(14-03-2014, 12:08 PM)opmi Wrote: (13-03-2014, 06:12 PM)tanjm Wrote: let's not forget that once you increase capacity, you are basically permanently increasing the fixed overhead of our health system. The ideal case is a health system that matches demand exactly - that's a tough act for anyone but armchair experts to follow.
then how come the Punggol LRT was built and more than 15 years when the area was barren land...fenced up and sitting idle for >15 years.
then how come Airport T4 is being built in anticipation of demand when T3 not maxed out yet.
health care is even more important than 2 above for Singaporeans. why cant Govt plonked more money to build ahead of demand?
It is all about political will. Money can come from somewhere. Hey, thats what reserves is for. Not for investing for investing sake.
I can understand where tanjm is coming from. But he missed out a bigger picture: policy making is not about PnL and simple maximisation for a simple reason: it is infrastructure building and that requires a lot of headrooms. It is not unheard of that power generators are 50% utilised in normal circumstances. There are primarily 2 reasons for it:
1) they are critical so it is relatively cheaper in terms of opportunity cost to have headrooms then the actual cost. Case in point is our MRT system. They have been focusing on actual maintenance cost rather than opportunity cost which we now realise is way above. that is why in other threads we have been emphasing that public goods cannot be totally commercialised because the downside is inhernetly socialised.
2) they are relatively inflexible. You can't lay an optical network overnight. Neither can you increase healthcare supply overnight. Or for that matter ANY infrastrastruture. That's why planning is paramount. In that sense water and healthcare are the same though forumers has commented rightly that the business models are not the same.
The correct approach is to have a socialist view ie create headroom and quality with
secondary objective of minimising cost, invest in more schools and training, while using capitalistic tools ie high salary and good environment, to attract healthcare workers.
Incidentally that's what our govt had been doing, and rather successfully to give them the credit. The current problem is not the supply planning, it is the surge in demand due to the population targets going way out of whack from the original plan.
In policy missteps, it doesn't happen overnight either. It takes years for people to feel the pain and pay the price. For example if we de-emphasize Mandarin in our current education system, it will be decades later before we realise we are losing out in the global system, just as our emphasis on English had brought us tremendous benefits since the 70s.
(16-03-2014, 02:43 PM)tanjm Wrote: Tough problem. If you price the true cost of hospitalization, people will complain that the poor are kept out. If you subsidize, people will over consume (and in the case of Singapore - still complain - because they want to consume class A facilities at class C prices).
Another oft quoted misunderstanding is that people think healthcare demand and supply is
directly related to price. It was even quoted in a parliament discussion. In some cases for eg dental or spectacles it is true, but I would challenge anyone to contract critical illness like AIDS or Leukemia to take advantage of the subsidy. That's where policies have to differentiate the 2 and why I fully support a universal critical illness coverage.
On another note, since this is the thread on population, is that influx of migrants do change our culture. I do not want to pin every blame on immigration but I have been quoted unreservedly that we have no issue with immigration since we are a migrant society in the first place... but the problem is we are assimilating into the immigrants' way of doing things rather than the other way because of the huge influx. If Singapore has decidedly beome more "ungracious' and more "uncourteous" the influx has to share the blame. The group theory logic is simple: if u just see A FEW rushing for the buffett lunch, what would you do?
The tipping point is not 50%... it is just 10%. Gone are our 40 years of courtesy campaigns. We used to even use wallets and handphones to "chop" seats....S'poreans uncaring?
Readers say yes ...and no
2014-03-18 00:31:25.34 GMT
By Maryam Mokhtar
March 18 (Straits Times) -- WHEN Ms Vivien Goh was five months pregnant, she tripped and fell on the pavement near her office at Raffles Place.
But she was quickly helped to her feet by a couple, who sat with her until she was able to get up and walk back to her workplace.
Meanwhile, frequent MRT user Steven Tannenbaum, a Massachusetts Institute of Technology professor, said he has "never not been offered a seat by a younger person, or seen a person in need not offered assistance".
