Don't fuel cost increases in dental care

An elderly patient getting a dental treatment.
An elderly patient getting a dental treatment.PHOTO: ST FILE

Results of a survey released by the Singapore Dental Association showed that 89 per cent of respondents were concerned about the cost of dental care in Singapore.

As a Singaporean dentist with a background in healthcare management, I believe there are several reasons behind the rising costs of dental care in Singapore.

First, dentists have to factor in the cost of getting a degree in dentistry, renting the premises and hiring staff - all of which have gone up by about 300 per cent since 2003. These costs are passed on to patients to keep practices viable.

Second, dental care has moved from a "fee for service" model to one that is closer to "welfare and insurance", following the introduction of Medisave use for some dental procedures, as well as the start of the Community Health Assist Scheme (Chas) subsidies in 2012.

Last year, a total of $64 million was given out for dental care under Chas (Changes to Chas dental subsidies from November, May 1).

While the availability of claims and funding converts needs into demands in a positive manner, it also inevitably drives the situation into over-consumption and over-prescription, increasing the costs of dental care.

This is especially so in healthcare, where information asymmetry between patients and providers is typically much more pronounced than in most other areas.

A dentist holds more information over a patient, which results in dental care decisions that are never unbiased.

The phenomenon exists in all healthcare systems, but it is more pronounced with the availability of insurance and subsidies.

The Singapore Dental Council's (SDC) proposal to require dentists to acquire certificates of competency for certain procedures will only exacerbate the cost of dental care for patients.

The cost of getting the certificate will be passed on to patients, and Medisave claims will be limited to a small group of dentists.

It is important for stakeholders in dental care - the SDC, dentists and patients - to work objectively towards improving the already high quality of dental care in Singapore and containing the costs of dental care in line with Singapore's economic situation.

I urge the SDC to focus resources and energy on understanding the changing dental care needs and demands of our population, and to make appropriate information available to the public to empower Singaporeans to make more informed choices about dental care.

Wilson Goh (Dr)

A version of this article appeared in the print edition of The Straits Times on September 23, 2019, with the headline 'Don't fuel cost increases in dental care'. Subscribe