News and activities of the International Institute of Medicine and Science Asean Chapter of IIMS, Inc. California, USA - Health care, Life Science, Education, Research, Philanthropy. Asean is the economic organisation of ten countries located in South East Asia: Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam.
As Asia braces for an unprecedented ‘silver tsunami’, SMU Assoc Prof Rhema
Vaithianathan is studying how it is changing not only the way we fund care for
the elderly, but also how that care is being delivered.
swiftly ageing population is in the spotlight once again. Figures released in
September 2013 showed that the proportion of Singaporeans aged 65 and above
jumped by 50 percent in the last decade to 11.7 percent of our citizen
population today. While this trend has many worrying about the pressures on our
economy, society and governance, it is a source of inspiration to Associate
Professor Rhema Vaithianathan, a health economist and expert on ageing at the
Singapore Management University (SMU).
Vaithianathan is a Senior Research Fellow with the SMU Sim Kee Boon Institute
for Financial Economics (SKBI) Centre for Silver Security (CSS). She is also an
Associate Professor of Economics at the University of Auckland in New Zealand.
Healthcare financing in Singapore
Singapore fascinating; it’s such an unusual system. I’m very excited by the
policy making in Singapore,” Professor Vaithianathan says.
points to the Central Provident Fund (CPF) and Medisave schemes as being unique
examples of how the government can spend so little on healthcare yet build one
of the best healthcare systems in the world with both low infant mortality and
high life expectancy.
issue Professor Vaithianathan is studying is healthcare financing.
interested in issues of ageing in Singapore and the impact of ageing on the use
of resources,” she says. “I’m very interested in healthcare financing reform in
Singapore, the way Medisave works, and how it could be strengthened with
pay-as-you go insurance.”
by the treasure trove of data about citizens collected by government agencies
and healthcare providers for administrative purposes, Professor Vaithianathan
is using this data to perform predictive risk modelling. The overall aim is to
develop automated algorithms to identify high-risk individuals who may require
emergency intervention for the benefit of not only themselves, but also the
such collaboration with Khoo Teck Puat Hospital (KTPH), a public hospital
managed by Alexandra Health, Professor Vaithianathan is studying patterns of
hospital visits to predict which patients are most likely to visit the hospital
can predict who’s at most risk of coming back to the hospital in the next six
months, you might be interested in deploying community-based services to try
and keep them out of the hospital,” she explains.
alerting relevant stakeholders of high-risk individuals, whether doctors and
nurses on issues of healthcare, or law enforcement on issues of security,
Professor Vaithianathan believes that this would allow for more efficient use
of national resources.
Gerontocracy in Japan
Vaithianathan’s interest in ageing populations extends across Asia, and in this
field, researchers are invariably drawn to Japan, the country with the oldest
population in the world.
years ago, she travelled to Hitotsubashi University in Japan on a foreign
scholar project grant to conduct research with Professor Reiko Aoki, a former
colleague at the University of Auckland.
aspect that interested them was the disproportionate voice of the elderly in
moment, Japan has many pro-elderly policies”, she says, “making reform in
favour of child-friendly policies very difficult to achieve.”
is unusual in that the minimum voting age is 20 and in general the voting
population is very old, which makes it difficult for Japan to undertake any
pension reform,” she explains.
tackle this problem, Professor Vaithianathan and Professor Aoki advocate a
system called Demeny voting, where children can have an electoral voice by
allowing parents or guardians to vote on their behalf. In doing so, the median
age of voters is reduced, which means the voting demographic is less weighted
toward those of pensionable age, giving pro-child policies a greater chance of
Looking to China
her focus towards the largest country in Asia, and indeed the world, Professor
Vaithianathan gets very excited when discussing China, a country which is also
experiencing an ageing crisis.
very interested in Asia in general, and in particular China. I’ve just finished
a nutrition project in China looking at the impact of the Great Chinese Famine
on survivors and their children,” she says.
collaboration with two researchers at the Australian National University,
Professor Vaithianathan looked to address a key question: Can we use
anthropometrics – or physical measurements such as height and weight – as a
summary statistic of economic conditions?
researchers analysed data from the China Health and Nutrition Survey collected
during the Great Chinese Famine from 1958 to 1961. They were keen to study why
despite the high death rates there was no discernible decrease in height among
those exposed to famine during their crucial growth years.
Vaithianathan’s team found that although growth was stunted during the famine,
the calamity imposed a selection for survivors and those genetically
predisposed to robustness tended to be tall.
findings revealed that females suffered more than males and rural communities
fared worse than urban populations during the famine. The study concluded that
raw height was not always a good measure of economic conditions during
by the outcome of her studies in China, Professor Vaithianathan says she hopes
to do more research there.
think it’s amazingly interesting what’s happening with healthcare financing
reform there,” she says, adding that she is now looking for collaborators with
access to interesting datasets in the country.