To make America great again, it appears some wonks over there have their sights trained on Singapore.

Well, Singapore's healthcare system, at least.

This is according to the latest Oct. 2, 2017 New York Times article, "What Makes Singapore’s Health Care So Cheap?", that gushes and coos over one of our republic's more efficient systems and what about our best practices the Americans can borrow.

A crash course on Singapore's healthcare and CPF

The NYT article is even-handed in its praise and criticisms, although it relies on some dated data from 1995 and 2001 to make a few counterpoints.

But it serves as a a good crash course on how Singapore's healthcare system functions, such as elaborating on the role of our Central Provident Fund (CPF) -- although not naming it in the article -- and explaining briefly the various healthcare programmes, such as Medisave, Medishield Life and Medifund.

So, it is not just written for Americans, but Singaporeans as well.

What Singaporeans can take away from this piece

As always, it is enlightening to read what outsiders have to say about Singapore.

The key takeaway from this NYT piece is that the Singapore healthcare system is dynamic as it relies on a lot of government intervention to rein in free market impulses, while letting market forces thrive enough to ensure abuse of the system is kept at a minimum.

This is why Singapore spends 4.9 percent of GDP versus 17.2 percent for America -- and remain relatively free from the moral hazard that plagues American healthcare where prices spiral out of control.

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Highly privatised system

This is why Americans would be surprised to find out that Singapore has an even more highly privatised healthcare system than America.

In Singapore, two-thirds of spending is private.

In the United States, only one-third is private.

This is achieved chiefly by letting patients in Singapore get what they pay for.

And Americans will also be surprised to find out that the Singapore government intervenes more than expected.

Top tier "A" wards mean patients fork out all and can be assured the best quality, while "C" wards assure patients the government foots the majority of the bill, up to 80 percent, according to the NYT piece.

This essentially allows a private system to challenge the public one, but the public system plays the dominant role in providing services.

In Singapore, the government established the proportion of each type of ward hospitals had to provide.

So, one aspect the government in Singapore can push through without much resistance, which the US can probably never achieve, is doing away with free market competition for healthcare as it does not drive costs down.

Costs increased as hospitals competed by buying new technology, offering expensive services, paying more for doctors, decreasing services to lower-class wards, and focusing more on A-class wards.

America's left and right like different things about Singapore's healthcare

Singapore's healthcare system is, therefore, admired by the American left and right, as they take away lessons each side wants to hear.

Conservatives cheer the individual contributions and Medisave account, but ignore the heavy government involvement and regulation.

Liberals admire the public’s ability to hold down costs and achieve quality, but ignore the class system or the system’s reliance on individual decision-making.

Reactions

The comments to the NYT piece were both appreciative and sceptical.

Those who are appreciative point to the broken system that is prevalent in America, where millions are uninsured and where doctors cannot even provide an estimate as to how much treatment will cost because that data is obscure to them. This can lead to runaway costs that regular people can ill afford.

On the other hand, those who are sceptical point out that Singapore's system catering to five to six million people might not be able to scale to fit America with 300 million people.

There is also the issue of pre-existing health, where Americans are judged to be nowhere as healthy as Singaporeans. This is where healthcare is viewed through a preventative lens and can boil down to culture rather than policy.

However, this is not the first time NYT has written positively about Singapore's approach to healthcare.

In March 2017, they wrote a piece called, "Make America Singapore".

Other US news outlets have also been charitable to our healthcare system.

Before that, in December 2016, Fox News also praised Singapore.