[Defending the Lion City] Defence vs Healthcare - which is more important?

Recruits undergoing Basic Close Combat Training at an SAF unit at the Basic Military Training Centre (BMTC) at Pulau Tekong on Jan 23, 2018. ST PHOTO: KEVIN LIM

Health, defence spending not a zero-sum game

Dr Yik Keng Yeong suggests in his letter that the Government is spending too much on defence compared with healthcare (Rethink of our health, defence costs needed; Feb 22).

As a national serviceman on my third cycle as a Reservist on Voluntary Extended Reserve Service, I feel it is necessary for us to move away from the narrative that social needs and defence are in competition.

The proportion of our annual budget spent on security has dropped by 10 per cent over the last decade.

"Instead, it would be more relevant to see defence as a form of insurance - one we would never want to draw on, but which is there when we need it."

Conversely, spending on social needs now takes up the lion's share of the budget.

In Budget 2017, Defence Minister Ng Eng Hen said that future defence budgets will aim to keep pace with inflation through a trajectory of 3 to 4 per cent annual growth.

His ministry would reprioritise programmes to meet new challenges, while addressing overall budgetary pressures of an ageing society and slowing economic growth, he said.

This year's defence budget of $14.8 billion is in line with this trajectory, growing about 4 per cent from last year.

"Defence capabilities cannot be ramped up instantly when danger emerges, but require long-term planning, equipping and training."

A continued focus on defence versus healthcare spending as a zero-sum game is an incorrect approach.

Instead, it would be more relevant to see defence as a form of insurance - one we would never want to draw on, but which is there when we need it.

Defence capabilities cannot be ramped up instantly when danger emerges, but require long-term planning, equipping and training.

"And Singaporeans can build lives, grow businesses and care for their families under the umbrella of defence that is provided by the Singapore Armed Forces."

Built up over the past 52 years, the stable and secure environment we enjoy and often take for granted has enhanced our economic vibrancy.

Tourists and international companies come to Singapore because it is safe, stable and secure.

And Singaporeans can build lives, grow businesses and care for their families under the umbrella of defence that is provided by the Singapore Armed Forces.

The global security environment is increasingly uncertain, and we cannot take our peace and security for granted.

Investment in defence and the need for everyone to play their part remain paramount.

Without defence, we will not have the safety and security on which to build a successful healthcare system and other hallmarks of a strong nation.

Nicholas Fang


A version of this article appeared in the print edition of The Straits Times on February 23, 2018, with the headline 'Health, defence spending not a zero-sum game'.
Source: The Straits Times, 23 Feb 2018



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Rethink of our health, defence costs needed

While our health budget at $10.2 billion, constituting 2.2 per cent of gross domestic product (GDP), seems like a lot of money, other countries spend far more on health care, with the United States topping the list withan expenditure of 17 per cent of GDP.

We all know why our healthcare costs are ballooning: ageing population, newfangled, exorbitant investigations and treatment regimes, reimbursements to doctors for procedures done rather than outcome efficiencies, all-in insurance without co-payments which encourage gouging by doctors, just to name the major ones.

Perhaps, because our health budget still seems far away from the levels of the US, there seems to be insufficient political will to manage health costs more strictly.

Allowing Medisave to be used for procedures in Malaysia (where, anecdotally, costs can be up to 10 times lower), mandatory use of generics where available (already enforced by some health insurances) and a more dedicated use of telemedicine will lower costs.

Our military budget has also ballooned over the last decade.

At $14.8 billion, it exceeds the combined budgets for trade and industry, national development, social and family development together with environment and water resources, which add up to about $13.7 billion.

Defence is paramount to our survival, but whereas we have not had a war for more than 50 years (granted that it may be because of our preparedness, as reflected by the oversized defence budget), we have need of trade, water, infrastructure and family support every single day - so, perhaps a rethink is needed?

Are there too many officers and generals who are paid too handsomely? Do we need the latest military planes when drones with smart bombs may suffice? Does the latest weaponry and the touting of a "4G army" really make us a better fighting force?

Yik Keng Yeong (Dr)


A version of this article appeared in the print edition of The Straits Times on February 22, 2018, with the headline 'Rethink of our health, defence costs needed'.
Source: The Straits Times, 22 Feb 2018

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Defense vs Healthcare

How do we determine how much to spend on them?

But in my opinion, here’s the bottom line.

Without Defense, there can be no Country.

Without a country, there can be no Home.

And when Singapore falls*, we won’t even have a home, let alone worry about healthcare or anything else.

* ... and Singapore doesn't even need to fall like we did in WW2. Our enemies simply have to destabilize us enough that our daily lives are disrupted, and international confidence in Singapore falters. That would already be enough to break our ricebowls.