This point is partly supported by the country's health care indicators. As of 2004, the Department of Health said life expectancy was 79.3 years and the infant mortality rate per 1000 live-births was 1.9.

It is also backed by the government's investment in the sector, which in the year 2004 was an estimated 5.9% of total government expenditure. Recurrent health expenditure topped about S$1.61 billion (US$950 million) in the same year, while development health spending touched S$97 million. There are about 11,840 hospital beds in 29 hospitals and specialty centers in Singapore. This is a ratio of about 3.7 beds per 1000 residents.

While there are private medical facilities available, the government remains the dominant health care provider, allowing it to control the supply of hospital beds, the introduction of high-tech medical equipment and the rate at which costs rise, which in turn helps set the bench mark for how much the private sector charges.

The cost of running the country's health sector is borne both by the government and the public, under the guiding philosophy of individual responsibility and community support. Patients pay for part of their treatment, an amount that varies depending on the level of service they demand. The remaining funds come from government subsidies, which aim to keep health care affordable for all members of the general public.

An extensive health care financing framework for individuals also exists. Singaporeans can help defray potentially high medical costs by investing regularly in one of the nation's health care savings plans, which include Medisave, MediShield and ElderShield. Medifund, targeted to those individuals unable to pay for their medical treatment, buttresses the system.

The country also boasts a strong biomedical-sciences sector. In 2004 manufacturing output from this sector surged by 33% on-year to S$15.8 billion, a figure that looks set to grow as an increasing number of multinational pharmaceutical and medical equipment firms set up operations in Singapore.

Numerous leading pharmaceutical firms have also set up their regional clinical trial centers in the city-state, including AstraZeneca, Aventis, GlaxoSmithKline, Merck & Co, Novartis and Novo Nordisk.

Outlook

According to the government, demand for a strong regional health center in Singapore should surge in the coming decades. Asia's population is expected to grow from 3.2 billion in 2002 to 5.6 billion in 2050, and with it will come an increasingly affluent and demanding class of people who will want the type of quality health care being offered in Singapore.

The burgeoning middle classes of India and China are two such target markets.

In 2003, about 230,000 foreign patients sought treatment in Singapore, and the country's Economic Review Committee has set a target of serving 1 million foreign patients each year by 2012.

The government's aim of developing a top-class regional health care center is evident through the recent opening of the "Biopolis", a center that will house a full complement of research and development (R&D) activities, including medical research, drug-discovery efforts and medical-technology research.

Work on phase two of the Biopolis has already commenced, a pointer to the success of the project.

"The overwhelming demand for spaces at Biopolis leading to the accelerated Phase II development, signals the exponential growth of the biomedical sciences R&D community in Singapore," Yeoh Keat Chuan, deputy director of the Biomedical Sciences Group of the Singapore Economic Development Board, said in June.

"It bears testimony to Singapore's success in building a world-class R&D environment."

It is expected that the center will eventually encompass about 2000 researchers.

The move to develop the nation's biomedical sector appears to be on track, highlighted by the decision of the European drug major, Novartis, to set up a US$180 million pharmaceutical-production center in Singapore. Work on the new plant and distribution center commenced in March, and once completed it is expected to employ more than 150 people.

Yet like many industrialized nations, Singapore's health sector is endeavoring to find ways to cope with the increasing proportion of the population aged more than 60 years. While in 1999 only 11% of the population was more than 60, by 2030 this group is expected to account for 27% of the nation's population.

The spiraling cost of medical technology, combined with rising expectations from a more demanding public are also key challenges confronting the nation's health system.

"All over the world, medical inflation exceeds the general CPI (consumer price index)," Health Minister Khaw Boon said in May. "If there is no transformation in the way health care is delivered, health care must eventually bankrupt all economies. We need to find creative ways to deliver more with less, maintain if not raise standards, while cutting out wastages and squeezing out inefficiency."

Government policy

Apart from providing a world-class health system for Singaporeans, the government continues to focus on attracting foreigners to the city-state, whether as patients or investors.

As part of the drive to attract more foreign patients, the government is continuing to position Singapore as a regional hub for medical treatment and research.

The government, partly through the Singapore Economic Development Board, is also looking to enhance the country's clinical-research base and biomedical-sciences industry. The continuing development of the Biopolis illustrates this.

Moreover, in light of the recent SARS (severe acute respiratory syndrome) epidemic and bird flu outbreak, the government is also setting up a Regional Emerging Disease Intervention Center as part of the Biopolis. This institution will endeavor to better monitor, treat and prevent critical infectious-disease threats in the region as well as government efforts to differentiate Singapore's health system from those in neighboring countries, helping to attract additional investment.

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