Mr Edmund Khoo Kim Hock's suggestion that private doctors would dish out unwanted treatment, including surgery, to meet financial targets is simplistic (Critical for private medical providers to change their ways; April 26).

The patient-doctor relationship is sacrosanct and most doctors do not betray this trust. The healthcare we enjoy in both the private and government sectors is, I dare say, world-class: It is efficient, of good quality and complementary to each sector.

The costs of such care, nonetheless, cannot be ignored.

Medico-legal concerns have invariably led to more investigations being ordered today, compared with just a decade ago.

There is no basis to say that doctors over-investigate because of referral fees from hospitals. Doctors receive no such fees from hospitals.

For a start, insurance companies are hardly the bastion for healthcare cost containment.

As private entities themselves, they have sold and profited from shield plans and promoted riders freely over the last 20 years.

Now, with a rising population armed with such policies maturing, it is no wonder that claims have risen - more people, more of them sick and invariably larger bills in a country that boasts state-of-the-art equipment and the best medicines available.

Medical tourism was a buzzword until only recently. I wonder if that has contributed to the bigger bills of today.

The Competition Commission of Singapore ruled in 2010 that having a guideline of fees was anti-competitive, akin to price fixing.

Thus, while change may be needed, a rational approach in identifying the true costs of rising healthcare is more critical as the problem is far more complex than doctors' fees alone.

Ernest Wang (Dr)