Singapore’s national statement at the United Nations General Assembly High-Level Meeting on universal health coverage, 21 Sep

Mr President, Distinguished Delegates.

1. It has been encouraging to hear so many countries talking about how they are strengthening universal health coverage for their population. Let me provide a different perspective today in the context of a city-state in Asia, which is Singapore.

2. The health and wellbeing of our population is at a pivotal, yet precarious moment. Asia, including Singapore, is ageing quite rapidly. With old age comes sickness, the cumulative impact of which is rising disease burden on our healthcare system.

3. Many developed countries in Europe, as well as Japan and Korea have already been grappling with this challenge. The shifting demography exposes a critical flaw in many healthcare systems around the world, which is that they are designed for sick care, rather than health care. The centre of gravity is in acute hospitals, with resources, knowhow and energy revolving around curing the sick. This works for a young population when relatively few people fall very sick, but it is not sustainable for an ageing population with rising disease burden.

4. Healthcare systems need to be re-organised to build health outside of hospitals, and to support the aged to live healthily in communities. More resources need to be invested in preventive care as a matter of discipline, even as the workload of hospitals is mounting. Governments need to leverage social, economic and environmental determinants of health, such as lifestyles, habits, education, employment and recreation to promote healthy populations.

5. Hence, universal health coverage in an era of ageing is more encompassing than the old definition. Primary care services to social factors that build health should all become universal health coverage over time. That is why in Singapore we are transforming healthcare; we are mobilising family doctors; we are mobilising community care; we are establishing a network of aged care centres around the island to build social circles around the aged, and so on and so forth.

6. Ageing is probably the most significant social development in many countries. It raises questions of sustainability in finance and healthcare provision, and retirement adequacy. There is however, one big silver bullet to ageing and that is to make our population healthier, so that when you are 65, you can still be considered young. With lifespans getting longer, this is not an unreasonable ambition. Thank you.