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  • Rethinking the Delivery of Welfare Programmes in Singapore

    Author/s:
    VIGNESH LOUIS NAIDU
    Year:
    2014
    Abstract:
    The Singapore government has always been quite mindful of the potentially corrosive effects of welfare in designing it social policies. In a small city-state with no natural resources, the Singapore government has always feared that the comprehensive provision of state welfare would reduce incentives for individuals to work and strive, and create an entitlement mentality among citizens. The government has therefore sought to keep welfare – or financial support for the poor, the old and the unemployed – on a short leash. The levels of financial help are also relatively low by the standards of developed countries. The emphasis instead has always been on self-reliance and individual savings, the family as the first line of support for the poor, the community as an important ‘helping hand’, and targeting state assistance at those that have no other means of support. To the extent that there is welfare in Singapore, it is low (as it is intended to meet basic needs only), strictly and carefully means-tested, and residual in nature. In social spending more generally, the government has focused more on ‘investment goods’ such as public housing and education, rather than on subsiding people’s consumption.This case examines how ideas from cognitive psychology and behavioural economics could inform the design and delivery of welfare policies in Singapore. It highlights concepts that are relevant to the formulation, implementation and communication of welfare programmes. Using examples of social support programmes in Singapore, the case explores how such programmes should be designed to accommodate people’s cognitive limitations.

     

  • Social Egg Freezing, Should It Be Permitted in Singapore

    Author/s:
    MICHELLE KHOO
    Year:
    2014
    Abstract:
    Could social egg freezing solve the population paradox in Singapore? Elective oocyte freezing (EOF) is one example of breakthrough medical technology that have the potential to cure not only medical problems but social issues as well.  Social egg freezing is increasingly an attractive option for women facing infertility due to social reasons, freezing her eggs for later use when she is ready for children. This case study explores the arguments and stakeholder perspectives surrounding EOF. The context is revealing of the new government-citizen dynamic that the traditionally paternalistic Singapore government has to grapple with.

    First Prize – Case Writing Competition 2013

  • What Determines the Goals of Healthcare Financing Policies in Singapre

    Author/s:
    ALISHA GILL
    Year:
    2014
    Abstract:
    In early 2013, Singapore’s Finance and Health Ministers announced that the healthcare financing system was being reviewed with a view to having the government shoulder a larger share of healthcare costs. The government’s share of national health expenditure would increase from the current one third to 40 percent, or more. As part of this review, the Health Ministry would also study how insurance could be used to finance a greater portion of healthcare costs. To provide perspective, MediShield, the basic catastrophic insurance scheme administered by the government, had covered only one to two percent of the national healthcare expenditure between 2002 and 2011. What are the factors that drive healthcare financing policies in Singapore?  And how could the healthcare financing system that was in place at the time of the Ministers’ announcements have been improved in a manner both politically feasible and fiscally sustainable?

     

  • Housing: How should Singapore’s Housing Development Board (HBD) Help Older People Monetise their Housing Assets and Age in Place?

    Author/s:
    WU WEI NENG
    Year:
    2013
    Abstract:
    This case explores housing monetisation in the context of Singapore’s rapidly ageing resident population, and the consequent challenges of ensuring retirement adequacy for the elderly and future elderly. It explores the linkages between Singapore’s policies on home ownership and asset enhancement, long-term residential property price trends, and the tendency for many retiree households to be “asset rich but cash poor”. It also explores the benefits of helping the elderly to “age in place”, assesses the options available to help them monetise the asset value of their properties, and discusses how these options can be enhanced.

     

  • The Government Weighs in on Housing in Hong Kong

    Author/s:
    RAKHI SHANKAR
    Year:
    2013
    Abstract:
    In July 2012, the property prices in Hong Kong were the highest in the world and providing affordable housing to the people of Hong Kong was among the top priorities of the government. The property prices had been rising in Hong Kong since 2009 due to various factors such as the inflow of money from rich Chinese mainlanders, low interest rates, a mismatch in the demand and supply and a stalling of public housing supply. The prices continued to rise into the beginning of 2013 in spite of several short-term measures taken by the government such as lower loan-to-value ratios, an increase in property transaction taxes, introduction of new stamp duties for overseas buyers etc. The steep rise in housing prices had resulted in the proliferation of cage homes where housing conditions were dangerous and deplorable. This case study raises several issues related to housing such as ownership versus rental, the provision of public housing and longer term measures such as land administration, market failures in the real estate market and the role of politics in guiding public policies.

