Overview
Healthcare in Singapore is the responsibility of Singapore Government’s Ministry of Health. Approximately 70-80% of Singaporeans obtain their medical care within the public health system which ensures affordable basic healthcare within for all. The system largely comprises of Medisave (a compulsory national medical savings account) with varying levels of subsidies and different price controls. Many Singaporeans also have supplemental private health insurance (often provided by employers) for services not covered by the government’s programs. The Ministry of Health and its statutory boards regulate both the public and private providers of healthcare in Singapore.
As Singapore is facing its first batch of aging citizens, diabetes is a growing concern for the medical service providers. Especially since more and more caregivers are caring for recipients who suffer from health conditions, one of them being diabetes.
What happens if you need to see a doctor?
There are at least 20 public, private hospitals, medical centres, specialist centres and 18 polyclinics located around Singapore. In every small neighbourhood, there will be at least one GP clinic available. When a person falls ill, they can choose whether to go to GP or polyclinic. The cost of consultation at a polyclinic is heavily subsidised while at a GP it will be a private consultation cost, depending on the doctor (in the region of $100-160 SGD/$74-118 USD). The cost of a HbA1c test is $25 SGD/$18 USD.
For people with diabetes, care strictly follows an appointment with your endocrinologist at the hospital, based on which hospital you were first admitted to for diagnosis. Most children with diabetes will go to the diabetes clinic at our only children’s hospital for follow-ups while adult clinics are located in many of the government and private hospitals. Some polyclinics also have type 2 diabetes care services, mainly for the senior citizens.
Who decides what medicines a doctor can prescribe?
The Health Science Authority of Singapore, a statutory board of Ministry of Health, controls and approves the type of medicine and medical devices to be imported into Singapore by the various pharmaceutical companies, after a series of rigorous testing. Once approved, the doctors will prescribe the most suitable drug to the patients based on their professionalism.
Practically, what is it like to live with diabetes in Singapore?
In general, Singapore conforms to a more conservative view of chronic diseases that other Asian countries hold. Diabetes is still not a topic openly discussed by the public. That in itself is an obstacle for those who want to spread both awareness and increase diabetes education. Additionally, in Singapore we do not have the “duty of care” legislation hence it is not required for government schools to have a school nurse whom diabetic school children will have to report to in order to have their blood glucose reading taken or insulin administered. Diabetes education is critical when patients meet up with their diabetes nurse educator and parents are the stakeholders to help inform their child’s teacher about the condition.
All diabetes related supplies have to be purchased as we do not have any insurance schemes that cover people with diabetes. A large number of standard drugs are subsidised by the Government. However, there are social work departments in hospitals to help assist patients who are from the lower income group. Diabetes is one of the conditions excluded from insurance coverage in many of the insurance policies available in the market. All diabetes medication (insulin or oral) must be prescribed by the doctor and obtained from the pharmacy at the respective hospital or polyclinic. The other supplies can be bought from any general pharmacy stores or from the Diabetes Society of Singapore office. For patients who visit private clinics, particularly ones who are long-term diabetics, insulin can be bought over the counter.
What about getting admitted to hospital?
Admission to hospital must first be recommended by the attending medical doctor or your diabetes doctor. Hospitalisation cost for Singapore citizens are subsidised according to the ward class you have chosen to be admitted to. A partial sum of the hospitalisation bill can be paid through Medisave account (national healthcare savings).
How does diabetes care vary throughout the country?
There are only two insulin pumps available in Singapore – Medtronic and Roche Accu-Check pumps. These are not widely used by people with diabetes in Singapore, probably due to their high cost for basic setup. The price for the cheapest pump, Medtronic Paradigm, is $3,500 SGD/$2,582 USD and the Medtronic Mini Med 640G costs $9,350 SGD/$6,897 USD. Monthly Medtronic pump costs are $198 SGD/$146. Many people with diabetes are on multiple daily injections. These costs between $21 SGD/$15 USD (Novorapid Flexpen, 300 units) and $51 SGD/$38 USD (Toujeo Solostar, 450 units). A box of 100 4mm insulin pen needles costs $45 SGD/$33 USD.
We are grateful to Heng Pei Yan, Candy Gan and Laura Ihry for providing much of this information.
Last updated 2021