Singapore: The Limits of a Technocratic Approach to Healthcare

A girl covering her face as she is being vaccinated for smallpox on 16 April 1959.

This article is part of New Naratif’s coverage of the Singapore General election 2020. For more, please visit our Singapore General Election 2020 portal. It was written before the ongoing novel coronavirus crisis.

In 1982, Singapore’s then-Health Minister Goh Chok Tong bravely boasted that his country’s health system was among the “best in the world”. At the same time, he foreshadowed its complete overhaul: “We should not rest on our laurels, looking down from Mount Everest. In organisational efficiency, in the pursuit of quality and excellence, there can be no highest peak.”[1] In February 2004, then-Health Minister Khaw Boon Wan raised the bar for hyperbole, defining his ideal as a healthcare system that has no patients. A month later, he declared his satisfaction that Singapore’s healthcare financing system was “probably” the best in the world.[2]

By its own bold claims, the Singapore government has consciously set itself up as a test case: can the relentless pursuit of “organisational efficiency”, “excellence and quality” solve the problem of the cost of delivering healthcare in a modern capitalist society? This question also goes to a much broader element of the government’s legitimating rationale: its claim that its at times seemingly hard-hearted and overbearing governance reflects the application of dispassionate and disinterested reason, and is the basis of Singapore’s success and prosperity.[3]

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