Through “foresighted and visionary planning”, Singapore has achieved first-rate healthcare “at a cost lower than in any other high-income country in the world.”

So said Margaret Chan, director-general of the World Health Organisation, who was speaking at the ministerial meeting on universal health coverage in the city-state last week. She said that this achievement “was firmly anchored in a value system that places a premium on fairness and inclusiveness as a route to social cohesion, stability, and harmony”.

Dr Chan noted that Singapore’s version of universal health coverage “balances the advantages of competitiveness and other market forces with the need for state intervention to steer these forces in the right direction”. It “balances freedom to choose providers, services, and facilities with an obligatory health savings account, the MediSave plan, with its emphasis on individual responsibility”, adding that “there is no free lunch. The plan works to protect against the over-consumption of care”.

The WHO chief was also fulsome in her praise for Bangladesh, saying its story “shatters the long-held assumption that countries must first reduce poverty, then better health will follow almost automatically”. She argues that Bangladesh “decided to reverse the order by first freeing populations from the misery caused by ill health”.

Dr Chan said the country “aimed for universal coverage of its vast and very poor population with a package of high-impact interventions”. To compensate for a severe shortage of doctors and nurses, it trained “and then closely supervised a brigade of community health workers, mostly women, who followed a doorstep-delivery approach”.

She concluded by claiming that “universal health coverage is one of the most powerful social equalisers among all policy options. It is the ultimate expression of fairness”. Any country that really wants to move towards such coverage “can do so. There are no excuses”.