#archive Healthcare spending may reach 3.5% of GDP in 2030

10 08 2013

This is the one article that talks about how much of it’s GDP Singapore spends on healthcare. Granted that we have “better outcomes”, I am not sure if we should be spending only 1.6% while we spend 24% on Defence.

He said Singapore is currently spending about 1.6 per cent of the GDP on healthcare.

By 2016, it would go up to two per cent of GDP and by 2030 when the rapidly ageing population will be the biggest driver of rising expenditure going forward, healthcare spending may reach around 3.5 per cent of GDP, taking into account demographic changes and higher medical inflation.

Mr Tharman stressed that Singapore should focus on achieving international standards for healthcare outcomes rather than simply on increasing spending.

Happy Nurses Day and a bit about Nightingale

31 07 2013

The week long celebration started on Monday. I haven’t been to the hospital the entire week, so I’m not entirely sure what is going on there nor have I been able to have a heart to heart talk with my nursing friends and colleagues.

I noticed, when I was in India, that they celebrate theirs on the 20th of May which is the birthday of Florence Nightingale. Although we grew up with the image of her as a self-sacrificial figure in the care of fallen soldiers, she was much more than that.

As an educated, empowered woman, she is, to an extent a feminist symbol for rejecting the suffocating expectations placed on an upper-class woman to be a baby-making machine. Instead, she decided to be a nurse, against the wishes of her her family. She was also known to travel widely and work with politicians, write extensively and do big-picture planning.

It is also easy to forget her role as a pioneer of the hospital  as a well organised system. Her experience in the Crimean War showed that many soldiers were dying from diseases apart from the battle injuries. She seems, from my reading of her Wikipedia entry, to be an early adopter of some sort of Evidence Based Medicine. Which, to put simply, is the use of scientific methods to understand if your treatment is working and to tease out the risks of it. Her background in statistics probably helped and she actually compiled data on her patients as opposed to basing her ideas on “experience”. The patterns she observed from this eventually led her to place great emphasis on sanitation.

The next time the ward sister reminds you the clean your hands in the MRSA ward, it’s Florence Nightingale speaking through her 😉

On a more personal note, although Nurses play a great variety of roles, my experience of them has largely been as “guardians”. Watching our backs, administering treatment, actually caring for patients, apart from merely treating them. Often, they take the brunt of the aggression from angry patients.

As a friend of mine often points out, I do wonder if they are under-appreciated by physicians, although there have been a lot of hints that the system could do better in taking care of them. Perhaps it is time to reconsider how nurses are remunerated? Maybe there is a need to clearly define, or perhaps redefine nursing? I do not know what the future holds and I don’t have immediate ideas. Nonetheless, I am greatly indebted to those nurses I have had to privilege to work with, both personally and professionally.

Happy Nurses Day!


And here is a picture of Nurses going on strike in Singapore in the 60s. It is still on the wall at SGH, I think 😛 Not that I am encouraging you to go on strike (we will all die), just that I have faith in the community to be resourceful and make bold reforms.

Nurses on Strike!

Welcome Doctor Google [satire]

24 10 2012

I was randomly trying to look up information for a report when I discovered this trick. I cannot believe that Google is actually sifting through pages to give you a differential diagnoses. I think at this rate, Google will achieve self-consciousness by the time I graduate. They might also add in an empathy module. As such, maybe I should just quit school and focus on rehearsing my “would you like fries with that?”*


*Or “ni yao fries?”

Non Indian Race preferred?

16 10 2012


Looks like just another real estate advertisement. Someone trying to tell you how amazing their apartment is. How it’s so nice that you should definitely think about renting it. Oh but of course, if you look at the last line in the picture, it’s “Non Indian Race, all other race prefer” in terrible English. I guess that means if you are Bangladeshi, Pakistani or Sri Lankan, you’re more than welcome.

That sounds a lot like Racial Discrimination to me. Seeing this in 21st Century Singapore makes me uncomfortable on one hand, on the other hand, I’m glad to know who to avoid.

(NSFW) I can imagine an ad like this in Singapore … NOT!