     

  • Healthcare Financing- How should costs shift from private pockets to the public purse

    Author/s:
    ALISHA GILL
    Year:
    2013
    Abstract:
    In early 2013, Singapore’s Health and Finance Ministers announced that the government was reviewing the country’s healthcare financing system with a view to increasing the state’s share of national healthcare spending from the current one-third to 40 per cent. This review occurred in the context of a fast-changing and politically more contested Singapore. Among others, Singapore’s population was ageing rapidly, income inequality had risen amid greater economic volatility in the past fifteen years, and citizens were increasingly concerned about the affordability of healthcare in a country that had always emphasised individual responsibility over social protection. As the government grappled with the question of how it should adjust the balance between collective and individual responsibility in healthcare financing, health policymakers in Singapore faced a number of interconnected challenges: diagnosing correctly the limitations of the current financing system; finding the right balance between economic incentives, social equity and fiscal sustainability; and developing sound alternatives that were acceptable to Singaporeans with unequal levels of wealth and health.

     

  • Extending Healthcare to the Informal Sector in Laos

    Author/s:
    BEÑAT OÑATIBIA CAMARA and ZHANG YINGXIN LOUISA
    Year:
    2012
    Abstract: 
    In 2000, the Ministry of Health of Laos was faced with the seemingly insurmountable problem of how to extend healthcare coverage to the country’s informal sector. Laos had just implemented a social health insurance scheme for the formal private sector to complement the existing civil servants insurance scheme, leaving a huge vacuum in healthcare for the remaining 80 percent of the population in the informal sector. Health financing for this group of people was difficult due to the challenges of obtaining financing from a government with low tax revenues as well as aid from external donors, the decentralized nature of the health system and operational difficulties in extending healthcare to the informal population. By illustrating the problems and the policy options available, this case prompts readers to consider the complexity in striking a balance between the trade-offs of efficiency versus equity, expediency versus sustainability and quantity in terms of coverage versus quality.First Prize – Case Writing Competition 2012

     

  • Drug Price Policy in Vietnam. Letting the market set prices is not as easy as it seems.

    Author/s:
    SARAH BALES
    Year:
    2011
    Abstract:
    In the Vietnamese pharmaceutical sector, from a situation of severe shortage and consequent widespread pharmaceutical smuggling, counterfeiting, speculation, and theft by health providers, stability was gradually regained by strict regulations on quality, but allowing prices to be set by the market under the economic reform policy initiated in 1986. However, this free market drug price policy was brought into question in 2003, when a 9% rise in drug prices during the first quarter sparked national attention. The Ministry of Health was pushed to more tightly control drug prices under pressure from the Government and public opinion. Drug price policies went through a series of revisions trying to balance the distortions from interfering with the market with the need to ensure that drug prices were affordable to the population and the health insurance fund. But the heavy burden of drug spending in the health system, both from high drug prices and over-prescription of more expensive brand-name drugs kept drug prices high on the public agenda.

    Second Prize – Case Writing Competition 2011

     

  • Radda Barnen Becomes Radda: From Donor Project to Sustainable Local Healthcare

    Author/s:
    NAEEM MOHAIEMEN
    Year:
    2010
    Abstract:
    After Swedish funders pulled out of a health clinic in Bangladesh, a local team took over and managed to cut wasteful expenses, bring in revenue and reach break-even. The case offers a model for breaking aid dependency by running organizations with local talent and a focus on financial sustainability, but at the same time, it highlights the limits of expansion due to resource constraints and land ownership barriers.

     

  • Cambodia’s Land Reform and Boeung Kak Lake – Institutions, Politics, and Development

    Author/s:
    R. SCHUYLER HOUSE and ANDREW BILLO
    Year:
    2010
    Abstract:
    Supported by numerous international aid organizations, Cambodia embarked on a massive land reform and property rights program in the early 2000s. The adoption of the 2001 Land Law and establishment of the World Bank Land Management and Administration Project (LMAP) in 2002, were welcome reforms and proved to be broadly successful and technically sound. Unfortunately, however, several high-profile failures, including the politically contentious development of urban lakeside property in Phnom Penh municipality at Boeung Kak, called to question the entire reform program and the greater institution-building project it represented. The problems at Boeung Kak were a direct result of conflicts between efficiency-gaining reforms and the interests of political elites – a common problem in many development contexts. Furthermore, there existed critical tradeoffs between the rights, immediate assistance to the poor and long-term economic development.

    First Prize – Case Writing Competition 2010

 

 

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