Many benefits to fixed-fee surgical packages

I agree with Dr Huang Shoou Chyuan that fee benchmarks for surgical procedures in private hospitals still leave informed patients guessing (Surgical fee guidelines a good job half done; Nov 23).

As long as the healthcare industry operates on a commercial for-profit basis, it should be subjected to fair business practices to compete under a free-market competitive environment.

The current model fails to protect the interest of patients as it emphasises performance-based pay and the idea that healthcare providers should compete based on delivering good outcomes.

There are many valid reasons why the all-inclusive fee package model is good for the community and healthcare industry.

First, it would ameliorate the asymmetry in medical information. Patients cannot verify if medical treatment has been provided competently. More tests, X-rays and examinations only pile up profits for hospitals and doctors.

As patients, employers and insurers are paymasters, it is equitable to transfer some risks to providers to avoid unnecessary tests, procedures and defects.

Second, an all-in package deal would level the playing field to moderate ever-rising healthcare costs.

It will coerce hospitals to make accountability a priority to ensure surgical procedures are done with best practice and to reduce costs through reduced errors and complications.

This model is not new. Many healthcare groups in the United States even offer quality assurance in coronary artery bypass grafts or hip and knee replacements with a 90-day warranty to cover specific complications or hospital admission.

Perhaps the public healthcare clusters could offer all-in packages for a limited range of surgical procedures and chronic ailments to entice private hospitals to follow suit.

This model will nudge all hospitals to re-organise their resources to assemble competent teams of surgeons and medical experts to deliver quality outcomes at moderated prices. It will also eventually lead the healthcare industry to find its own price level and offer a fair deal for patients, employers and insurers.

Paul Chan Poh Hoi

A version of this article appeared in the print edition of The Straits Times on November 29, 2018, with the headline 'Many benefits to fixed-fee surgical packages'. Print Edition | Subscribe