Changes to health insurance must benefit all stakeholders

Patients and staff at the main waiting area of the Accident and Emergency Department of the newly opened Ng Teng Fong Hospital.
Patients and staff at the main waiting area of the Accident and Emergency Department of the newly opened Ng Teng Fong Hospital.PHOTO: SPH

I thank Ms Pauline Lim, executive director of Life Insurance Association, Singapore, for her response to my earlier letter and for agreeing with me that more can be done to improve efficiencies to keep healthcare coverage affordable for Singapore residents ("Managing claims costs can keep health insurance sustainable"; Tuesday).

I agree with her that we need insurers, doctors, healthcare providers and regulators to come together to address the issue.

Unfortunately, given that the vested interests of each of these parties are very different, I am not confident that the recommendations made by the Health Insurance Task Force will make much difference.

More transparency on doctors' charges will not solve the conflict-of-interest issue.

What incentive is there for doctors and other medical providers to lower their charges and hurt their own pockets, when lower charges benefit the insurer's bottom line ("Limits set by insurers tie doctors', patients' hands" by Dr Chong Jin Long; last Friday)?

Policyholders pay a premium to buy the coverage they require.

They can consume only what they pay for.

Insurance companies will not pay beyond the policy limit or coverage.

If there are no claims or there are savings in claims costs, the insurer is the party that benefits.

It is hard to see how policyholders will opt for cheaper treatment just to lower costs for insurers.

More importantly, Ms Lim has not addressed the direct concerns of wastage caused by the duplication of health insurance cover between employee group benefits programmes and Integrated Shield plans ("Rethink 'two premiums for one risk' practice" by Ms Fong Hang Yin; yesterday).

In a game where the rules are seen to largely benefit only one party - the insurer - you can be certain the other parties will find ways to circumvent the rules and not lose.

The insurance industry needs to disrupt itself by changing the rules of the game so that other stakeholders can be assured of benefits too.

Patrick Tan Siong Kuan

A version of this article appeared in the print edition of The Straits Times on October 27, 2016, with the headline 'Changes to health insurance must benefit all stakeholders'. Print Edition | Subscribe