I'd guess drug abuse there for example is far lower than other western countries - do drugs there and lose you life promptly - no slow death through the health care system costing lots of money...
I'd also guess Singapore has a very stable homogeneous population as in practically zero immigration.
Another detail rarely mentioned is much of the medical technology used in other countries is developed in the United States where American citizens pay for that development and other countries get the benefit without the heavy front end investment/cost.
Nope. Singapore has a diverse, though largely Asian, population, with considerable immigration (also Asian), although they try to control it.