The government's healthcare system is based upon the "3M" framework. This has three components: Medifund, which provides a safety net for those not able to otherwise afford healthcare, Medisave, a compulsory national medical savings account system covering about 85% of the population, and Medishield, a government-funded health insurance program. Public hospitals in Singapore have a considerable autonomy in their management decisions, and notionally compete for patients, however they remain in government ownership and government appoints their boards and Chief Executive Officers and management reports and is responsible to these boards. A subsidy scheme exists for those on low income. In 2008, 32% of healthcare was funded by the government. It accounts for approximately 3.5% of Singapore's GDP.