The $52,000 clinic and a free market fallacy

Last week, Dr Shaun Lum — general practitioner, and, presumably, optimist — stepped up to the table and placed a bid that would make most hedge fund managers blush. S$52,188 a month. That’s what he offered, and won, for the right to operate a clinic in the heartlands, tucked beneath an HDB block in Tampines. The news, predictably, set off a torrent of online disbelief, eye-rolls, and a kind of weary resignation that only Singaporeans can muster in the face of yet another price headline.

For some, this was an unalloyed triumph of the “free market” ideal. “See,” they assuage stubbornly, “the system is working! No one held a gun to Dr Lum’s head; he made a voluntary bid, outbid the competition, and secured the right to do business. If the price feels mad, then perhaps we’re just not ambitious enough.”

Slow down. Dr Lum isn’t some property speculator out to flip units for a quick buck. He’s a medical professional committed to providing primary care in the places where people live. His decision to put S$52,000 on the line each month isn’t the wild swing of a casino gambler; it’s the considered move of someone who knows what’s at stake.

So why does a clinic in a housing estate, a supposed bulwark of affordability, command a price that wouldn’t look out of place on Orchard Road? And is this really proof that “the market” is healthy, or is it a warning signal we’re too used to ignoring?

To be fair, Dr Lum is not the villain here. He is a protagonist trapped in a system that is quietly, efficiently, and almost invisibly raising the stakes for everyone. His willingness to pay is shaped by forces that go far beyond personal ambition or confidence in his medical practice.

The architecture of scarcity

It is tempting to shrug and say, “That’s just how much things cost,” as if price were a product of some primal, cosmic force. But anyone who has tried to open a business in Singapore will tell you: price here is less an emergent property and more an orchestration.

Scarcity, in this city, is rarely a matter of accident. The supply of retail units, especially in HDB estates, is finite by decree. The government acts as both referee and player: it releases new units by the drip, not the flood, ensuring there is always more demand than supply, more bidders than winners. When a new retail unit opens for bid, it does not go to the best proposal or the boldest new concept. It goes to the highest bidder, full stop.

What began as a system of managed supply for the public good has quietly become a system of managed scarcity for maximum yield. We are left with a peculiar hybrid — public assets governed by private market logic, but only ever on the state’s terms. The field is open, yes, but the fences are tall and the gates are few.

It is in this engineered drought that bids like Dr Lum’s make sense. When the pool is small and the thirst is great, even a rational actor will gamble big. Every round of bidding sets a new record, resets expectations, and locks in a new, higher floor for everyone who follows.

This illusion of choice has consequences far beyond the retail unit. To call what’s on offer a “market” is accurate — there are bids, transactions, movement. But scratch beneath the surface, and what you see is not a grand bazaar of possibility but a narrow corridor lined with identical doors. Having a menu of identical clinics to choose from, each priced to cover the exorbitant rent (the same document shows that Normanton Healthcare, Caring Medical, My Family Clinic (TH), and 94 Dawson Family Clinic won clinic bids at Telok Blangah, Tampines, Champions Way, Margaret Drive, and Dawson Road, with monthly rents ranging from S$13.7k to S$25.9k), is a kind of choice, but hardly the kind that builds real communities. As Indian economist and philosopher Amartya Sen reminds us, freedom is not measured by the options in front of us, but by the real opportunities those options afford.

For Dr Lum and other practitioners, the calculus is brutally clear: outbid or be outbid. Once the lease is signed, there is little room for failure, little tolerance for missteps. Every dollar that goes to rent is a dollar not spent on staff, equipment, or patient care. For patients, if every clinic is passing along the same rental burden, what difference does choice make? Prices converge. Services converge. The market has engineered a quiet, persistent sameness.

The real winner

If you follow the thread of any market, eventually you reach the hand that holds the reins. For state-linked landlords and government agencies, every successful bid is a line item on a spreadsheet — a yield to be optimised. Scarcity ensures that units rarely go empty. Bids rise, yields climb, and the “market” is lauded as efficient. But what this market is efficient at is not allocating opportunity — it’s efficient at extracting value.

Make no mistake. Dr Lum’s successful bid will ripple through the neighbourhood. Other landlords will see the new high-water mark and recalibrate their own ambitions. Competing clinics will face impossible expectations about what it costs to stay open. Meanwhile, the true price is paid not by the landlords or even by the most aggressive bidders, but by everyone who comes after — patients, families, the very people the system claims to serve.

This is not the invisible hand that Adam Smith envisioned, quietly guiding resources to their most efficient uses. It is the visible, gloved fist of market makers — those who decide how much supply is enough, how much demand is tolerable, and how much risk everyone else should bear. When the price of survival is a monthly bet larger than most people’s annual salary, what you’re left with is not meritocracy, but endurance.

But perhaps the real revelation is not that Singapore’s system fails to be a true free market, but that true free markets, with perfect information, unlimited competition, and no barriers to entry, are themselves a theoretical fiction. 

Even in less manipulated environments, markets are shaped by power imbalances, information asymmetries, and the simple fact that those with capital can always outlast those without it. The “free market” ideal assumes a level playing field that has never existed and perhaps never can. What we’re witnessing in Singapore is not a distortion of free market principles, but their logical conclusion: a system where freedom belongs to those who can afford it, and efficiency is measured not by social benefit, but by yield extraction.

Play

What are we really defending?

Step far enough back from the endless headlines, and a pattern emerges. The Singapore version of the “free market” has become less about opportunity and innovation than about yield and endurance. There’s a strange pride, sometimes, in the way we defend the status quo. We point to high rents as a measure of success, not excess; to tightly rationed supply as a sign of good governance, not gatekeeping.

Dr Shaun Lum’s S$52,000-a-month lease is not a scandal, nor is it an aberration. It’s a signpost. It tells us that in order to serve, you must first outbid; that the right to heal or feed or teach is mediated by a relentless calculus of scarcity and price. This is not spontaneous order. It’s a system designed for yield above all else.

What gets lost in all of this is the moral imagination: the simple idea that markets should serve people, not the other way around. What kind of freedom is it when the price of entry is so high that only the boldest, wealthiest, or most desperate dare apply? Perhaps this is why so many Singaporeans greet each new rental record not with envy, but with exhaustion. We sense that something is out of balance — that “market efficiency” is a cold comfort when the community is priced out, and when doctors, bakers, and barbers must risk everything for the privilege of staying afloat.

So what are we really defending when we praise this system? Is it resilience, or just resignation? Is it opportunity, or a sophisticated method of exclusion? The next time someone tells you that the market is free and that Dr Lum could have just walked away, that no one is forced, remember what that freedom actually costs. It is the freedom to bid, and bid, and bid again, until the only real choice left is who will finally blink.

Until then, the game continues. The house always wins, and the rest of us are left to wonder whether, in the grand lottery of Singapore’s “free market,” we’re the lucky ones or simply the last to lose our seat.