In 1987, the Singapore Medical Association introduced fee guidelines for doctors in the private sector to act as a restraint on their charges.

Unfortunately, in 2010, the Competition Commission of Singapore ruled that these guidelines infringed on free-market competition and abolished them.

Since then, doctors have been free to charge as they wish and there have been cases of overcharging. The cost of medical services in the private sector has also seen phenomenal increase since then.

The move to make private surgery fees public will have limited impact ("Listing of op fees at private hospitals helps patients" and "More transparent fees 'a positive step'"; both published on Oct 6), as the fee-for-service model offers unbundled services that are paid for separately.

This may encourage some doctors to offer more non-surgical treatments, since payment is dependent on the quantity of care given.

There will always be black sheep in any profession. Unscrupulous doctors know they are in a position to charge whatever they fancy by preying on patients' fear, misery and lack of medical knowledge.

Some doctors also indiscriminately charge higher fees, knowing that insurers will cover them 100 per cent.

Patients should protect themselves by clarifying the fees before agreeing to any procedure.

If they believe the charges are unreasonable, they may get a second, or even third, opinion.

However, ultimately, the sick are at the mercy of their doctors. They may not be in the correct frame of mind nor possess the time or knowledge to compare prices.

In the presence of imperfect competition, medical care must not be dependent on market forces, and the Competition Act should not apply to healthcare.

Edmund Khoo Kim Hock