Quote of the Day: Singapore’s Healthcare System

No, Singapore does not have a free market for health care. What it does have is an alternative to the European/American welfare state, in which private saving and private insurance do what employers and governments do in other countries. The Singapore philosophy is:

-Each generation should pay its own way.

-Each family should pay its own way.

-Each individual should pay his own way.

Only after passing through these three filters, should anyone turn to the government for help.

If the United States adopted a similar approach to public policy, there would be no deficit problem in this country.

How the system works. In Singapore, people are required to save for health care, retirement income, and other needs. They can use their forced saving to purchase a home, pay education expenses, and purchase life insurance and disability insurance. For individuals up to age 50, the required saving rate is 36% of income (nominally divided: 20% from the employee and 16% from the employer). Of this amount, 7 percentage points is for health care and is deposited in a separate Medisave account. Individuals are also automatically enrolled in catastrophic health insurance with a deductible of about US $1,172, although they can opt out. When a Medisave account balance reaches about US $34,100 (an amount equal to a little less than half of the median family income) any excess funds are rolled over into another account and may be used for non-health care purposes.

(bold original)

This is from healthcare expert John Goodman senior fellow at the Independent Institute Blog

Is Stem Cell therapy the cure for HIV?

I am a fan of technology. For me, advances in technology serves as the foundation for the great transition: From the mass based top-bottom social phenomenon known as the industrial age to the niche and specialization based bottom-up dynamic called the information age-digital economy. 

So when I encounter what appears as potential breakthroughs, I post them here.

Is Stem Cell therapy the cure for HIV?

From Reuters:

Two men with HIV have been off AIDS drugs for several months after receiving stem-cell transplants for cancer that appear to have cleared the virus from their bodies, researchers reported on Wednesday.

Both patients, who were treated in Boston and had been on long-term drug therapy to control their HIV, received stem-cell transplants after developing lymphoma, a type of blood cancer.

Since the transplants, doctors have been unable to find any evidence of HIV infection, Timothy Henrich of Harvard Medical School and Brigham and Women's Hospital in Boston told an International AIDS Society conference in Kuala Lumpur.

While it is too early to say for sure that the virus has disappeared from their bodies altogether, one patient has now been off antiretroviral drug treatment for 15 weeks and the other for seven weeks.

Last July Henrich first reported that the two men had undetectable levels of HIV in their blood after their stem-cell treatment, but at that time they were still taking medicines to suppress HIV.

Using stem-cell therapy is not seen as a viable option for widespread use, since it is extremely expensive, but the latest cases could open new avenues for fighting the disease, which infects about 34 million people worldwide.

There are many implications from these developments whether social, moral, commercial and etc…, nonetheless stem cell technology could just one be significant area for advances in healthcare.

Mobile Internet: Welcoming Dr. Smartphone?

I think the major springboard in the next wave of advances in the technology sector will be in the applications aspects of the mobile internet platform.

Aside from games, mobile health services along with Mobile banking and mobile commerce are likely the high growth areas to watch.

In terms of healthcare here is a clue where application development trends are headed for, from Reuters

Tired of long waits at the hospital for medical tests? If Korean researchers have their way, your smartphone could one day eliminate that -- and perhaps even tell you that you have cancer.

A team of scientists at Korea Advanced Institute of Science of Technology (KAIST) said in a paper published in Angewandte Chemie, a German science journal, that touch screen technology can be used to detect biomolecular matter, much as is done in medical tests.

"It began from the idea that touch screens work by recognizing the electronic signs from the touch of the finger, and so the presence of specific proteins and DNA should be recognizable as well," said Hyun-gyu Park, who with Byong-yeon Won led the study.

The touch screens on smartphones, PDAs or other electronic devices work by sensing the electronic charges from the user's body on the screen. Biochemicals such as proteins and DNA molecules also carry specific electronic charges.

According to KAIST, the team's experiments showed that touch screens can recognize the existence and the concentration of DNA molecules placed on them, a first step toward one day being able to use the screens to carry out medical tests.

As I have been saying, the information or digital age will change or reconfigure the way we do things.

Sunshine Industry: Telemedicine or Digital Healthcare

The emergent digital healthcare or telemedicine industry will likely be a sunshine industry.

The Reuters reports,

Mobile technologies will be increasingly deployed to enable people in Asia to monitor and manage their health, with the market expected to hit $7 billion by 2017, an industry official said.

In parts of Europe and the United States, diabetics can now have doctors monitor their blood sugar levels by punching daily readings into their mobile phones and doctors can provide answers to expectant mothers via short message services (SMS).

Jeanine Vos, who heads the mobile health unit at Global System for Mobile Communications Association (GSMA), said such technologies are finding their way into Asia.

GSMA represents nearly 800 mobile operators around the world and 200 other mobile-related companies such as handset makers, software, media and Internet companies.

"We foresee that market opportunities can reach $7 billion by 2017 (from under $500 million now)...We are really at the start of a take-off," Vos told Reuters in an interview.

The figures were derived from a study conducted by GSMA and PricewaterhouseCoopers and will be released in full in December. Fifty-five percent of that amount would involve health monitoring services and 24 percent, diagnostic services.

Companies that stand to gain from the expansion of mobile technologies for healthcare purposes include mobile operators, device manufacturers, software developers and healthcare providers, Vos said.

Digital healthcare are evidences of how rapidly evolving technological progress has been permeating into vast areas of industries.

Although Asia has the demographic scale that should work to her advantage, telemedicine will be a global phenomenon. And I do hope that competition will lead to lower healthcare costs.

Besides telemedicine should substantially help improve the world’s life expectancy given that access to health information will become widespread. And as previously pointed out, telemedicine may reshape the global health industry.

