I share Mr David F. Grant's apprehension over inexorable rises in healthcare costs ("Rising healthcare costs: Don't let genie out of bottle"; yesterday).

With MediShield Life soon to be implemented, some take comfort that big hospitalisation bills will not wipe out their savings, as the national programme will cover the bill. But the fact is that when insurance pays, all subscribers face mounting premiums.

MediShield Life will encourage unnecessary referrals to specialists and excessive encumbrances on tertiary care. Patients will insist on using branded medicine over far cheaper but similarly efficacious generics, and redundant and expensive hospital stays over outpatient treatment, as insurance covers larger hospitalisation bills but not smaller outpatient ones.

The genie was already let out of the bottle when fee caps for doctors were deemed to contravene anti-competition laws, and removed, and when increasingly litigious patients sought astronomical compensations, and these were granted by the courts.

Yik Keng Yeong (Dr)