Research Data and Conclusion
A comparative study of the ageing population of the four asian tigers (Singapore, Taiwan, Hong Kong and South Korea) and the medical spending of each country.
Population trends of each region:
Inference and Observation:
The following can be inferred from the graph :
Singapore : Singapore’s elderly dependency ratio is increasing and it is predicted to increase at an even faster rate throughout the years while its youth dependency ratio is decreasing steadily. Although it is predicted to rise after a few years.
Korea: Similar to Singapore, Korea’s elderly dependency ratio is increasing and is predicted to increase even faster nearing 2015. Although Korea’s youth dependency ratio is decreasing as of now, it is predicted to rise steadily after 2015.
Hong Kong: Hong Kong’s Elderly Dependency Ratio is the highest, which leads to the inference that it has the highest number of elderly residents. Unfortunately, the ratio is steadily increasing while its youth dependency ratio is the opposite. The youth dependency ratio is the lowest of all the four countries, however, it shows signs of increasing after 2015.
Taiwan: Like the other regions, Taiwan’s elderly dependency ratio is also increasing at an accelerating rate, while youth dependency ratio decreases steadily. However, the youth dependency ratio is predicted to increase in a few years.
From this graphs, we can see that Singapore, Korea, Hong Kong, Taiwan’s youth dependency ratio decreases while its elderly dependency ratio increases steadily. This is the prediction of what happens. But the statistics from the past to the present are quite accurate and we can confirm that all of these regions have an ageing population that will continue to age throughout the years. This also confirms that need for medical health will increase with the years as the elderly need proper care and their rate is increasing thus more people will need better health care.
Medical Spendings of each region:
The 3 ‘M’s system
- each citizen accumulates funds that are individually tracked, and such funds can be pooled within and across an entire extended family.
- Low cost insurance scheme that is designed to provide coverage for large subsidised bills
- A fund set up by the government to help needy singaporeans who can’t pay their medical bills
- an affordable severe disability insurance scheme which provides basic financial protection to those who need long term care,especially old age.
Government Spending amounts only 3-4% of total GDP,yet it is ranked 2nd in the world shows that it is extremely efficient.
The fund also helps the needy,elderly and poor
Some of the spendings are modified to help the elderly (Medifund silver etc.)
Singaporeans shoulders the highest amount of healthcare expenditure among developed countries.
It Covers 6% of GDP(Gross Domestic Product), estimating $971 per head
The National Health Insurance
- Everyone resident in the country is eligible regardless of nationality or profession. Foreigners living in South Korea who are registered with the National Health Insurance Corporation receive the same medical benefits and services as Korean nationals.
- High quality healthcare is available in South Korea in general hospitals, oriental hospitals (which use traditional eastern medical practices), public health centres and private hospitals. There is a three tier provision of medical facilities, depending on the size and the number of departments.
- A patient visits a doctor. After diagnosis, the patient pays a small amount of deductible ,usually a small percentage of the cost set by NHIC to obtain a prescription. The patient takes the prescription to a pharmacy, where again she pays a small amount of deductible to get her medicine. Then the doctor and the pharmacist claim the full cost of the visit to the NHIC. The NHIC pays the doctor and the pharmacist, out of the premium that every Korean has paid.
Health Care insurance enrolls all koreans enrolled inside.People pay half of the premium through their paycheck.The less the income,the less they pay.Doctors can be visited for little money.Thus people frequently visit the doctor when they get sick,so diseases can be discovered earlier.
Certain Disease can still be costly as some treatment for these diseases can be elective and thus would not be insured for. Doctors are paid less as the price for their treatment is controlled. Patients purposely visit the best doctor for minor ailments wasting time and money for the doctors as minor ailments can be rid of even by any certified doctor.
In 1995, Taiwan formed the National Health Insurance (NHI) model. The NHI is operating based on a fee for service (FFS) system. The patient will only need to pay a small amount of price set by the Bureau of National Health Insurance (BNHI) for each medical service received; and the rest of service payment will be covered by the BNHI. Doctors and hospitals contracted with NHI make of their income through this mechanism. This made healthcare much better in Taiwan, this can be justified with the increase in 1991 where the GDP was US$424,117 while in 1992 where the GDP was US$499,859 and the GDP increases even more after that. Out of the 23.34 million people in Taiwan, 11.2 % of whom are above 65 years old.
The NHI has good accessibility,citizens can visit any doctor,and visit any level in a hospital as they wish.It also has comprehensive coverage.It covers almost all services.From dental care to parturition,from Western medicine to Traditional chinese.It provides abudant care for the people.It has a high coverage of about 99%,so medical bills are usually cheap.
