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Written by: Super User

Category: Solutions

Published: 17 October 2025

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Rep. Boebert,

In my last email I had some suggestions about what could be a knifepoint into the heart of some very bad medicine.  After 25 years of watching this boil and fester, I'm still convinced kidney dialysis is putting out some bad medicine.  But after attending your virtual townhall meeting I realize you are a very busy person.  So if I didn't get your attention yet, this might: KIDS!! and Dialysis.

So much for a rehash. I've written about a possible knifepoint into the heart of bad medicine,  now it might be time to throw a tomahawk.  Kidney Dialysis hasn't been my only interest over the years, I've been a fan of Medicare-for-All.  However it looks like the president may have stumbled on something better years ago!  But being a busy person he may have had to move on before exploring it properly?  Back in 2016 and 2017 I wrote a couple of letters-to-the-editor about this alternative in the Fort Collins Coloradoan newspaper: Letters+articles from Fox News and New York Times. 

It seems I've heard the reason the system mentioned hasn't been implemented is that it would be too hard to do.  But we now have a president with, uh, unconventional ways.  Also from the letters, it might be noticed that I've been a bit unhappy with the president.  There was one incident during his first campaign that sent me into a rage, but over the years I've gotten it down to a slow burn - story for another day.       

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Written by: Super User

Category: Solutions

Published: 17 October 2025

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By Ross Douthat
March 18, 2017

I HAVE been devoting this space to deliberately implausible ideas lately, and the time has come to turn to an issue that our politicians are actually debating: health care reform. Though “debating” might be a strong word, since the politicians I’m talking about are all Republicans, and it’s hard to have a serious argument when most everyone involved (including our unhappy president) really, really wishes that they could just stop and talk about tax cuts instead.

In theory there is a coherent vision underlying Republican health care policy debates. Health insurance should be, like other forms of insurance, something that protects you against serious illnesses and pays unexpected bills but doesn’t cover more everyday expenses. People need catastrophic coverage, but otherwise they should spend their own money whenever possible, because that’s the best way to bring normal market pressures to bear on health care services, driving down costs without strangling medical innovation.

This theory — along with, yes, a green-eyeshade attitude toward government expenditures on the working poor — explains why conservatives think a modest subsidy to help people buy health insurance makes more sense than Obamacare’s larger subsidies. Republican politicians may offer pandering promises of lower deductibles and co-pays, but the coherent conservative position is that cheaper plans with higher deductibles are a very good thing, because they’re much closer to what insurance ought to be — and the more they proliferate, the cheaper health care will ultimately be for everyone.

Is there an existing health insurance system that vindicates this boast? Yes, in a sense: There is Singapore, whose health care system is the marvel of the wealthy world. Singaporeans pay for much of their own care out of their own pockets, and their major insurance program is designed to cover long-term illnesses and prolonged hospitalizations, not routine care. The combination has produced genuinely extraordinary results: The island state has excellent health outcomes while spending, as of 2014, just 5 percent of G.D.P. on health care. (By comparison, a typical Western European country that year spent around 10 percent; the United States spent 17 percent.)

However, there has never been a major Republican policy proposal that just imitates what Singapore actually does. That’s because the Singaporean vision is built around personal responsibility and private spending, but also a degree of statism and paternalism that present-day American conservatism instinctively rejects.

First, Singaporeans do not spend money voluntarily saved in health-savings accounts. Under their Medisave program, they spend money saved in mandatory health-savings accounts, to which employers contribute as well. Second, their catastrophic insurance doesn’t come from a bevy of competing health insurance companies, but from a government-run single-payer system, MediShield. And then the government maintains a further safety net, Medifund, for patients who can’t cover their bills, while topping off Medisave accounts for poorer, older Singaporeans, and maintaining other supplemental programs as well.

So the Singaporean structure does not necessarily minimize state involvement or redistribution. It minimizes direct public spending and third-party payments, while maximizing people’s exposure to what treatments actually cost. And the results are, again, extremely impressive: By forcing its citizens to save and manage their own spending, the Singaporean system seems to free up an awful lot of money to spend on goods besides health care over the longer haul of life.

This is the point in a normal column where I would note the insuperable political obstacles to getting a Singaporean plan through Congress even if Republicans embraced it. (And for the record, I am quite certain that making America Singapore wouldn’t generate quite the same cost savings for cultural reasons alone: A sprawling empire of free spenders is never going to be as disciplined as a city-state ruled for 30 years by Lee Kuan Yew.) But I’m dealing in political implausibilities these days, and if you simply wish away the hurdles, there is a stronger case by far for trying to get to Singapore than for the jerry-built, incoherent thing that Paul Ryan is struggling to maneuver through the House.
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What’s more, the federalist health care compromise floated recently by Senators Bill Cassidy and Susan Collins is a little closer

alternative that would 1) auto-enroll the uninsured in catastrophic coverage and 2) directly fund health savings accounts for the working class and poor. The first isn’t MediShield (there’s no public option) and the second isn’t Medisave (no mandatory saving). But together, they’re more Singaporean than what RyanCare does and doesn’t do, and better for it.

