I’m happy to get my medical care in Singapore these days…

I’ve been reflecting a lot recently about medical care here versus the US.

Screen Shot 2014-03-24 at 3.08.46 PMI know this building WAY too well

I initially injured my back in 1995 playing tennis in high school.  I had the occasional issue with my back throughout the years, and would get short term physical therapy to resolve it.

In 2006 I injured my back in June.  My insurance required me to jump through roughly a zillion hoops, refusing to allow an MRI or even a surgical consult.  It wasn’t until September when I had to be taken to the hospital via ambulance from work, and was hospitalized that an MRI happened.  The doctors at that hospital decided that I needed surgery.  However, they couldn’t fit me in for several weeks after I was discharged, and because my insurance wouldn’t cover that hospital in a non emergency setting, it was yet another month before I finally got the surgery in October.

It was four months of increasing agony until I couldn’t walk on my own, using a walker and wheelchair.

The insurance company only allowed x number of follow up visits and x visits of physical therapy.  It wasn’t enough, but seeing a doctor would’ve cost upward of 400 dollars, and doctors won’t charge you in cash in the US–it must go through an insurance company.

It was absurd, it took forever, and it is the root of many of my current issues.  Had I been in Singapore the process would have been a zillion times faster, I would have received more follow up care, and if/when my insurance ran out I could afford to pay for whatever dr’s visits I wanted.

Screen Shot 2014-03-24 at 3.27.35 PM

Not long after my surgery I started having pain radiate through my hip and down my leg.  It was never really examined–based on symptoms, it was diagnosed as bursitis.  I’ve been dealing with it on and off for just over seven years.

Last year when I hurt my back here in Singapore things moved fast.  I was admitted, given an MRI, and solutions were proposed.  We went with one, but when it didn’t work I had a spinal injection less than a week later.  Total time from injury to solution–2 weeks.

Since May 2013 I’ve seen my surgeon and pain management specialist regularly.  I’ve received weekly PT, and once my insurance cap ran out, I was able to afford the fees.  If necessary, I could pay for my doctor’s visits as well.

More importantly, the pain that has recurred since 2006 has finally been correctly diagnosed and is finally being treated properly.

Screen Shot 2014-03-24 at 3.38.25 PM

I have been diagnosed with piriformis syndrome, which is a longer term recurring issue with the pirformis and the sciatic nerve.  My doctor has posited, and I tend to agree that because my nerve was compressed for such a long time, it has suffered some permanent damage, making it more easily agitated and more painful when the piriformis becomes inflamed than it might otherwise be.

Screen Shot 2014-03-24 at 4.07.29 PM

Today my friend Kirsten posted this link about a US medical bill and the atrocious cost of medical care in the US.  When I searched for the cost of treating appendicitis in Singapore, I discovered it would cost roughly half of this IF I were among the most expensive bills at the most expensive private hospital.  At the least expensive public hospital it would be 1/10th the amount even it’s among the most expensive bills there.

When we first moved to Singapore I was scared of the medical care here–after living in one of the best cities in the world for medical care, I didn’t trust local care.  I would have preferred US care.

Four years later, after significant experience with the medical care here in Singapore, there are areas where I do still prefer US care (Elanor’s stroke follow up–although that’s in part because there are no pedi stroke specialists in SG).  However, for the majority of most care, I prefer Singapore.

The benefits to (private) care in Singapore are that generally speaking you can get an appointment quickly (as opposed to weeks or even months later in the US).  Issues are dealt with promptly, and doctors are allowed to use their best judgment.

I do have insurance, but that has also been far more streamlined.  I pay for most things up front and then put through claims for reimbursement.  In emergency hospitalizations, paperwork is faxed and dealt with quickly.  For non emergency situations–like my proposed tonsilectomy–I can send in an answer and get a response within a month.  I have caps for the most part, rather than procedure specific instructions as I do in the US.

When my insurance doesn’t cover something or I exceed my cap for physio (for example) the cost of seeing a doctor, or paying for a procedure is fairly affordable for our family (although I’m aware that they’re still expensive for many people in Singapore-I’m aware of my financial privilege).

Screen Shot 2014-03-24 at 4.26.19 PM

While I have yet to adjust to Celcius measures of temperature, height and weight, preferring US Customary Units, I have adjusted to my many options for medical care in Singapore and I am grateful for them

I would, however, like to know what medical care is like for other people in Singapore.  What someone who makes minimal wages (McDonald’s pays 1500 SGD per month, for example) could afford to do or would do in the case of a medical emergency.  Whether or not there is subsidization of care for low income patients–although I imagine the likelihood is low as Singapore is opposed to social welfare?  I have been typically asked for proof of ability to pay for care as I enter the A&E (at KKH for the girls) or before I am admitted (at parkway hospitals)–what happens if you can’t?  What about regular medical care like annual exams, or care for strep throat etc.

Please do share answers to those questions in comments if you know them.  Thanks in advance.

This entry was posted in Expat to Expat Advice, medical, Pregnant Expat, Singapore and tagged , , , , , , . Bookmark the permalink.

3 Responses to I’m happy to get my medical care in Singapore these days…

  1. Mummy Ed says:

    Interesting question! I am definitely thankful for the amazing healthcare we have here, and my second son is testimony to that – I’m not sure if he’d have survived past his third day of life if we’d be living somewhere else in the world.

    Anyhow, my husband is in private medical care, for his practice, they will charge patients under CHAS a subsidized rate and the balance will come from the G. I have a friend who works in the A&E so I asked him about what they do, so especially for emergencies they will treat first and “talk later”. Patients who require financial assistance will be referred to social workers. Usually once you’re in the “system” as a subsidized patient, you’ll always get the subsidized rates.

  2. I’m so sorry for your (lack of ASAP) medical care in the U.S., but I did want to point out that in most states doctors gladly accept cash, and will usually charge much less than they’d bill an insurance company. I was shocked to discover that this was not the case in Massachusetts!

    Do they have things like a quick care or minute clinic in Singapore? If yes, how much would a doctor’s visit for a minor injury or illness cost?

  3. I see my ENT at this hospital and I agree it’s a lovely hospital. Costs of medical care here higher compared to UK but I certainly think the speed and quality of care and facilities more than make up for it.

Comments are closed.