By Lee Hui Chieh

IT IS unrealistic to expect national spending on health care not to increase in the future, said Health Minister Khaw Boon Wan yesterday.

Now at a low 4 per cent of gross domestic product (GDP), spending will go up but would still be reasonable if kept below 10 per cent of GDP, he said.

If spending on health care reached 8 to 9 per cent of GDP, it would mean an individual would need to use some 15 per cent of his own income on medical expenses, including health insurance premiums and co-payments.

Speaking at a dialogue with more than 200 doctors yesterday, he noted that Singapore has managed to cap national health-care spending at 4 per cent of GDP and still achieve high standards of health care compared with the United States, which spends 16 per cent of its GDP on health care.

These were 'results which we can be proud of', he said.

But spending must go up, with medical advances making treatments and drugs costlier, and plans by the Health Ministry to recruit more doctors, nurses and other health-care professionals to improve standards of care.

He said: 'How high will it go? That's really a question for society at large to answer.'

Mr Khaw felt that a cap below 10 per cent of GDP would be a fair amount and that individuals would be prepared to spend 12 to 15 per cent of their income on health care.

He was responding to a question from Dr Francis Chin, an associate consultant from the National Cancer Centre's department of radiation therapy.

Dr Chin later told reporters he was happy to know that the Government was prepared to increase health spending, which he felt was necessary given patients' rising expectations.

Medical ethics were also discussed yesterday.

Mr Khaw felt that Singapore doctors generally had high ethical standards, despite fears by patients that commercial interests were challenging traditional values of medicine.

For example, a survey found that 60 per cent of general practitioners practised aesthetic medicine, which seemed high at first glance, he said.

But only 6 per cent of their daily work involved some aesthetic procedures, and most of these were in fact done for legitimate medical reasons.

Mr Khaw credited the high ethical standards to years of nurturing of junior doctors by senior doctors, whom he likened to 'accomplished gongfu masters', passing on technical skills as well as values and ethos.

The dialogue was organised by public health group Singapore Health Services (SingHealth) to launch its book, Behind The Stethoscope: Personal Reflections On Life In Medicine.

The book had been conceived to inspire young doctors, many of whom feel they lack guidance, said one of its editors, Dr Jeremy Lim, SingHealth's director of policy and research.

Put together over eight months by a team of nine including Dr Lim, the book features contributions by 56 doctors from both the public and private sectors.

The book is available at $14.90 at all SingHealth retail pharmacies, the National University of Singapore Cooperative bookstores and Books Kinokuniya.

Profits will be used to help needy patients of SingHealth institutions.

huichieh@sph.com.sg

This article was first published in The Straits Times on September 11, 2008.

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