It has a weak referral system.The Taiwanese are allowed to visit any doctor they want.Thus they might not use special care properly.Large medical institutions are always at full capacity from patient admission,patients might find it difficult to get admitted.
Hong Kong has an estimated population of 7,184,000 and around 14.3% of the population is made up of the elderly. This is because Hong Kong has the second highest life expectancy and fifth lowest infant mortality in the world. The life expectancy is 84 years for women and 79 years for men to be exact.These factors lead to Hong Kong having some of the best medical services. Infact, the first ever live donor liver transplant was carried out in Hong Kong in 1993 The table below shows the total expenditure on health (TEH) as a percentage of Hong Kong’s GDP from 2001 - 2011. From the table, it can be inferred that the Hong Kong spent the most on medical care in 2002. Although there was a decline in the expenditure from 2006 to 2008, the medical spending started increasing after 2009. Currently. as of 2011, the total expenditure is 5.1% of Hong Kong’s GDP.
(Adapted from: http://www.fhb.gov.hk/statistics/en/statistics/health_expenditure.htm)
The other picture below shows the total expenditure on health in Hong Kong in 2013.
The Hong Kong Health System
Outpatient care, mostly primary health care, is provided predominantly by private general practitioners, who provide over 70 percent of all outpatient consultations. Public
general outpatient clinics provide approximately 15 percent of all outpatient consultations at a
subsidized rate to mostly those with low income and patients with chronic conditions. The
remaining 15 percent of outpatient visits are provided by private practitioners of alternative
medicine, in which traditional Chinese medicine practitioners constitute the largest group.
Expenditure on outpatient services constitutes around 50 percent of the total health care
expenditure. Roughly 75 percent of outpatient expenditure is financed by out-of-pocket
payments, with the remaining financed by employers or insurance
The public hospital system is heavily subsidised.It provides well recognised quality health care service at an affordable price.
There are excessive work loads, rising staff shortages and worsening waiting times in the public sector. The private sector has limited hospital capacity and can be easily affected by changes in the dominant and highly subsidized public sector.Elderly might not get their treatment on time
Table of Comparison:
Elderly Dependency Ratio
Total Health Expenditure % of GDP (%)
Total Expenditure (International $)
Now, let us go back to our hypothesis and see whether it is true...
We believe that the region that has the highest ageing population would have a higher medical spending as there are more elderly to be taken care of.
Which country has the most efficient way of handling healthcare issues?
According to Bloomberg’s health care efficiency rank, the ranking are as followed:
1st: Hong Kong
However, Taiwan cannot even be found in the top 50. This shows Taiwan’s lack in the health care efficiency and the little amount it spends on health care.
Our Results(Compared to hypothesis)?
Well, it is not true. The hypothesis is proven wrong. Hong Kong, which has the highest Elderly Dependency ratio of 18, has a total health expenditure of GDP of 5.2% , which is lower than Taiwan. Singapore, which has the lowest elderly dependency ratio, has the 2nd most efficient way of handling medical spendings followed by Koreas(with an elderly dependency ratio of 16) and lastly Taiwan(with an elderly dependency ratio of 15).
Despite Singapore having the lowest old age dependency ratio among the 4 asian tigers, its has already started preparing for the aging population,it has modified its policy for the elderly such that it would better fit them. Something that they can improve on is that the contribution rate from the beneficiaries is still quite high among developed countries,which can be bad for the elderly as they might not be able to pay for the fees
Korea have a good system to counter minor ailments.Yet it is not really prepared for the aging population.Despite facing such an aging population, Korea has yet to change its system to face the problem.The system does not cover chronic diseases which the old is prone to,as optional treatment are not covered.Thus more improvements can be made.
Taiwan’s National Insurance covers most services,and it is also cheap.But the referral system is poor thus the elderly might not find the right specialist,time might be wasted
Hong Kong’s health care system requires no financial contribution.As long as you have a Hong Kong ID card,you can use the system.Yet there are problems with staff shortages and longer waiting time.This can affect the service for the elderly
Overall, we feel that Hong Kong has the best healthcare system for the elderly in the 4 asian tigers.It funds most of the fees for hospitalisation,it is avaliable for everybody.It provides a comprehensive treatment for most diseases.It is specially made for those who are underprevilege including the old,with cheap and good service.This shows that the government understands the problem and is trying to resolve it.It is also very efficient,with the total spending at about 5.2%.So it is the best among the 4 countries.
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Link to the presentation - https://docs.google.com/a/s2013.sst.edu.sg/presentation/d/19i9pU3s0R_xKcCBOTO4qVPLq0dzIMjf8qxTlOlzshAM/edit#slide=id.p