SINGAPORE — The increasing longevity of Singaporeans may be a substantial healthcare success but some here will struggle to afford the rising healthcare costs of living to 100, a study commissioned by insurance giant Prudential has found.

The study, called Healthy for 100? Healthy care in Singapore, published on Tuesday (July 23) concluded that many Singaporeans will spend their latter years in ill health, and urged younger people — and the nation as a whole — to do more to prevent chronic illness.

The study was researched and written by the Economist Intelligence Unit (EIU), which sought the views of 203 healthcare practitioners in Singapore ranging from general physicians to nurses, senior management and administrators.

It found that more than half of Singaporeans over the age of 60 suffer more than one chronic condition. A rising number will fall into this category of "multi-morbidity", especially as Singaporeans’ life expectancy inches towards 100, it found.

The report noted that in 2015, 11.7 per cent of Singaporeans were 65 or older and that the United Nations estimates this will more than double to 26.6 per cent by 2035.

The findings echoed last month’s report by the Ministry of Health done in collaboration with the United States-based Institute of Health Metrics and Evaluation. It found that on one measure Singaporeans are now the world’s longest living people — with an average life expectancy of 84.8 years in 2017, outliving the Japanese by six months — but that many will spend these additional years in ill health.

The latest study — which put the average lifespan here at 83.1 years and rising — is a continuation of one conducted by Prudential last year which highlighted four areas that contribute to the length and quality of life: Finances, health, work and relationships. This year, the EIU explored the healthcare issue in greater detail.

At a media briefing on the study, Dr Lim Wee Shiong, a senior consultant at the Institute of Geriatrics and Active Ageing at Tan Tock Seng Hospital, said that while the population is not inherently unhealthy, it has different medical needs than in years past. These include multi-morbidity and a greater threat of diseases such as dementia, as the population ages.

PREVENTIVE HEALTHCARE FROM AN EARLY AGE

While 70 per cent of the doctors and clinicians surveyed say individuals need to be responsible for their own healthy ageing, eight in 10 say the national healthcare system must place more emphasis on disease prevention.

Respondents also believe that more than half of Singaporeans aged between 25 and 45 are not being proactive in preventing common chronic illnesses such as diabetes and heart disease, which is a cause of concern.

“I think that when we are at that age, we seldom think of the ramifications. Young Singaporeans are not very active in disease prevention because the idea of being disabled or ill seems far-fetched,” said Dr Lim.

Echoing these sentiments, Dr Sidharth Kachroo, head of medical portfolio management at Prudential Singapore, said: “A healthy lifestyle doesn’t happen overnight. The earlier we start taking care of our well-being by keeping to a good diet and lifestyle, the higher are our chances of ageing well. After all, good health is earned, not given.”

Dr Lim added: “The focus on disease prevention cannot be overemphasised — it is extremely critical from a long-term perspective.”

“Good health when one is old does not happen by chance but is the consequence of preparation."

SOLUTIONS TO THE CONUNDRUM

The report said that nearly half of the respondents (49 per cent) believe Singaporeans are, to some degree, unprepared for the health-related expenses of living to a ripe old age.

Dr Jeremy Lim, partner and head of health and life sciences (Asia Pacific) at global consultancy Oliver Wyman, said in the report that this is a legitimate concern. “Singapore, like the rest of the world, has seen healthcare inflation far outpace general inflation,” he added.

Nevertheless, he said these concerns could be overblown from the perspective of the patient. Citing grants and Medisave as ways to address rising costs of treatment, he also suggested new funding models.

While under the current system, patients are charged according to the amount and type of treatment which they receive, a system where fees charged to the patient are determined by the improvement in their health could be a better approach to pricing healthcare, he added.

LONG-TERM CARE FOR OLDER CITIZENS

Access to adequate care was a major concern among those surveyed. While 51 per cent agree that their patients have access to the caregiving support they need, only 26 per cent are confident their patients will have adequate access to caregiving support in 10 years’ time.

According to a study published by the Lien Foundation in August last year, a place in a nursing home run by a voluntary welfare organisation in Singapore can easily cost about S$2,400 per month — over half of the average Singaporean’s gross monthly income.

Recognising that this is a “wicked problem”, Dr Jeremy Lim said: “With so many moving pieces, it is really challenging which to do first or if all need to move in concert.”

He added: “I don’t think we have cracked the code yet, hopefully we will get it right. These are global problems and Singapore's adjustment to rapid ageing is an opportunity to show the world how it should be done."