IMPACT OF EXTENSION OF BENCHMARKS ON SURGEONS' FEES COVERING SURGICAL PROCEDURES

NOTICE PAPER NO. 1989
NOTICE OF QUESTION FOR ORAL ANSWER
FOR THE SITTING OF PARLIAMENT ON 3 JULY 2023

Name and Constituency of Member of ParliamentMr Yip Hon WengMP for Yio Chu Kang SMC

Question No. 4700

To ask the Minister for Health with the extension of the benchmarks on surgeons’ fees to cover all surgical procedures (a) what is the anticipated impact on the number of doctors who can be admitted to insurance panels, so that policyholders have a wider range of doctors to choose from; (b) whether more insurance companies will be willing to accept the benchmarks and abide by these to pay out claims; and (c) how will the Ministry ensure that health insurance costs are kept affordable.

Written Answer

The Ministry of Health (MOH)’s fee benchmarks serve as a reference for doctors, hospitals, patients and insurers, on what is considered a reasonable fee for routine and typical cases. While not mandatory, the fee benchmarks have fostered price transparency, instilled discipline in charging and helped moderate increases in fees since 2018.

Integrated Shield Plan (IP) insurers take reference from the fee benchmarks in setting their panel fees, which they have adjusted to at least the lower bound of the fee benchmarks. While MOH has encouraged them to consider the full range of the fee benchmarks, the decision on panel fees would need to be balanced against the insurer’s own commercial considerations, and the needs of the policyholders.

Panel fees aside, insurers may differ in the number of doctors they choose to empanel as it could depend on other panel selection criteria. Doctors may also choose not to be empaneled if they have a sufficiently large patient base. Nevertheless, IP panels have grown considerably since August 2021, with most having at least 500 private specialists. Under the Extended Panel initiative, policyholders may also access key panel benefits such as co-payment cap if their specialists are on other insurers’ panels and agree to the insurers’ terms.

Apart from the fee benchmarks, MOH has introduced other cost-management measures, such as minimum 5% co-payment for IP riders, the introduction of the Cancer Drug List, and the removal of as-charged coverage for cancer drug treatments. We will continue to monitor the situation and take further steps if necessary. We encourage all parties to play their part in keeping costs sustainable.