Benchmarks for medical fees need more teeth

Senior Minister of State for Health Chee Hong Tat has said that the removal of the Singapore Medical Association (SMA) fee guidelines had no significant impact on medical costs (Parliament: Fee benchmark part of bigger strategy to keep healthcare costs affordable, says MOH; ST Online, Jan 8).

The statistics on medical inflation that he cited are most intriguing.

In particular, he said that government measures and subsidies have helped to reduce healthcare inflation between 2013 and 2016 to 1.2 per cent.

This figure does not tell the complete story.

Although government assistance programmes such as the Pioneer Generation Package have helped to alleviate the burden on patients, they do not directly tackle underlying increases in medical costs.

Between 2005 and 2015, the overall rise in healthcare costs was 30.6 per cent, outstripping general inflation of 21.7 per cent.

This spike coincided with the removal of SMA fee guidelines in 2007.

Without enforceable limits, the Ministry of Health's fee guidelines would have decidedly limited utility.

Last April, Beijing introduced mandatory legislation on healthcare costs.

This helped to ensure compliance as well as curb profiteering.

Singapore's approach, with guidelines meant only for general reference, is perhaps too passive, especially given the magnitude of the problem and the gravity of the subject.

Paul Chan Poh Hoi

A version of this article appeared in the print edition of The Straits Times on January 19, 2018, with the headline 'Benchmarks for medical fees need more teeth'. Print Edition | Subscribe