1 10 2012

I always ask, why is their politics so fun?

via Pharyngula

Correction, I found Silverman’s 2008 Vote of Obama Video. Same irreverent Jewish humour. I think it’s better than Jackson’s

(NSFW) Sarah Silverman : Buy back your right to vote by getting a gun

22 09 2012

Not the first time Silverman had an awesome/crazy idea to solve society’s problem. Last time, she almost figured out how to “feed the world”, but I guess, I shouldn’t really link to that video.

Singapore’s the richest, if you know what I mean

20 08 2012

As an ex-magician (hopefully, I get back to doing that soon), I’m always interested to know how people are deceived. It’s also one of the reasons why I like Medicine because you always ask yourself what could be causing a lab test to be falsely increased or what’s this thing that might be behaving like an infection (without being one). And so I was curious when a friend made a post about his friends comments on the “Singapore is the richest” article circulating around. It parallels what happens often in the field of biomedical research as well, the idea that a certain research finding, though not necessarily false, could be interpreted in a few ways.

Now, all I know about economics is that if you run out of money, print more!* So here’s Mr Isaac Chua explaining how the statistic doesn’t actually mean we’re all really rich.

“Decided to post this because it seems like many are misinterpreting the figures. Perhaps it’s due to the misleading title.

In the article, Singapore tops the GDP per capita list.

Yet, the gross domestic product (GDP) is the “market value of all officially recognized final goods and services produced within a country in a given period.” (Wikipedia) [Me : feel free to read further on Wiki]

It has nothing to do with personal incomes or wealth.

GDP is measured in several ways, and one of them is the expense method: GDP = C + G + I + (X – M).

C = Consumption
G = Government spending
I = Investment
X = Exports
M = Imports

A high GDP may come from high consumption, which could indicate that people are generally rich (or taking lots of debt). But it can also come from high government spending (such as for infrastructure) or investment (investment in here is not your own personal investment, but investment that companies make in property, machinery, etc.). A country that also has a high net exports (i.e. exports > imports) also has a high GDP. A high GDP may indicate a lot of money and goods are changing hands among people in the country, and out of the country.

So GDP has nothing to do with personal incomes or wealth. They may be correlated, but they are not the same thing.”

*Kidding, even I’m not that dumb. However, I do not doubt that there might just be genius who figures out  a “right way” to do it.

Cannibal virus update

5 06 2012

Get A Kit,    Make A Plan, Be Prepared. emergency.cdc.gov

I didn’t realise how big that story would end up. People from the US are going crazy about it. I think part of it is fueled by excited Left 4 Dead fans and part by paranoid folks. I think it might have gotten worse since the CDC (Centre for Disease Control) denied the virus story when asked by Huffington Post. This was compounded by the fact that last year, the CDC actually used the Zombie Meme to promote emergency preparedness, gosh, Americans. That’s the equivalent of our media warning us about a post-PAP government (no, it’s not actually, that’s very scary indeed)

Buzzfeed has made a little google map tracking these incidents. Which is rubbish. It’s a combination of people being violent and biting each other and chemical spills which together make it look like the country is erupting in apocalyptic violence.

I doubt that violence in America is a new phenomenon. I went to actually try and dig out statistics to find out if this kind of crime is increasing and although the FBI does collect and publish this, the closest I could get was to sort it according to weapon. There’s a section that refers to crime where personal effects such has hands, feet etc were used so I get the impression that Miami boy’s crime will count under that. That being said, violent crime seems to be on a decline (bottom of the page), which is, well, less scary.

I did dig out two important worrying trends. First, there’s this Bath Salts epidemic that’s making it way through America. Drugs screw with your body, don’t take them. Second, that Florida has very little investment in its infrastructure to take care of the mentally ill. That means people not fully reaching their potential, perhaps more crime, and the social acceptance of people with mental illness declining even further. Damn. I need a break

Don’t fall for that fake LQP-79 story.

31 05 2012

I hope you didn’t fall for this obvious fake, it’s got some worried commentators asking about this new LQP-79 virus. Some comments I read online suggest this one came from 4Chan but I couldn’t confirm this.  This one is definitely rubbish, here’s why.

