ABSTRACT
This chapter examines the historical development of public health care and health care systems in Singapore and traces the performance of the institutional mechanisms established in the pre-reform era from 1819 to 1983. It provides important historical context necessary for understanding urban health care financing reforms in Singapore by showing that the establishment and institutionalization of public health and health care systems in Singapore were the products of Western presence in the nineteenth century and by looking at the efforts of the People's Action Party (PAP) government to consolidate and modernize the health care system inherited from the British. The historical overview of the health care system in Singapore showed that political institutions significantly affected the establishment of the health care system in Singapore. The chapter concludes by discussing the development trajectory of health care in Singapore in the pre-reform era using the lens of historical institutionalism.
