation...

i guess the previous election gave them a wakeup call, so be patient

[tanjm]

The ideal case is a health system that matches demand exactly - that's a tough act for anyone but armchair experts to follow.

So would you care to shed some light to educate plebeians like us? I.e. why the government can miss a fundamental issue. Note: Some studies appear to suggest that the demand for healthcare for those aged 65 and above are several times that of the regular population.

let's not forget that once you increase capacity, you are basically permanently increasing the fixed overhead of our health system.

So what about newater and the desalination plants? Do you mean that their capacity matched our demand exactly without any buffer? So why the government can increase the overhead on water but not healthcare?

actually newwater and desalination provide only about 50% of our water needs and there's a water security angle.

If you build 10 more hospitals, you are going to get nurses, doctors, pharmacists, radiologists, and other associated allied health care professionals from ...... where exactly? Or maybe beds and airconditioning is enough?

[tanjm]

Btw, I'm not saying G did everything it could. They could have made mistakes in capacity planning. But I see you guys criticizing without data is quite amusing. How many can tell me (without googling), the average occupancy rate of our hospitals? How many years from first year uni to finish housemanship for a doctor? How many nurses and doctors do you need per 100 beds in a hospital? Do you know anyone who was actually turned away because beds were full or are you just reacting to newspaper reports of hospitals setting aside extra beds in tentage?

[HitandRun]

actually newwater and desalination provide only about 50% of our water needs and there's a water security angle.

But do we use 100% of the newater and desalination capacity during normal periods of time? Obviously not... that's why the current drought has little impact on our water supply and the government is able to ramp up the supply to fill up the gap left by the drought.

If you build 10 more hospitals, you are going to get nurses, doctors, pharmacists, radiologists, and other associated allied health care professionals from ...... where exactly? Or maybe beds and airconditioning is enough?

That is precisely the point, isn't it. The healthcare system requires a long lead time to expand its capacity. And if the government not far sighted enough (I would prefer to think the government was not deliberate in trying to deny healthcare to its citizens), we have a shortage situation....

[Riderr2000]

Without a doubt, we need more beds, but to measure the beds / population ratio historically against the same ratio today will lead to misleading conclusions. New treatment paradigms and healthcare delivery models are structured to reduce the load on hospital beds. I.e. minimally invasive surgery (keyhole surgery) and other advances in less invasive and interventional procedures greatly reduce recovery time. A heart bypass will lead to 6-8 days in the hospital. A stent implant will only require 1 day.

To be fair to the SG govt, the physician and bed shortage issue is a global issue, both in the developed and developing world. To address issues of overcapacity, IMHO, is not simply to build more infrastructure, but to look at the overall patient pathways, and explore what are the innovative, and effective ways to reduce the consumption of healthcare. More effective population screening, early detection, preventive approaches, better ways of diagnosis and treatment, all help to reduce the load on the hospitals. Again, these are issues faced by all countries, and driven by similar trends globally.

There is also a bit of a conundrum -if your healthcare system sees extraordinary success, an indicator is that your population lives a whole lot longer... and the aged population are the ones with the most healthcare needs. I have a lot of empathy for the planner in a resource constrained world. Building more hospitals and beds, you decrease the available land for residences (driving up home prices, another sticky point), commercial buildings (increasing rent in malls anyone?) and offices (cost of doing business?). Import doctors, nurses, health techs, and you drive unhappiness with the ever increasing influx, patients having issues being served by non-Singaporeans, etc. etc.

[Contrarian]

> if your healthcare system sees extraordinary success
> Without a doubt, we need more beds

Our health system is not health. It is TREATMENT. Western style treatment. Super expensive.

1. If everyone makes regular exercise a daily affair, 45 mins - 1 hr, the immune system will be stronger.

2. Doctors must prescribe supplements as well as medication. or refer them to pharmacies. And prescribe medicine.

3. Medisave must be allowed for going to gym and season pass to pool and games.

We will need a lot less beds and a lot less $8bn funds.

[HitandRun]

Without a doubt, we need more beds, but to measure the beds / population ratio historically against the same ratio today will lead to misleading conclusions.
.
.
.
.
Import doctors, nurses, health techs, and you drive unhappiness with the ever increasing influx, patients having issues being served by non-Singaporeans, etc. etc.

Riderr2000

Since you are an insider, perhaps you could share with us what went wrong in your political masters' demand and supply model? Did the model factor a 5.5 million population in 2013 or failed to forecast the demand due to aging or was too aggressive in the "productivity savings" assumptions? When did they discover the problem and why KBW or maybe even LHK was slow in enacting the policies to change course? Or did the model simply assume that demand can be throttled just like bandwidth?

[Riderr2000]

HitandRun,

Since you were already wrong on your first presumption, I have no idea how to reply to the rest of your post.

I think your assumption of what I do probably colored your response and made you miss my point - i.e. 1. Bed and physician shortage is a global issue, and while there has been much discussions on how to solve it, the ideal solution is still far away. 2. increasing number of beds alone is not the best solution. Focusing on that alone will lead to the wrong conclusions. We have to think broader than that.

I dont have a solution - I have thoughts on how best to approach the issue. The point raised on allowing CPF to be used for prevention / healthy living over therapy sounds like a good suggestion.

Happy to hear your suggestions and debate based on that though. In fact, if you do have a good solution, I would encourage you to raise it beyond this forum, and even beyond our national boundaries.