【文章內容簡介】 bed plement of 11,276.Hospital admissions total approximately 369,456 in 1997.The MOH operates five hospitals for acute health care, and fourhospitals with special functions. The hospitals are as follows:Acute Care:Alexandra HospitalChangi General HospitalNational University HospitalSingapore General HospitalTan Tock Seng HospitalSpecial Functions:KK Women amp。 Children Hospital maternityWoodbridge Hospital mentalView Road Hospital mentalCommunicable Disease Centre infectious diseaseAng Mo Kio Community Hospital subacute careSingapore General Hospital, Tan Tock Seng Hospital, KK Women amp。Children Hospital, Ang Mo Kio Community Hospital, National SkinCentre and Singapore National Eye Centre were privatized by theMOH under the umbrella of Health Corporation of Singapore (HCS)to give these hospitals management autonomy. This enables thehospitals to pete effectively against private hospitals.These hospitals are also monly referred to as restructuredhospitals, and they account for about 74% of public specialistoutpatient consultations in Singapore.The National University Hospital is also an autonomous hospitaldirectly reporting to the MOH instead of the HCS. It is also ateaching hospital for the National University of Singapore.There are 13 private hospitals in Singapore with a bed plementof 2185. The largest private health care operator in Singaporeis Parkway Group Healthcare, the health care division of ParkwayHoldings Limited which is listed on the Singapore Stock Exchange.Parkway, which owns Gleneagles Hospital, Mount Elizabeth Hospitaland East Shore Hospital, accounts for twothirds of privatehospital beds. Gleneagles and Mount Elizabeth are the twolargest private hospitals providing acute care.Raffles Medical Group (RMG) which owns Raffles SurgiCentre is inthe process of building a 428bed hospital in the centralbusiness district. It will be pleted by end of 1999 and willbe the second largest private hospital after Mount Elizabeth.RMG also manages medical service centers at the Singapore ChangiInternational Airport and Hong Kong39。s Chek Lap Kok Airport.The other seven private hospitals are:Adam Road HospitalHMI Balestier Medical CentreKwong Wai Shiu HospitalMount Alvernia HospitalRaffles SurgiCentreRen Ci HospitalSt. Andrew39。s Community HospitalThomson Medical CentreWestpoint Family HospitalYoungberg HospitalWards in the MOH hospitals are segregated into singlebed rooms,twobed rooms, fourbed rooms, sixbed rooms and tenbed rooms.Nonresident patients are not eligible to stay in the sixbed andtenbed wards as these wards are subsidized by the MOH. Privatehospital wards offer singlebed rooms, twobed rooms and fourbedrooms.Health Care ExpenditureGovernment health care expenditure in 1997 was US$ billionor about US$300 per capita. The per capita total health careexpenditure (public and private) was US$745 in 1996 or % ofSingapore39。s Gross Domestic Product (GDP).Health Care FinancingThe financing philosophy of Singapore39。s health care deliverysystem is based on individual responsibility, coupled withgovernment subsidies to keep basic health care affordable. Tohelp Singaporeans in the copayment for hospitalization expenses,the Singapore Government introduced the following health carefinancing plans:MEDISAVE: a pulsory savings plan to help individuals save andpay for their health care expenditure.MEDISHIELD: a catastrophic insurance plan to help meet the costof large medical bills。 andMEDIFUND: a health endowment fund which provides a safety net forthe poor and needy.Under Medisave, Singaporeans pay between % of theirsalaries into a medical savings account managed by the CentralProvident Fund (CPF, a Government trustee pension fund). Thispercentage is part of the mandatory 40% of ine which allresident Singaporeans contribute to the CPF. Medisave is usedfor hospitalization expenses including day and convalescenthospitals as well as hospices. Certain expensive outpatienttreatments are included such as day surgery,radiotherapy/chemotherapy, renal dialysis, invitro fertilizationand hepatitis B vaccination.Medisave withdrawal is subject to the following limits: S$300 (about US$170) per day for daily hospitalization charges。and a fixed limit for the various surgical procedures listed underMedisave39。s guidebook Using Your Medisave.Medisave also allows payments to approved health insuranceschemes such as MediShield Plus, Ineshield and ManagedHealthcare System.As of December 31, 1996, there were million Medisave accountstotalling US$ billion. The amount of Medisave withdrawn wasUS$204 million for 1996. The average Medisave balance per accountwas US$3,612.MediShield was implemented in 1990 as a supplement to Medisave,to cover expenditure for any serious or major illness. Medisavewas designed to cover average medical expenditures. As acatastrophic insurance plan, MediShield reimbursements are onlyfor expenditures that exceed a deductible (technical term usedby MediShield). MediShield will pay only 80% of the excess.Amounts which are not reimbursed by MediShield are deducted fromMediSave or the patients39。 health insurance plans.MediShield Plus, an extension of MediShield since July 1994,includes a second tier optional plan to cover hospitalizationexpenses in higherclass wards. This plan is targeted atpatients using private hospitals or Class A and B1 wards in thepublic sector.Medifund is an endowment fund set up specially to help poor andneedy Singaporeans pay for their medical care. Medifund wasstarted in April 1993 with an initial endowment of US$140 millionfrom the Singapore Government. Only interest ine from theendowment fund which is distributed by the MOH hospitals is usedto pay hos