The unfortunate case of a man for whom bariatric surgery went wrong should prompt the Singapore Medical Council to consider making insurance coverage for doctors compulsory. It has not done so as yet, although the law allows it to impose that requirement. This would appear intriguing, not least because all public sector doctors are insured and backed by the hospital. The situation is different in the private sector but, even there, the majority of doctors do insure themselves. Since they do so for good reason, the question is: why isn't insurance made mandatory? Surely it cannot be the case that doctors who do not insure themselves are so certain of their professional skills that they consider coverage unnecessary. If that were to be so, insured doctors would be acknowledging a relative lack of proficiency - an absurd idea and one hardly designed to draw patients to their clinics.

Insurance protects doctors from the possibly heavy penalty of lawsuits when outcomes go awry for patients. In the present case, the doctor was insured as a surgeon but he claimed not to have known that bariatric surgery required an additional premium. He has since raised his coverage - making the perfect point for comprehensive insurance in the first place. It gives doctors the financial peace of mind they need so that they can focus their skills and care entirely on the patient's medical condition without having to worry about what could go wrong inadvertently.

For patients, whether doctors are insured can make a substantial difference to their chances of recovering financially from medical catastrophes. The bariatric surgery patient was covered by his right to claim from the doctor or clinic (unless the doctor is bankrupt and not covered by his employer). In his case, the doctor owns the clinic and does not have much money. Hence, the patient settled for less than half the cost of his medical bills. A solution might lie in private sector patients opting for surgery performed only by insured doctors. But most patients would hardly make the effort to check insurance details when, habitually, they trust their doctors' professional expertise and the economic ecosystem in which professionals operate. "Caveat emptor", let the buyer beware, is not a good principle to apply to doctor-patient relationships because they are different from ordinary commercial transactions.

Certainly, Singapore would not wish to encourage the appearance of a litigious society that tempts patients to sue doctors for every perceived fault in treatment. That is an unwanted extreme which could be created by awareness that doctors are covered by adequate insurance. If insurance premiums soar, so will healthcare costs. However, the courts can be relied upon to balance both justice and public policy considerations when considering claims of medical negligence.