  • Even Zombie Apocalypse Academy thinks it’s false.
  • If you look at the interface of the article, it represents that of Huffington Post’s Healthy Living Section

    I checked Huffington Posts recent articles and this one wasn’t there. That being said, I wouldn’t trust Huffington Post to cover anything scientific appropriately
  • The Necrotizing fasciitis is underlined by spell check, probably in someone’s text editor. Even WordPress’ text editor is underlining half my blogpost as I write this.
  • Necrotizing fasciitis doesn’t really eat your skin away, at least that’s an inaccurate description. Nec Fac, as we medics contract it, happens when infectious bacteria end up in a layer surrounding your muscle called fascia, this also affects the very deep layers of skin. The spreading infection cuts off blood supply to your skin and causes it to die off. Because of the lack of blood supply, antibiotics (which need to travel through blood to affected areas) are not so effective and the preferred option is to surgically remove the skin down to the muscle (gruesome medical pictures here)
  • I couldn’t find a reference to that statement by Armando Aguilar. He seems somewhat experienced with regards to the side effects of drugs. They can make you do some crazy stuff and throw your brain off balance, to put it mildly. He claims to have seen similar cases where he’s seen people on drugs get violent and naked. I think that’s a legitimate explanation.
  • It’s not so easy to identify an unknown virus. We have hypothesized that some viruses might trigger the immune system to attack one’s own body, leading to various kinds of autoimmune dieases but this has been hard to prove. Unless science has progressed extremely rapidly since I first started med school (a mere 3 years ago) I doubt it’s easy to discover a new virus in less than a week.
  • It’s difficult to tweak brainwaves to follow a specific pattern. However, there’s a fungus Ophiocordyceps unilateralis, that invades ants, eventually their brains, and makes them climb up to the top of plants to die so that the fungus can spread its spores effectively. There’s also a disease in humans called pica, where, likely due to malnourishment, people crave non-foods. I think the real explanation is still drugs, but it’s fun to consider the possibilities.

That being said, I don’t think it would hurt if we all trained to run fast. And stock up on some food, and stayed healthy so we have good immune systems. I’m just sayin’

P.S While I was doing a bit of research for this and people were speculating in all sorts of ways, I ran into this comment, so full of win.

1955 : Hock Lee Bus riots, 2012 : MRT Riots?

15 03 2012

Edit: In case anyone is interpreting this an an incitement to violence, no. I am suggesting that we have a sensitive situation on our hands that we need to be extremely cautious about. I don’t think violence is moral nor is it a solution.

I think this is serious business. No kidding, I mean that when I say it. Some amount of public discourse recently has been dominated by situations where people had hateful speech and were silenced for it, because it caused disharmony. Now I do disgree with the way that was handled although it seems to have settled for now.

Saying that some group of people have “little true joy” or that there are “more dogs here than people”, I think is only mildly inflammatory compared to what has been happening over the past few months. That is what people say, those are opinions (ignoring for now, their truth or falsehood). The disruption of the transport system, on the other hand is something that happens. That hundreds of thousands of people experience firsthand, where money and time are lost. Where our Singaporean Pride is bruised and this has happened a couple of times already.

I have been fortunate to have avoided that inconvenience because my destinations have either been nearby or I was taking a bus. So I’m not thay frustrated about the disruption but I always thought “Damn, this can’t be happening in Singapore”. I’m sure you felt the same. I think if people start to lose faith in the system, especially if it is objective and justified. And that, i believe has even greater potential to sow disharmony and unrest than anything a silly college student can post on Facebook (or their cca noticeboard), consequently, it should be taken a hell lot more seriously.

I think that at this point, people are doing their best to sort it out, logistically but I wonder if there’s more to be done, in a non-technical sense. The time is ripe for a paradigm shift. Not in a top down sense, I actually beloved that the Government is already doing what it can (and its powers are limited). It has to be bottom up. There is a need for greater participation of the average Singaporean (and yes, even foreigner) in various aspects of Singapore society. We need brains over bereaucracy, to ask more questions and engage the people above and below us. Ok damn, class is starting soon (yes at 7am), ill think about it more and post later.