The Cure that Works
Talk of universal healthcare is a discussion that will persist in the United States until we find a solution that makes sense for everyone — lower, middle, and upper class. After watching Dr. Sean Flynn’s lecture about his book, The Cure That Works, I believe he might be onto something. Before analyzing Dr. Flynn’s ideas on improving the U.S. healthcare system, I want to comment on Singapore’s healthcare system, which, at first glance, seems almost perfect. I also want to preface this by saying I was unaware of healthcare systems outside of what we have in the U.S., so this video made me realize just how much Americans accept as the standard, even if that standard isn’t necessarily the best option.
Singaporean Healthcare System
Dr. Sean Flynn used Singapore’s healthcare system to highlight the key differences between a decentralized system and a more centralized one like what we have in the U.S. A decentralized system means the government is not the main provider of healthcare resources; instead, private practitioners operate independently, running their own practices and setting their own prices. This raises a concern: what if doctors overcharge? In a decentralized system, competition naturally prevents this issue. If one doctor charges twice as much as another with the same qualifications, patients will go to the more affordable option, forcing providers to lower their prices to remain competitive. As a result, healthcare costs in Singapore and other countries with similar systems remain relatively low compared to those in the U.S.
Another intriguing aspect of Singapore’s healthcare model is price transparency. Individuals receive a “menu” of prices before undergoing any medical procedure—whether it’s a routine checkup or a major surgery. This allows people to make informed decisions about their healthcare rather than being blindsided by surprise medical bills after the fact. In the U.S., medical pricing is often unclear, and patients frequently don’t know the full cost of treatment until after insurance adjustments are made, which can take weeks or even months. This lack of transparency creates financial stress and uncertainty for many Americans who are already struggling with high medical expenses.
But what happens if someone in Singapore can’t afford medical treatment in an emergency? The Singaporean government has already addressed this through mandatory savings. This system operates similarly to Health Savings Accounts (HSAs) in the U.S., but with one significant difference: participation is required. Every working citizen must contribute a portion of their income to this account, which has a guaranteed interest rate of at least 4%. This ensures that individuals have funds set aside specifically for healthcare expenses. It’s a logical system that seems beneficial in the long run, so why hasn’t the U.S. adopted something similar? The answer lies in the historical development of American healthcare.
U.S. Healthcare System
Dr. Flynn explained how our system evolved into its current form. Historically, large corporations like Ford and General Motors used free healthcare as an incentive to attract workers, even when competing companies offered better working conditions. Over time, this practice became widespread, leading to employer-sponsored insurance becoming the standard in the U.S. The introduction of Medicare and Medicaid in 1965 further solidified a centralized approach, where a third party—either the government or an insurance provider—controls the financial transactions between doctors and patients. Unlike Singapore’s decentralized system, this model limits direct competition, making it difficult for healthcare prices to decrease naturally.
Now, let’s talk about emergency funding. One reason why mandatory savings would be difficult to implement in the U.S. is that many Americans live paycheck to paycheck. Unlike in Singapore, where citizens are required to save, a similar system in the U.S. could place additional financial strain on individuals who are already struggling to cover basic expenses. However, a comparable approach—such as the system Whole Foods offers its employees—could be a viable alternative. Whole Foods provides employees with $1,850 per year to help cover their insurance copays. If the money isn’t used, employees can keep it, and the company will cover any medical expenses exceeding that amount. This approach incentivizes people to save for emergencies rather than relying entirely on third-party insurance coverage.
However, not everyone would use this money wisely. Some might spend it on luxuries, such as the latest iPhone or a down payment on a new car, instead of saving it for medical emergencies. This highlights a key difference between the U.S. and Singapore—Americans are not conditioned to think about healthcare savings as a necessity. In Singapore, it is ingrained into the system, ensuring that citizens always have a financial safety net in place. In the U.S., a significant cultural shift would be necessary to make mandatory savings successful.
Now, let’s examine existing HSAs in the U.S. compared to Singapore’s system. In Singapore, mandatory healthcare savings are so effective that, if necessary, every citizen could survive off of them for five years. In stark contrast, if all U.S. HSAs were combined, the funds would last no more than 13 days. The discrepancy is shocking, but it makes sense when considering the overall spending on healthcare. In the U.S., healthcare expenditures account for 18% of the GDP, while in Singapore, they account for just 4%. The sheer difference in spending and efficiency between the two systems is impossible to ignore.
So, what is the solution?
Solution
While mandatory savings would make sense for someone like me—who already contributes to a savings account—many Americans, especially those living paycheck to paycheck, would likely oppose it. That’s why I believe Dr. Flynn’s proposal, incorporating a system similar to Whole Foods’ model, could be a more realistic alternative. By offering financial incentives for healthcare savings while still providing safety nets for those who need them, this approach could create a more balanced system.
Another crucial reform is price transparency. For elective cosmetic procedures, patients always know the cost upfront because most insurance plans don’t cover them. Why shouldn’t the same apply to essential medical treatments? It would be like using food stamps at a grocery store without knowing the total cost until after checkout. If people had access to clear pricing before receiving treatment, they could make better financial decisions and reduce unnecessary healthcare spending.
At the very least, these changes—promoting savings incentives and increasing price transparency—are necessary steps toward improving the U.S. healthcare system. While we may not be able to fully replicate Singapore’s model, we can adopt key aspects that would help lower costs, increase competition, and provide Americans with more financial security when it comes to their healthcare. Until we implement meaningful reforms, the debate over universal healthcare will continue, and Americans will remain stuck in a system that is far more expensive and less efficient than it should be.