前幾日聽美國脫口秀，一個黑人女子吐槽美國醫療系統，說它suck。
口語裏我們常聽到suck這個詞，表示“很糟糕、很爛”的意思。
她抖段子，說如果有一天她走在路上被車撞，斷了一條腿，她會給自己訂去英國的機票，而且是頭等艙，她會坐在那要一杯可樂，再把她的腿放在另一個座位上，然後要一桶冰。她其實想說美國醫療費的貴。
那麽今天，我們來看一下新加坡醫療是如何優質低價的。
以下內容來自2020年《財富》雜書
你能想像美國醫療系統提供比現在更好的服務，然而費用卻能便宜75%嗎？這個數字不是印刷錯誤，也不是虛構的；而是真實的有全民醫療保險的新加坡的狀況。
新加坡的平均壽命爲85歲，比美國的多出5年。幾十年前，新加坡還嚴重落後于美國；而現在，這個城市國家的嬰兒死亡率更低，其他醫療指標也比美國的好。新加坡的醫生和醫療保健提供者和美國的一樣好，和世界上其他任何地方一樣好。
很多醫生在美國或其他國家的頂級學校接受培訓。新加坡一直在世界各地尋找最佳實踐和尖端技術。
沒錯——新加坡的醫院和診所會毫不猶豫地購入最新最好的設備和裝置。
來看看新加坡各種醫療程序的價格。在美國，心髒搭橋手術要花掉你（和你的保險公司）約13萬美元。
在新加坡呢？1.8萬美元。
髋關節置換要便宜72%，心髒瓣膜便宜92%。
那裏的藥品價格只是我們的一個零頭。保險費很便宜——
20歲以下約爲50美元，80多歲的老人一年只需一千多美元。此外，如果你養成了壞習慣，比如暴食或抽煙，那麽你的保險費會增加。和美國不同，在新加坡，個人來付保險費用，所以它是靈活的，不受工作的限制。
因此，新加坡擁有強健的個人保險市場。
新加坡是通過壓榨醫生的工資來實現這一切的嗎？不。
全科醫生和專家的稅後收入（新加坡的所得稅率只是我們的一個零頭）大致相當。並且新加坡的醫生不會被醫療事故成本或花費大量時間填寫保險單所困擾。
隨著今年競選活動的升溫，醫療費用問題將再次成爲焦點。不幸的是，我們將就這個問題，將我們今天的制度與某種歐洲風格的單一支付體系進行對比。
兩種模式都和新加坡的不像。所以這個國家是怎麽做到的？
下面附上英文原文：
Can you imagine the United States having a health care system that delivers better outcomes than those we get today at a cost that is 75% less?
That number is not a misprint or a fantasy; it’s the reality in Singapore, where there is universal coverage.
Life expectancy is 85, more than five years better than in the U.S. Decades ago, Singapore seriously lagged the U.S; now, infant mortality is lower and other medical metrics in the city-state are also better than they are here.
Doctors and health-care practitioners are every bit as good in Singapore as they are here, or just about anywhere else in the world.
Many get trained in the U.S. or at top-flight schools elsewhere.
The nation is always scouring the world for best practices and cutting-edge technologies.
That’s right—Singapore’s hospitals and clinics don’t hesitate to buy the latest and the best equipment and devices.
Just look at the prices of medical procedures in Singapore. In the U.S. heart-bypass surgery will set you (and your insurer) back some $130,000.
In Singapore? $18,000. A hip replacement costs 72% less and a heart valve 92% less.
Drug prices there are a fraction of ours. Insurance premiums are inexpensive—
about $50 for those under 20 years of age and a little more than $1,000 a year for those in their late 80s.
Moreover, if you pursue bad habits, such as overeating or smoking, your premiums go up.
Unlike in the U.S., individuals pay for the policy, so it’s portable, not tied to their jobs.
Therefore, Singapore has a robust individual-insurance market.
Does Singapore accomplish this by underpaying physicians? Nope.
The after-tax incomes (Singapore’s income-tax rates are a fraction of ours) of general practitioners and specialists are about equal.
And docs in Singapore aren’t plagued by malpractice costs or countless hours spent filling out insurance forms.
As this year’s election campaign heats up, the issue of health-care costs will come to the fore again.
Unfortunately, the issue will be cast as the system we have today versus some version of a European-style single-payer system.
Neither model resembles what Singapore does. So what does that country do?