Sweden keeps trying to shrink inequality by making the bill more anonymous. Singapore did the opposite: it put the healthcare money in an account with your name on it.

Singapore runs MediSave — a mandatory personal healthcare savings account. A slice of wages, 8 to 10.5 percent depending on age, goes into that account. Citizens and permanent residents can log into CPF and see the balance, deposits, withdrawals, and claim statements for hospital stays, surgery, selected outpatient care, and insurance premiums. It is not an anonymous tax. It is a pot you can actually look at.

That is the thesis. Visible money changes behavior. Invisible money does not.

Singapore is not “the only country with medical savings accounts.” It is the country that made them universal and mandatory for residents, then stacked insurance (MediShield Life) and a last-resort fund (MediFund) on top. Healthcare itself is mixed: public hospitals do the heavy lifting; private hospitals exist for those who pay more. Choose a subsidized C or B2 ward and you get high subsidies and team-based care in a shared room. Choose A-class or private and you get more choice of specialist — and a much larger bill, because MediShield Life is sized for subsidized wards.

Nobody is thrown out of the system for having a thin MediSave balance. An unemployed citizen still has MediShield Life, ward subsidies, family MediSave if someone will share it, and MediFund after that. What they do not get is a free upgrade to a private room and a named consultant. That is not cruelty. That is a price list.

Does it work on cost? Total current health spending in Singapore sits in a band of about 4.5 to 5.6 percent of GDP, depending on the year and the source. The United States is around 17 percent. Life expectancy is higher in Singapore — about 84 years against just under 80 in the US. Correlation is not a miracle cure, and Singapore is a city-state, not Sweden. Still: they spend less and live longer while making the co-payment visible.

Could Sweden copy the whole machine? No. Should Sweden keep pretending that more anonymity automatically means more equality? Also no. A named account would not abolish solidarity. It would make the trade-off honest: work, save, see the balance, choose the ward you can actually fund — and keep a floor so no one is denied basic care.

I started saving for my own old age before I was 25 because I never trusted the state to remember my name on the invoice. Same instinct here. Same reason I moved from living off dividends to owning a 70/30 mix I can actually see: From 100% Dividends to 70/30.

If the money has no name, neither does the waste.

Read this, then look at your last tax statement and ask one question: how much of your healthcare money could you even find if you tried? If the answer is “none,” say so in the comments — and send this to one person who still thinks an anonymous pot is the same thing as fairness.

Official explainer: MediSave, Ministry of Health.