Financing to Foster Community Health Care: A Comparative Analysis of Singapore, Europe, North America and Australia

Abstract

Affluent countries face increasing health costs arising from the chronic illnesses of their ageing populations. Reforms are already being implemented, but in the face of considerable criticism. Community care, linked with self-care and family care, promises ways of containing costs, but questions of effectiveness and equity remain. Community care makes use of community infrastructures to foster family care and self-care supported by volunteer networks. Singapore, an affluent country that faces steeply rising costs because of its rapidly ageing population, has designed health financing around the strong tradition of family loyalty in an attempt to contain costs. Immediate family members can be called on to help meet each other's health costs. A comparison of community health arrangements in different countries shows that containing health costs through community care may shift the burden of care in unintended ways and with unintended consequences.