RVHS H1 ECONS P1 QP

This document consists of 8 printed pages. [Turn over 1 Name:________________________ Class:_______ ECONOMICS 8819/01 Paper 1 12 September 2017 3 hours Additional Materials: Answer Paper READ THESE INSTRUCTIONS FIRST Write your index number and name on all the work you hand in. Write in dark blue or black pen on both sides of the paper. You may use a soft pencil for any diagrams, graphs or rough working. Do not use staples, paper clips, highlighters, glue or correction fluid. Section A Answer all questions. Start each case study on a new sheet of paper. Section B Answer one question. Start this question on a new sheet of paper. At the end of the examination, fasten all your work securely together. Your answers for each case study in Section A and the essay in Section B are to be handed in separately . The number of marks is given in brackets [ ] at the end of each question or part question. RIVER VALLEY HIGH SCHOOL YEAR 6 Preliminary Examination II in preparation for General Certificate of Education Advanced Level Higher 1

2 © RVHS 2017 8819/01 Section A Answer all questions in this section. Question 1 Healthcare in Singapore Figure 1: Singapore Government healthcare spending Source: Ministry of Health, accessed 31 July 2017 Extract 1: More healthcare workers needed in Singapore The number of elderly Singaporeans is growing faster than ever. There were 460,000 people aged above 65 in 2015. By 2020, this number will rise to 610,000. As Singapore’s population ages rapidly and more suf fer from chronic age-related ailments, 30,000 more healthcare workers would be required in 2020 as compared to 2015. In addition, Singapore will also need to completely rethink the way it cares for the elderly, said Health Minister Gan Kim Yong. These workers - including doctors who specialise in healthcare services for the elderly and highly trained nurses capable of helming clinics in primary and community health settings - will be required to staff the additional facilities on the way. These include six new polyclinics, 2,100 public hospital beds, 9,100 beds in community hospitals and nursing homes and 7,600 more places in day, home and palliative care. Source: The Straits Times , 20 October 2016 Extract 2: Medical tourism ambitions under threat Indonesians, Thais and Malaysians came in droves to receive quality medical treatment in Singapore's private hospitals. But 15 years on, Singapore's ambition to become a healthcare hub appear to be receding quietly. The region's wel l-to-do medical tourists are looking elsewhere for treatment, meaning that local players have had to extend their reach abroad. 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Year Million ($)

© RVHS 2017 8819/01 [Turn over 3 The main reason Singapore is falling behind is that hospitals in countries such as Malaysia and Thailand have stepped up their game, said Mr Je an-Luc Butel, president of consulting firm K8 Global. While they may not have the state-o f-the-art technology that Singapore's private hospitals possess, they can carry out standard surgery at a fraction of the cost. "This makes the competition very, very tough - our abilit y to attract the low- or medium-budget traveller is virtually gone." Mr Butel said. Dr Zubin Daruwalla, healthcare director of PwC Sout h East Asian Consulting, said that "The value of the Singapore dollar and its appreciation make us less affordable.” In Singapore, a relatively low-cost simple treatment like the total hip replacement surgery at a private hospital would set a patient back around $14,000. I n comparison, the same procedure at Mahkota Medical Centre in Malaysia - which treats m ore than 80,000 foreign patients a year - costs the equivalent of only $8,800. In the face of all this, some hospitals have develo ped innovative ways to make medical travel more than just treatment. At Farrer Park Hos pital, where foreigners make up half the number of patients, a tablet can be used to view me dical records, order meals and even shop online, and have the purchases delivered to a location of the patient's choice. "If we can manage our services and costs properly, maintain our high standards of care, there is no reason why Singapore cannot be at the f orefront of not just the regional, but also the global medical tourism market," said Mr Roy Que k, chairman of Thomson Medical. He added that Singapore will always be a popular desti nation for complex treatments, a sentiment echoed by Dr Kelvin Loh, chief executive of Parkway Pantai's Singapore operations division. "There is a growing trend of international patients coming to Singapore for complex medical treatment," he said, adding that its ability to handle such cases has drawn patients from new markets such as China and India. Source: The Straits Times , 17 October 2016 Extract 3: Singapore’s healthcare success did not come cheap or easy Singapore's success in providing affordable and acc essible acute healthcare is a result of strong controls, argues one expert. The issue of healthcare reform has become ever more contentious, as governments look to curb spending and limit their fiscal responsibiliti es. In the face of anxieties over rising healthcare costs, Singapore’s healthcare model has caught the world’s eye, especially its medical savings account scheme, Medisave. Observers see it as a clever mechanism for reducing the fiscal obligations of the government w hile building households’ capacity to pay for their own healthcare needs. Singapore’s healthcare system is not without its ch allenges. Though Singapore has managed to maintain modest overall spending, it has a rapidly ageing population and most healthcare expenditures continue to be financed out -of-pocket. Then for outpatient services, poorer and older Singaporeans are finding it increa singly unaffordable and inaccessible. Although the government maintains a safety net, Med ifund, for patients who cannot cover their bills, there are still Singaporeans who strug gle to afford the medicine when they need them. Source: Channel NewsAsia , 24 May 2017

© RVHS 2017 8819/01 [Turn over 4 Extract 4: The benefits of a healthy workforce When it comes to your workforce, the aim is to keep employees happy and motivated enough to work at maximum productivity no matter the job role or task. The biggest benefit of a healthy workforce for an e mployer is undoubtedly a lower absentee rate. On average, employees in the UK lose over 2% of their working hours per year due to absence. Usually there are a number of costs associated with this, such as the cost of cover whilst the person is off, potential additional over time costs for other employees and possible retraining depending on the terms and length of the absence. If an employee is fit and well, their productivity is much higher than if they are working whilst ill. Also, studies have shown the link between empl oyee engagement and their health or well-being. This means that if your workforce is ge nerally well and healthy, they will be more engaged in their role, offering a happier and more efficient environment to work in. Being unaware, the consumers are also not taking st eps to prevent their conditions from becoming severe. The bottom line is that screening tools that can alert people in the early stages of a disease exist. Whatever the reason - fe ar, ignorance, lack of interest - the fact is that people aren’t making use of them, even when screening programmes are free or heavily subsidised. Source: Glasgow Medical Rooms Journal , 12 May 2016 Questions (a) (i) Describe how Singapore government healthcare spending has changed f