This paper assesses Singapore's healthcare financing arrangements in terms of their efficiency, fairness, and adequacy. Singapore represents an interesting case study because it is perhaps the only high-income, rapidly ageing country to rely on mandatory savings to finance healthcare, thus eschewing extensive risk-pooling arrangements, generally regarded as efficient and equitable. The paper argues that parametric reforms, i.e. relatively minor changes in the parameters of current schemes which preserve the existing philosophy and system design, will not be sufficient to meet healthcare financing objectives. Systemic reforms, which will bring Singapore into the mainstream of health financing arrangements found in the OECD countries, are urgently needed. Their design and timing should be based on good quality, timely and relevant data, and an environment conducive to vigorous debate.F i nanc ing healthcare rep re sents an im por tant long-term fis cal chal lenge glob ally (Heller, 2003). 1 In high-in come coun tries, re tire ment and healthcare fi nanc ing mech a nisms are sep a rated. Each uses a mix ture of so cial risk pool ing (though its ex tent and cov er age vary), tax a tion, man da tory employer-em ployee pro vi sion, pri vate in sur ance, tax-ad van taged vol un tary sav ing, and out-of-pocket pay ments (Econ o mist, 2004). Among the highincome East Asian na tions, Ja pan, the Re pub lic of Ko rea, and Tai wan (China) have adopted so cial risk-pool ing in sur ance pro vi sion with universal cov er age (Ii, 2005;Ramesh, 2004). 751. Other phe nom ena with sig nif i cant fis cal chal lenge iden ti fied by Heller (2003) are re tirement, cli mate change, in fec tious dis eases, and tech no log i cal changes.The ar ti cle has bene fited con sid er ably from use ful com ments by the anon y mous ref er ees. We would also like to thank M. Ramesh and M. Gautrey for their help and sug ges tions. The usual ca veat ap plies.Un less oth er wise noted, dol lar ref er ences are to Sin ga pore dol lars. In Au gust 2005, US$ 1 = S$ 1.67; €1 = S$ 2.00 approx.

Singapore represents an instructive case study in responding to rapid ageing, growing inequalities, and significant relative poverty. Unlike other high-income Asian countries, it has relied on single-tier mandatory savings to finance retirement, housing, and to a lesser extent, healthcare. To address the low fertility rates, it has permitted the share of the non-citizen population to triple between 1990 and 2005 to nearly 30 per cent. This is subtly altering Singapore's socio-political dynamics, while assisting in sustaining growth and competitiveness. The paper argues that Singapore has the fiscal, institutional, and organizational capacities for a modern multi-tier social security system. Singapore is, however, determined to continue with current inadequate and inequitable arrangements, requiring individuals and their families to bear disproportionate risks in financing retirement, healthcare, and short-term income support. This reflects conscious policy choices arising from a Darwinist vision of society, and the need for socio-political control.Singapore, an affluent 1 and rapidly ageing city State, has pursued a strategy of high-growth, 2 high net immigration, and minimal social risk-pooling elements in its social safety nets to manage globalization. As

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Most emerging market economies intend to attract foreign direct investment (FDI), expecting that efficiency spillovers from FDI positively influence the productivity of domestic firms. The Indian automobile industry has been a key beneficiary of FDI, ever since the economy opened up since the early 1990s. Employing a stochastic frontier analysis (SFA), this paper first compares the technical efficiency of foreign firms (FFs) vis-à-vis domestic firms (DFs) in the Indian automobile industry for the period 2001-2014. Second, the paper identifies the key determinants, which explain the differences in technical efficiency between FFs and DFs. Finally, the paper analyses the transmission of spillovers from FFs to DFs in terms of competition, demonstration, and information effects. The results reveal higher technical efficiency (TE) of foreign firms over the domestic firms; that younger firms, both domestic and foreign, were relatively more efficient; and domestic automobile firms did not benefit from exporting activities, mainly due to their inward-orientation. The analysis in this paper suggests that the spillover effects is prominent only through demonstration effect. The competition and information effects are not significant channels for transmission of spillovers from foreign to domestic firms in the Indian automobile industry.