And investors may handsomely profit from this promising field if they meticulously do their homework.

Telemedicine: Health Care of Tomorrow

From Teladoc.com (hat tip Prof Mark Perry)

1. You wake up one morning with sudden cold-like symptoms: stuffy nose, cough, congestion. You don’t want to miss time at work by sitting in an urgent care or ER waiting room. What to do?

2. Simply log in to your account or call 1-800-Teladoc to request a phone or online video consultation with a Teladoc doctor. You can use Teladoc from home, work, on vacation, or while traveling internationally. The average doctor call back time is 22 minutes.

3. A U.S. board-certified doctor or pediatrician licensed in your state reviews your Electronic Health Record (EHR), then contacts you, listens to your concerns and asks questions. It's just like an in-person consultation. There is no time limit to the consult.

4. The doctor recommends the right treatment for your medical issue. If a prescription is necessary, it's sent to the pharmacy of your choice.

5. Teladoc costs far less than in-person visits: $38 or lower, depending on your plan design. Teladoc charges the credit card you provided when requesting your consultation or your billing information on file. You can request a receipt for deductibles or reimbursement, if needed. The doctor updates your HIPAA-compliant EHR based upon the consultation. Teladoc is a qualified expense for HSA, FSA and HRA accounts.

6. At the end of every call, the doctor will ask if he's answered all of your questions, and we'll follow up to make sure you're delighted with the service.

I am hoping to see telemedicine flourish not only abroad but also in the Philippines soon.

I understand that the Philippine government has initiated telemedicine aimed at the remote areas. But I don’t think the government is the answer.

And yes this could be seen as a sunshine investment opportunity.

Nonetheless, considering the exponential growth of the internet in the Philippines, where usage now is about 6.3% of the population and growing...

Chart from Google Public Data

...digital healthcare trends will surely be headed in this direction.

McKinsey Quarterly On The New Japanese Consumers

McKinsey Quarterly has an interesting outlook about the changing habits of Japanese Consumers.

1. A shift to value.

Japanese consumers have been switching preference from classy and branded products to discount stores and online retailers. The reason according to McKinsey Survey: expensive products, “annoying stuff” and “inability to shot at my own pace”

And shifting to value also means bulk buying

[my comment: an aging population is expected to spend less on material things and spend more on health, as noted below this appears to be compounded by economic stagnation.]

2. Home entertainment.

Japanese have also been more “home” oriented in terms of entertainment. And part of the homeward bound lifestyle is that the Japanese have gradually embraced digital revolution through online shopping

Japan is said to lag the US and UK in spite of high penetration level of broadband, and the past reasons for this according to McKinsey have been,

-Japanese consumers love the physical shopping experience;
-mobile-phone screens are too small;
-the density of retail establishments means that online shopping has less of a convenience advantage;
-credit card penetration is low.

However this seem to be changing as more Japanese spend online.

The online market for physical goods (excluding ticket sales and electronic downloads of media such as music, movies, and software), notes McKinsey, is estimated to be nearly $30 billion, compared with only $1.3 billion in 1999



A noteworthy quote ``It’s worth underscoring the tight relationship between online shopping and broader shifts in consumer behavior. In a consensus-driven society where individual choice and expression have historically been frowned upon, the ability to browse products, compare prices, and make purchases relatively anonymously is creating new attitudes and empowering consumers.” (bold highlights mine)

[my comments:

-Online activities are growing not only in Japan but in most parts of the world. Perhaps the reason for the shift to value is that online provides more opportunities for comparison and thus end up with least expensive but still high quality value products choices.

-In addition, since our assumption is that Japanese have broadband connectivity at home, social activities by the youth are conducted online, than in malls.

-Third, the online experience is promoting "individual choice and expression", which probably means more appreciation of freedom]

3. More Travel.

They’ve been more willing to travel more to take advantage of discounters. And one apparent beneficiary of this shift has been private label products.

4. Individualized healthcare

The new trend also suggest that the Japanese are also “directing their own healthcare” spending or that Japanese are spending more for health.

According to McKinsey ``One effect of the greater interest of the Japanese in directing their own health care has been the growing popularity of drugstores, which have been Japan’s fastest-growing retail channel since 2000: store numbers have increased by 4 percent and sales by 8 percent.”

[my comment-Politically perhaps this implies the trend towards less dependence on government welfare.]

5. They have reportedly been receptive to affordably priced “environmental consciousness” products.

Reasons for the shift:

Mckinsey says part of this comes from the recent downturn compounded by the economic weakness in the past 2 decades where the consequences has been the “disappearance of life-long jobs and the increase in part-time and temporary labor”.

McKinsey adds that the emergence of a new generation which characterize “Less materialistic youngsters” had possibly been a product of an era “never knowing the boom times the two previous ones experienced.”

The new lifestyle has “prompted the nickname the hodo-hodo zoku, or “so-so folks” (or, even worse, “slackers” or “herbivore men”).”

[my comment-that's likely plus the web 2.0 factor]

A third of final factor possibly contributing to such changes in behaviour have been a “series of small, largely unrelated” regulatory adjustments

McKinsey notes that ``Japan’s government reduced the maximum freeway toll on weekends to ¥1,000 regardless of the distance traveled—a huge discount that encouraged trips outside Tokyo to big-box discounters and large-format retailers such as Costco and Ikea. Other examples include regulations allowing the wider sale of over-the-counter drugs; a mandate that all employees over the age of 40 (about 50 million people) take a test to determine whether they are at risk for conditions such as diabetes and high blood pressure and, if they are, requiring them to exercise and diet; and recent changes to reduce underage smoking. The Japanese government has also pushed to increase awareness of and access to health remedies, in part to address the challenge of paying to treat these conditions.”