Late Billionaire Charlie Munger Said American Medical Costs Are ‘A Disgrace’ And That Singapore Does It Better At ‘20% Of What We Pay’

At the Daily Journal Corporation’s annual meeting on Feb. 15, 2023, Charlie Munger was asked about companies choosing to self-insure, and the answer wandered somewhere more interesting. “The cost of American medical care and medical insurance is a disgrace,” he said. “If you go to Singapore, you’ll find that they do the whole thing better than we do and it costs 20% of what we pay.”

Munger was 99 years old that day and died later that same year on Nov. 28. He was Warren Buffett’s business partner for more than four decades and vice chairman of Berkshire Hathaway (BRK.A) (BRK.B) until his death, and he had spent years complaining publicly about what American medicine costs. The remark has been quoted plenty of times since. What nobody has done is check it, which is unusual, because unlike most billionaire opinions, it names a country and a number and is therefore falsifiable.

Two claims are packed into that sentence. Singapore does it better, and for a fifth of the price. They need separate testing, because they don’t both come out the same way.

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Start with the money, on a like-for-like basis. The World Bank publishes current health expenditure per capita adjusted for purchasing power, drawn from the World Health Organization’s global health expenditure database, which puts both countries on the same footing and in the same currency. For 2023, the most recent year available for both, the United States spent $13,473 per person, and Singapore spent $6,551. That makes Singapore’s spending about 49% of the American figure, not 20%. 

One standard measure gets close to Munger’s number. Measured as a share of the economy rather than per person, the United States spent 16.7% of GDP on health in 2023, and Singapore spent 4.5%, which puts Singapore at about 27% of the American level. That is a different question from what a country spends per person, and it flatters Singapore partly because Singapore is richer and its population skews younger. It is the closest any conventional metric comes to 20%, and it is still not 20%.

The other half of the claim holds up better than the arithmetic does. Singaporeans born in 2024 could expect to live 83.4 years against 78.9 years in the United States, a gap of about four and a half years. Infant mortality ran at 2.2 per 1,000 live births in Singapore and 5.5 in the United States. On the two comparisons most often used to judge a health system, Munger’s “better” is supported. The “20%” is not.

He also said something in the same answer that almost none of the coverage carried. “And, by the way, I have no idea how to get from where we are to where Singapore is,” Munger went on, “because all the people that are getting all of that extra money fight like fierce tigers to hold onto it.” He finished: “I don’t know how to fix the costs in American healthcare. They are totally out of control.”

Berkshire, Amazon (AMZN), and JPMorgan Chase (JPM) announced a joint venture to attack employer health costs in January 2018. Named Haven, it was disbanded in January 2021 after three years. “Warren tried to fix it with Amazon and all that stuff,” Munger said in the same 2023 session. “He failed, too. Everybody has failed at it.” Five years earlier, at the 2018 Daily Journal meeting, he had gone further, calling a system that “runs out of control on the cost side” not only regrettable but “evil.” Others have kept swinging at the same target: Mark Cuban has argued that the way to fix American healthcare is to remove insurance companies from the equation, a proposition UnitedHealth Group (UNH) and its peers would presumably contest.

Since Munger said it, the number a working family actually sees has kept climbing. KFF’s employer benefits survey put the average annual premium for family coverage at $23,968 in 2023, the year of that meeting, and at $26,993 in 2025, the most recent year published, on a survey whose sample changed slightly in between. Whether Singapore costs a fifth or a half is an argument about a ratio.  

On the date of publication, Caleb Naysmith did not have (either directly or indirectly) positions in any of the securities mentioned in this article. All information and data in this article is solely for informational purposes. For more information please view the Barchart Disclosure Policy here.