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Singapore-Style Healthcare (Universal + Competition)

Grade BModerate Evidence

Mandatory health savings + catastrophic insurance + price transparency. Singapore spends 4% GDP with better outcomes than US at 17%.

Rank #10 of 12 policies

Welfare Score
+40
Causal Confidence
64%
Policy Impact
54%
BH Average
72%

📊 Bradford Hill Criteria Scores

Temporality100%
Plausibility100%
Strength of Association99%
Analogy85%
Coherence80%
Biological Gradient66%
Consistency55%
Specificity38%
Experiment25%

💥 Impact Breakdown

Income Effect
+20%
Health Effect
+40%
Combined Welfare
+40

📋 Policy Details

Type
regulation
Category
health
Recommendation
implement
Current Status
US spends $4.3T/yr (17% GDP) with worse outcomes than peers
Recommended Target
Hybrid model: mandatory HSAs + transparent pricing + catastrophic pool
Rationale

Singapore: life expectancy 84 (US: 77), infant mortality 1.7 (US: 5.4), healthcare spending 4% GDP (US: 17%). Key: mandatory savings accounts + price competition + catastrophic coverage.

Blocking Factors
political oppositionindustry resistance

🔬 Evidence Assessment: Bradford Hill Criteria

The Bradford Hill criteria are nine principles used to establish evidence of a causal relationship between a policy intervention and its outcomes. Originally developed for epidemiology (1965), they provide a structured framework for evaluating whether an observed association is truly causal. Each criterion is scored from 0 to 1.

Strength of Association99%

How large is the association between the policy and the outcome? Larger effect sizes increase confidence in causation.

Consistency55%

Has the relationship been observed across different populations, settings, and times? Replication strengthens causal claims.

Temporality100%

Does the policy change precede the outcome change? Temporal ordering is a necessary condition for causation.

Biological Gradient66%

Is there a dose-response relationship? More of the policy leads to more of the effect? Gradients support causation.

Experiment25%

Is there evidence from randomized controlled trials or natural experiments? Experimental evidence is the gold standard.

Plausibility100%

Is there a plausible mechanism explaining how the policy causes the outcome? Mechanistic understanding increases confidence.

Coherence80%

Does the causal interpretation fit with existing knowledge? The relationship should not contradict established facts.

Analogy85%

Are there analogous policies that have produced similar effects? Similar interventions with known effects support the claim.

Specificity38%

Is the effect specific to this policy rather than a general phenomenon? Specific associations are more likely causal.

How is the Causal Confidence Score calculated?

The Causal Confidence Score (CCS) of 64% is a weighted average of the nine Bradford Hill criteria. Experiment and temporality receive higher weights since they provide the strongest evidence for causation. The CCS is then combined with the estimated effect magnitude to produce the Policy Impact Score (PIS) of 54%.

See the Optimal Policy Generator paper for full methodology.

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Analysis: · Optomitron OPG