Prime Minister Lee Hsien Loong's National Day Rally Speech 2009 on 16 August

We are preparing for our long-term future by strengthening our social safety nets. After food and shelter, I think good health is one of the most important basic requirements which human beings have. It is more important than money. Singaporeans know that we have good doctors, good hospitals. Their worry is whether they can afford it, especially in the future after they grow old and retire. We have done many things to mitigate this worry. We have a 3M (Medi Save, Medi Shield, MediFund) system designed precisely to keep health care affordable to all, even and especially, the lower income group. And we have steadily improved and upgraded and extended the 3M system so Medi Save now covers long term outpatient treatment, MediShield now provides higher insurance payouts, Medi Fund –we have increased the amounts, it is giving more help to the needy to settle their outstanding hospital bills. So as a result, MPs see fewer cases of residents unable to afford healthcare, and medical social workers report that the MediFund is adequate to cover hospital bills. We will continue to improve this and to widen the 3Ms progressively but we have to do it carefully because we want to keep the system working and there are pitfalls.

But I know that Singaporeans are still concerned. We see medical science advancing, we see new technologies, new drugs, new procedures. People can live longer, but it costs more. And those who are in their 50s looking after aged parents, they feel the burden and they wonder “what will happen to me when my turn comes?”. They asked, “I am all right now, what about the future?” We need to gear up our healthcare systems to prepare for this ageing population and we are doing that. So today I would like to explain the implications of our ageing population and how we are preparing our healthcare system to cope. What does it mean when we say our population will be older? It means there will be more demand on health care because older people are sick more often. But this also means it is a different pattern of health care. Younger patients do not go to hospital so often. When they go to hospital it is an acute problem which can be treated within a few days and then they go home well. I remember I was admitted to hospital once as a teenager for an appendicitis operation and my doctor who was a wise old man said, “I am so happy to treat you because you are a young man, I treat you, you will go home well. When I treat my older patients, I see them, they get better, after a while they come back again and I have to treat them again. It is much more complicated.”


But now we have many more older patients who are admitted more frequently with multiple complaints. After a few days in hospital their acute condition probably has stabilised, they no longer need intensive and complex treatment but they are still not well enough to go home. You may not need to have the heart monitor, you may not need to have the blood or oxygen monitor, you may not need to have the nurse look at your every two hours or the doctor look at you twice or three times a day but you are not quite ready to go home and you still need several weeks to recuperate and to get better before you can be discharged. After they go home they may still need continuing medication for underlying long-term conditions. Maybe they have diabetes, maybe they have heart disease, they may need aspirin, they may need statins. There are so many things which you have to take not just when you are sick but for the rest of your life. And even when you are at home, you may get sick again and you may have to come back again. So we have to respond to this by putting in more resources into our hospital system, building new hospitals. We got the Khoo Teck Puat Hospital coming up in Yishun, we have got Jurong General Hospital coming up in the west, and that is good. Well, the buildings are easy to do, but getting the people to man them, the doctors, nurses, specialists, physiotherapists, that takes more doing but we are in the process of doing that. It needs money. We are in the process of increasing the budget too. We need to improve our 3M system. We are doing that too.