Soaring healthcare costs are a major worry in many countries, especially in fast-ageing ones like Singapore. Any move that boosts transparency in healthcare charges and helps rein in fee hikes would be welcomed by both patients and insurers. The challenge is how to do so impartially and without hurting competition in the medical sector. A decade after fee guidelines set by a doctors' association were scrapped for being anti-competitive, Singapore will institute new ones from next year to be overseen by the Ministry of Health. The new benchmarks will take the form of a reasonable fee range and be determined by an independent committee based on data of actual transacted fees, their distribution and the nature of the procedures.
The aim is to help consumers make more informed decisions, as is right because buyers of medical services can be especially vulnerable when faced with what seems like a choice between recovery and ill health or perhaps even death. Without assuming that doctors exploit patients, it is important for the authorities to have a hand in regulation so that anxiety over serious health problems does not lead to patients paying whatever is demanded of them.
At the moment, private-sector fees for medical procedures can range widely, with doctors free to charge what they like. Last year, the Health Ministry received 23 complaints of overcharging, mainly by private practitioners. While doctors are ethically bound not to overcharge, it is difficult to say for certain what amounts to excessively high fees if they cannot be measured against any yardstick. That explains the many calls over the years for a guideline, which have now been finally heeded. The move is long overdue.
The fee benchmark gives the Singapore Medical Council a norm with which to work in the event of complaints. While doctors are not required to follow the planned benchmarks, they, too, stand to benefit from greater clarity on what the sector deems to be reasonable fees. Some doctors hope that the black sheep who have given the profession a bad name by overcharging will now be exposed, especially as high fees are not necessarily a sign of better quality. It is here that the benchmark will play an educative role. Patients will know what to expect in terms of the range of fees, while being assured of the quality of care.
Ultimately, the goal of healthcare policy must be to maximise value to patients. This means achieving the best outcomes at the lowest cost. It is a complex challenge because it involves addressing a myriad of interconnected factors in providing patient care and treatment. Fee guidelines are a step in the right direction. They can help address cost concerns provided they are well crafted and are seen as fair by both doctors and patients.
