Singaporeans unprepared for health costs of longer lives

NEARLY half of healthcare practitioners believe Singaporeans will be hard-pressed to cope with the health expenses of living to 100, a survey by Prudential has found.

This is because a greater number of them possibly need to manage more than one chronic disease in their old age.

But residents themselves are even more pessimistic - 55 per cent in a separate survey said they were not ready from a health and wellness perspective to reach 100.

The number of older adults who develop more than one chronic condition, called multi-morbidity, has been growing with more than half of Singapore's residents who are older than 60 falling into this category.

Last month, it was reported that Singaporeans topped the world in life expectancy in 2017, with an expected lifespan at birth of 84.8 years, the longest lifespan in the world. But 10.6 of these years would be spent in poor health, according to the Burden of Disease in Singapore 1990-2017 report, by the Institute of Health Metrics and Evaluation in the United States in collaboration with Singapore's Ministry of Health (MOH).

While Singaporeans are living longer - and inching towards 100 - many are spending their older years in ill health. Prudential's own study titled "Healthy for 100" was conducted and researched by the Economist Intelligence Unit.

Prudential Singapore chief executive Wilf Blackburn said: "As medical costs continue to rise, we must evaluate the role we can play in making healthcare more affordable and accessible. As insurers, this means changing the way we engage with customers. We want to go beyond covering their medical bills to coming up with innovative solutions to help them live well for longer. Staying healthy is the best strategy to keep one's medical expenses low in the long run."

Preventative healthcare is seen as key to addressing the medical demands of an ageing population and containing costs in the long term. Eight in 10 doctors and clinicians surveyed said Singapore's healthcare system must place more emphasis on disease prevention. Seventy per cent said individuals need to be responsible for supporting their own healthy ageing. More than half of Singaporeans aged 26 to 45 are not taking the initiative to proactively prevent common chronic conditions such as diabetes and heart disease. Technology is seen as part of the preventative healthcare solution - 77 per cent of respondents say greater investment in at-home technologies to support chronic disease care will be needed as the population ages.

Prudential is expected to launch a digital health app later this year, a fruit of its partnership with UK-based healthcare technology company Babylon Health, which offers a suite of AI-powered health services.

Prudential head of medical portfolio management Sidharth Kachroo said in a discussion yesterday: "Why not move from cure to prevention, why not leverage health technology to reach people and help them manage their lifestyle? We're on the verge of a digital healthcare ecosystem... basically about helping those who are healthy to stay healthy and help people move back to a healthy lifestyle, or manage conditions so they do not get worse.''

Survey respondents point to better integration of care around the patient as a way to prepare for an ageing population and rising multi-morbidity. Two in five healthcare practitioners believe a more integrated approach where there is synergy between primary care, hospitals, long-term care and home care could reduce inefficiencies, hospital time and costs. Singapore's healthcare system is seen to lack coordination across various care providers and over-dependent on specialist care.

The report also highlighted the need for new funding models. Currently the system is based on a fee-for-service model where fees are determined by the amount and types of treatment given to a patient. A value-based model, where fees are determined by the improvements in patients' health, could be a better approach to pricing healthcare.