I refer to Mr. Basant Kapur's response, 'Aids-Subsidies Dispute Boils Down to Mindset' (Straits Times, July 27, 2001).
Although Mr. Kapur asserts that countries such as Finland and Denmark - with very similar population sizes to Singapore - are able to afford subsidies for non-standard drugs, the argument does not do justice to the heterogeneity of the situation in these countries.
First, population size does not equate to the size of the tax base. For example, according to data from the International Monetary Fund, Denmark's tax receipts are four times that of Singapore, whereas Finland's is but a third. Hence, there is a need to look beyond mere population size in determining the economic priorities of a country.
Second, whereas the total health expenditures in these two countries are evidently a larger component of GDP as compared to Singapore's (Singapore health expenditure weighs in at around 2 per cent of GDP), the picture becomes clearer when the totality of government outlays are considered. Finland and Denmark expend 4.5 and 4.1 per cent of total government expenditure on defence, respectively, while Singapore allocates 27.9 per cent of its expenditure on the same.
This seemingly disproportionate amount can be justified somewhat by the circumstances that Singapore finds itself in, especially since it does not have the security cushion of NATO to fall into. Does this necessarily imply a mindset that treats its citizens as 'economic entities' and hence ignores their welfare? Surely not, for the safety of our nation from foreign aggressors is a very valid social and political concern.
Mr. Kapur also derides the possibility that subsidies would distort incentives for individuals to take adequate preventive measures, citing the low proportion of AIDS cases in the two nations. This ignores the counterfactual, that is, what these ratios would be in the absence of subsidies. Although there is no way to ascertain this assertion, we cannot rule out the possibility that these figures might very well be lower such subsidies.
Does the issue then reduce to one of mindset? I entirely agree. But it is not the mindset of the government that is of issue here; it is the mindset of each individual. If Singaporeans can be made aware, through public education, of the tremendous risks and the simple precautions that can be taken to prevent contracting the disease, the entire subsidies debate would be rendered moot.
Kapur, B. 'Aids-Subsidies Dispute Boils Down to Mindset', The Straits Times, July 27, 2001. Online: http://www.straitstimes.com.sg/forum/story/0,1870,59929,00.html.