The Health Care Miracle in East and Southeast Asia: Activist State Provision in Hong Kong, Malaysia and Singapore.

This article focuses on the performance of health care in Hong Kong, Malaysia and Singapore. The activist role of the state in health care provision, at least partly established by the British in the colonial period, has enabled all three systems to combine low costs with high outcomes. Hong Kong is the largest spender on health care in terms of both U.S. dollar and percentage of GDP, followed by Singapore and Malaysia. The three countries' total health care expenditure is, in fact, lower than the 5 per cent of GDP recommended by the World Health Organisation for developing countries. Another notable feature is that private expenditures are either on par with, or often larger than, public expenditures in all three countries, again distancing them from high-income countries, where much health care expenditure is usually accounted for by the public sector. In the early 1990s per capita health care expenditure increased significantly in all three countries, though the increase was quite modest when placed in the context of their very high economic growth.