The Greatest Politician of our Time

Before becoming the country’s leader, he had never held a political position. His views about how a society should function were clear and controversial. With a vision to tear everything down and build it back up, he surrounded himself with like-minded colleagues. Together they founded a new country, the likes of which no one had ever seen.

Singapore was barely more than a swampy island when Lee Kuan Yew, became the country’s founding Prime Minister. The year was 1965, they had just survived a war, and Singapore was struggling. By every measure it was a desperately failing country. There were no natural resources, the economy was in shambles, a majority of its people were living in poverty, malnutrition was rampant, and infant mortality was too high. At $500, Singapore shared the same per capita income as Ghana.

Lee Kuan Yew’s master plan ruffled a lot of feathers. He was disruptive and ruthlessly honest as he held tightly to his principles. His first step was to introduce a five-year plan that included a focus on urban renewal, construction of public housing, greater rights for women, educational reform, and industrialization. And that was just the beginning.

The vision Lee Kuan Yew had for Singapore profoundly marked its future: “Everyone will have their place, equally: language, culture, and religion.” The government pledged to provide equality and opportunity and set about to create a nation of social harmony.

The notion of social cohesion seemed far-fetched for some in Singapore. After all, they were trying to recover from the ravages of war and keep newborns from dying. In many cultures today, it would probably seem a bit too “Kumbayah”, but it worked.

The nation identified its most vulnerable citizens and recognized that when they have access to health and healthcare services, everyone thrives. Singapore reduced its infant mortality rate faster than any society in history. Lee Kuan Yew maintained that no one (not even a visitor to the country), would go without healthcare. Along with providing access to health for all citizens, the country invested heavily in medical education. People began to thrive and they created jobs. The ripple effect positively impacted education, access to food and resources, and the ability to own homes and properties.

Today, Singapore is called the world’s most successful society. Their unemployment rate consistently stays under 3%, and its citizens are some of the best educated in the world. 90% of them own their own home and the per capita income is $55,000. When it comes to health, they live longer than we do – by a long shot. Their newborns have three times the life expectancy of a baby born in the U.S. Much of this is due to the personal health savings plans that every citizen has and passes on to family members.

Lee Kuan Yew, the ultimate non-politician, changed the rules. Ahead of his time (or perhaps right on time), he found a way to solve for Social Determinants of Health in a country whose citizens were struggling to survive. With access to community resources and their basic needs met, individuals and families are informed and play an integral role in their care plan. Singapore spends 3% of its GDP on healthcare – including treating non-citizens. The U.S., in comparison, spends 17%, and the percentage continues to increase every year.

The United States is not Singapore. However, there are lessons for us in healthcare to learn from the most prosperous nation on earth – a country that went from last to first within one generation. What is the lesson? Singapore pursued the Triple Aim relentlessly – as a society, not just as a healthcare system. This lesson is foundational for value-based care.

This article was written by Jamo Rubin, MD, Founder and CEO of TAVHealth.

You can see the original article on Jamo Rubin’s LinkedIn page at:

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