The don and his wife, both in their 70s, have been shuttling between Singapore and the United States over the last five years for work.
These two accounts were among more than 90 responses from citizens and foreigners to The Straits Times after the paper ran a piece asking if Singapore was suffering from a "massive compassion deficit".
That was a phrase used by freelance writer Charlotte Ashton in a BBC Viewpoint piece, in which she recounted how, in her 10th week of pregnancy, she was overcome with nausea while taking the train to work and had to crouch for 15 minutes because no one offered her a seat.
Ms Ashton, who moved to Singapore from London last year and said she had been happy here until that incident, concluded that Singapore suffers from a "massive compassion deficit".
Her comments prompted online posts by Prime Minister Lee Hsien Loong and two ministers, urging Singaporeans to be kinder and more gracious.
It also spurred more than 90 readers to write in to ST with passionate accounts of their encounters with kind and callous Singaporeans, and their theories on why Singaporeans behave the way they do.
They were evenly split between those who think Singaporeans lack compassion and those who say people here are among the kindest they have met.
Of the nine foreigners who wrote in, six shared positive experiences of how Singaporeans behaved towards them on trains and in malls. The other three related negative encounters.
Mr Simon Hulber, who has been here since 1998, said "the rudeness and indifference I experience does seem more confined to public transport". He added that this was "no different from other crowded mass transport systems around the world".
Agreeing, Ms Vicki Loh, who is five months pregnant, finds it "impossible to get a seat on the train (or) bus". She added: "Given that my daily commute is about one hour each way, coupled with back pain due to the pregnancy, public transport is not looking to be a feasible means of getting around any more, especially as I get bigger."
Others stressed, however, that such ungracious behaviour did not represent Singaporeans as a whole, given the significant number of foreigners living and working in the Republic.
"We all know Singapore as a country consists of many other foreigners (who) live, work, transit (here)... How (does) anyone know if those people (who) are not compassionate, not kind and not gracious are Singaporeans?" asked Mr Mok Tuck Sung. At least 11 other readers made the same point.
Singaporeans also "tend to be rather self-conscious and feel embarrassed when our offer of help is rebuffed", observed Ms Irene Sim. She said that many have grown up reserved, preferring to "mind our own business".
But how an individual acts, argues Ms Dawn Lee, should not be a benchmark for painting a picture of the larger society.
"Indifference and apathy exist in individuals, not in entire populations. Some foreign cultures view kindness as weakness and vulnerability as exploitability... wherever they are in the world," said the 35-year-old, who has lived and studied both here and overseas.
Agreeing, reader Edwin Chow said: "Singapore is by no means perfect but I believe that what we have here is a mix of misery and joy, selfishness and compassion, no different from any other developed city. One generally finds what one is looking for."
maryamm@sph.com.sg
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Charlotte Ashton replies
IN AN e-mailed reply to The Straits Times, journalist Charlotte Ashton wrote that she left Singapore last week to return to Britain for a couple of months to have her baby.
Ms Ashton, who had been living in Singapore since last year and was working as a freelance writer, sparked debate with her BBC Viewpoint piece headlined "Does Singapore deserve its miserable tag?"
In it, she described how she and her husband were happy here until an incident on an MRT train during her 10th week of pregnancy. She became overcome with nausea and had to crouch for 15 minutes during her commute as no one offered her a seat. She felt that Singaporeans had "let me down".
"In terms of my report for the BBC's From Our Own Correspondent programme, it comes from a personal perspective based on my experience of Singapore and various conversations I've had with Singaporeans and expats living in Singapore.
"Pieces of this kind inevitably stir debate and I've had as many messages of support as I have criticism. Whether my conclusions are shared by others, I welcome the fact that
Singaporeans are so keen to take part in a lively debate about this subject."
Before you speak, listen. Before you write, think. Before you spend, earn. Before you invest, investigate. Before you criticize, wait. Before you pray, forgive. Before you quit, try. Before you retire, save. Before you die, give. –William A. Ward
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