Behind the ideology and theory: what is the empirical evidence for medical savings accounts?
نویسنده
چکیده
Singapore’s Medisave scheme has attracted widespread interest around the globe, due to its innovative ideas and the salesmanship of Singapore’s leaders (Kwa 1994; Nichols, Prescott, and Phua 1997; Phua 1997). While countries as different as the United States, South Africa, and China have adopted some of the core ideas of Medisave, its impacts have not been critically examined. The essay “Medical Savings Accounts in Singapore: A Critical Inquiry,” by Michael Barr, attempts to partially fill this void and gives a major explanation for this gap—the reticence of the Singapore government to provide complete information about its health system performance. Nonetheless, several major conclusions can be reasonably drawn from the remedial actions taken by the government to correct the Medisave scheme. This commentary provides the economic explanation for Medisave’s failure to curb health expenditure, which has led the Singapore government to abandon its reliance on price competition and to demand constraints in an effort to structure its health care system and impose controls on supply and prices. I also point out several irrational and inconsistent features of the Medisave scheme that have caused financial hardship for Singapore’s citizens and have adversely affected the cost-effectiveness of its health care system. It’s curious why Singapore has not taken action to ameliorate them. Barr’s essay correctly distinguishes the philosophical principles and rhetoric of Medisave from its economic impacts. Under Medisave, patients pay a large portion of medical expenses directly out of pocket, and only
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عنوان ژورنال:
- Journal of health politics, policy and law
دوره 26 4 شماره
صفحات -
تاریخ انتشار 2001