Of course they’re also a bigger compromise with paternalism than the Republican Party’s True Conservatives are currently willing to accept. They have their principles, and making America Singapore is simply a non-starter.

I just hope those principles are a comfort to them when the next wave of liberalism delivers us to a much more plausible health insurance destination than Singapore: Straightforward single-payer, in the form of Medicaid for almost all.

I invite you to follow me on Twitter (@DouthatNYT).

Original NYT's article

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Written by: Super User

Category: Solutions

Published: 17 October 2025

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By Sean Flynn ,
November 29, 2016
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Give how badly we’ve managed to botch up health care here in the United States, you’d probably be surprised to find out that another country—Singapore—has used forgotten American ideas to build the world’s greatest healthcare system.

As the political debate over health care reform heats up again, it is important to understand both what Singapore has built as well as the fact that everything that it has accomplished has been shown to work just as well here in the United States, too.

Singapore is the only country in the world that can boast of being in the top five in infant mortality, life expectancy, and maternal mortality.  Better yet, when Business Week compared countries on 21 different healthcare metrics, Singapore stood out as the world’s healthiest country.

By contrast, the U.S. health care system delivers mediocre results while spending more than any other nation on health care. The United States ranks 41st in life expectancy, 55th in infant mortality, and 49th in maternal mortality while spending nearly 18 percent of GDP on health care.

By contrast, other developed nations deliver much better results while spending between 9 and 12 percent of GDP.  So getting our 18 percent of GDP down to the typical 9 to 12 percent would be a major accomplishment.

But the fact remains that Singapore is managing to deliver the world’s very best health outcomes for just 4.7 percent of GDP—or less than half of what Canada, Japan, and the United Kingdom are spending.

How does Singapore do it? By empowering consumers and fostering competition.

The most fundamental way to empower consumers is by providing real health security. So Singapore provides true universal access as well as coverage for preexisting conditions. Singapore then builds on that by making sure that everyone—rich and poor, young and old—has money to pay for access to the same doctors and the same facilities.

This is done by ensuring plentiful contributions into health savings accounts and by providing a high-deductible health insurance plan that people can actually afford—not only the premiums, but the deductibles and copays, too.

Providing people with adequate health savings balances and universal high-deductible health insurance transforms people into empowered consumers. The government then provides them with price-comparison data as well as provider-performance data so people can comparison shop both on price and quality.  The result is the world’s most competitive healthcare market—one in which providers have to deliver on both quality and price if they are going to survive.

The results are startling. Major surgeries cost 62 to 92 percent less in Singapore. As just one example, a heart-bypass surgery that would cost $130,000 in the United States costs just $18,000 in Singapore. Overall, Singapore spends 72 percent less per person on health care than the United States and between 46 and 57 percent less than Canada, Japan, France, and the United Kingdom.

If we could cut our health care spending down to Singapore’s level, we would have annual savings of about 12.2 percent of GDP, or about $2.1 trillion per year. 

That’s such a huge amount of money that we could balance the federal budget, bring Medicare and Medicaid into long-run actuarial balance, and still have over $1 trillion per year left over to spend on other crucial national priorities such as infrastructure, education, and national defense.

A key point is that everything that Singapore has accomplished has already been shown to work here in the United States.  Whole Foods Markets has a wildly popular Singapore-style health care plan that was approved by its unions.  And the State of Indiana proved that Singapore-style health insurance works for both middle-class government employees as well as indigent Medicaid recipients.

Local control also creates flexibility and strength in addition to slashing red tape and administrative costs. By empowering individuals to choose and by forcing providers to compete, the healthcare system becomes bottom-up rather than top-down.

That bottom-up perspective is important for policymakers looking for solutions. The decentralization that comes from empowering individuals will allow our healthcare system to cope with the size and diversity of United States far better than the central planning and rigid rules embraced by our current system.

We the People is the basis of our Constitution.  It should also be the basis for totally reforming our healthcare system. We can provide the highest quality, lowest-cost healthcare in the world if we only get out of our own way and trust ordinary Americans to make wise decisions for themselves and their families.

Fox Original article

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Written by: Super User

Category: Solutions

Published: 17 October 2025

Hits: 65

2016 Fort Collins Coloradoan 'Letter to the Editor': 'A reason to almost manage a smile' (a CNBC interview with former Schering-Plough CEO Fred Hassan was mentioned, he hinted president Trump could be looking at Singapore's health care system back during his first campaign)

2017 Fort Collins Coloradoan 'Letter to the Editor': 'Here's a health care system with promise'  (personal experience along with a Red and Blue look at Singapore's system)

Fox News: 'Want to ditch ObamaCare?  Let's copy Singapore's health care miracle'

New York Times: 'Make America Singapore' 

Update 10/21/2025: Another article was recently recalled that is a nice dive into the Singapore system: CommonWealth profile