Fee benchmarks facilitate charging, help payers make informed decisions

MOH reply

We thank Mr Paul Chan Poh Hoi (Benchmarks for medical fees need more teeth; Jan 19), Dr Yik Keng Yeong (Let free market mechanism set doctors’ fees; Jan 23), and Mr Edmund Khoo Kim Hock (Fee guidelines make medical charges more transparent; Jan 24) for their feedback on the fee benchmarks for medical procedures and services.  

The introduction of fee benchmarks is part of a larger strategy to keep healthcare costs affordable and sustainable as we prepare for an ageing population.

The fee benchmarks seek to encourage appropriate charging and enable patients and payers to make more informed decisions. 

Charges above the benchmarks may not necessarily constitute overcharging, as there will be circumstances where higher charges may be justifiable.

Doctors who charge above the benchmarks should, however, be prepared to justify their charges when queried by patients and payers. 

As Senior Minister of State for Health Chee Hong Tat explained in Parliament on Jan 8: “The benchmarks would help us to identify the small number of doctors who overcharge. “This is information for us to be able to use, for patients to use, for insurers to use and for the authorities, including the Singapore Medical Council, for them to be able to take action and prevent the small number from raising healthcare costs for everyone else.”

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Forum letter: Benchmarks for medical fees need more teeth

Senior Minister of State for Health Chee Hong Tat has said that the removal of the Singapore Medical Association (SMA) fee guidelines had no significant impact on medical costs (Parliament: Fee benchmark part of bigger strategy to keep healthcare costs affordable, says MOH; ST Online, Jan 8).
 
The statistics on medical inflation that he cited are most intriguing.
 
In particular, he said that government measures and subsidies have helped to reduce healthcare inflation between 2013 and 2016 to 1.2 per cent.
 
This figure does not tell the complete story.
 
Although government assistance programmes such as the Pioneer Generation Package have helped to alleviate the burden on patients, they do not directly tackle underlying increases in medical costs.
 
Between 2005 and 2015, the overall rise in healthcare costs was 30.6 per cent, outstripping general inflation of 21.7 per cent.
 
This spike coincided with the removal of SMA fee guidelines in 2007.
 
Without enforceable limits, the Ministry of Health's fee guidelines would have decidedly limited utility.
 
Last April, Beijing introduced mandatory legislation on healthcare costs.
 
This helped to ensure compliance as well as curb profiteering.
 
Singapore's approach, with guidelines meant only for general reference, is perhaps too passive, especially given the magnitude of the problem and the gravity of the subject.
 
 
Paul Chan Poh Hoi

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Forum letter: Let free market mechanism set doctors' fees
 
 
It seems unfair to single out the medical profession for special treatment after fee caps were removed and the genie has been out of the bottle and running amok for 10 years (Benchmarks for medical fees need more teeth, by Mr Paul Chan Poh Hoi; Jan 19).
 
While it is disconcerting that medical fees are stratospherically high, the same can be said of general costs of living in Singapore.
 
If the Government is to be deemed impartial, then a slew of measures must be mandated across all services and trades to rein in profiteering professionals and slay wanton inflation.
 
Architects must charge no more than a certain percentage of construction costs, lawyers must not exceed a certain fee no matter how long the court appointments drag on, car dealers cannot sell their wares at more than a certain multiple or fraction of the open market value, chief executives' salaries must be pegged to profits and so on.
 
The list is infinite.
 
But this would destroy the free economy as we know it. Doesn't Singapore pride itself on selling a product well worth its value, without artificial limits placed?
 
It is universal practice to use price mechanisms to differentiate a mediocre service from an excellent one.
 
Hence, marquee doctors in possession of unique skills, using the best equipment and catering to the elite and affluent should be allowed to charge accordingly without interference from the state.
 
The fee-regulating authorities are caught between a rock and a hard place, with no way to appease all parties.
 
 
Yik Keng Yeong (Dr)