Forum: Doctors on insurance panels deserve to be fairly remunerated

AIA Singapore medical director Alan Ong alluded to collaboration between doctors and insurers as an important aspect of controlling healthcare costs (The coming healthcare crisis: Unsustainable financing, March 7).

The Singapore Medical Association agrees.

However, collaboration is a two-way process.

Currently, doctors on insurance panels have their fees unilaterally determined by insurers, with most fees pegged substantially below the doctors' usual rates.

While it is reasonable to set a cap on doctors' fees, doctors deserve to be properly remunerated.

In deciding on fair remuneration for doctors, we suggest that the insurers refer to the fee benchmarks published by the Ministry of Health.

The insurance industry, via the Health Insurance Task Force, provided the initial backing for these benchmarks.

Unfortunately, many insurers have not adopted them but instead offer remuneration rates below the lower bound of the benchmarks.

Dr Ong also mentioned that insurers steer higher volumes of patients to panel providers, which may certainly benefit doctors on the panel.

Our concern is that in order to achieve an adequate volume of patient referrals, insurers tend to limit the number of doctors on their panels.

Patients may be unaware that this limits them in their choice of healthcare provider.

This could pose a practical problem: In the event of an emergency where timely treatment is essential, it may be difficult to find a panel doctor who is able to attend to the patient at short notice.

We support the efforts of insurers in maintaining the affordability of insurance premiums.

However, patients should not be unduly restricted in their choice, and doctors should be dealt with fairly.

Our view is that if fair remuneration is provided, more doctors will come on board, and patients will benefit from being able to choose from a wider pool of providers.

Along the same lines, insurance panels should not be closed panels that benefit only a select group of providers.

Also, some efforts should be made to address the larger issue of hospital and facility charges, as these may take up more than half of the cost of a hospitalisation encounter.

Lee Yik Voon (Dr)

President

Singapore Medical Association