Strengthening primary care in Singapore: aligning vital health system components

Abstract

Primary health care in Singapore faces significant challenges related to fragmentation and misaligned incentives, despite the country’s impressive health outcomes and efficient healthcare system. This paper examines the country’s primary care system through four key dimensions: governance, provision, financing, and payment. It argues that insufficient coordination and integration, stemming from a lack of appropriate incentives and controls for healthcare providers, are at the source of the system’s shortcomings. The fragmented nature of primary care provision, limited government influence over private providers, and the predominance of fee-for-service payments hinder efforts to strengthen primary care in the country. Existing initiatives to address these issues have had limited success due to inadequate mechanisms for altering provider behavior. The paper contends that policy interventions focused on aligning incentives and strengthening governance are crucial for building a primary care system that effectively serves the population’s evolving health needs.

Keywords

• Health policy design
• health care reform
• governance of health care
• health care financing
• health care provision
• health care payment