Singapore: The Limits of a Technocratic Approach to Health Care

Being a tiny, easily managed polity run by Western-educated technocrats, Singapore is an ideal laboratory for those who believe that there is a “logical” answer to the problem of health-care funding in economically advanced societies. Certainly the ruling elite in this not-very-democratic country is convinced that Singapore is the epitome of a rational, technocratic state in which rule is based on supposedly impartial, objective criteria. The government's achievements in the delivery of health care are at the forefront of its showcase of technocratic achievements. This article uses the Singapore government's innovations in health-care funding as a case study to explore and test the limitations of trying to apply purist technocratic premises and methodologies to governance. The limitations it uncovers raise the question of whether a technocratic approach to governance can ever deliver the promised results and suggests that the attraction of “technocracy” is a chimera.