While I agree that the underlying responsibility of the Government is to ensure that every Singaporean has access to affordable healthcare, encouraging our people to go abroad for discounted treatment has its merits too ("Citizens' healthcare must remain the state's responsibility" by Mr Paul Chan Poh Hoi; Aug 28).

Singapore remains one of the most attractive destinations in the region for medical tourism, as it offers state-of-the-art facilities and English-speaking doctors and nurses.

We have carved a niche in areas such as cutting-edge cancer treatment, organ transplantation, heart surgery and fertility programmes.

However, we have failed to stay ahead of the game, as neighbouring countries have also acquired new capabilities and modern facilities. They are also significantly cheaper.

Patient mobility in Singapore is increasing.

Affluent citizens will search for the highest possible quality of healthcare, which includes going overseas to destinations such as the United States. Others may look for less expensive treatment abroad.

In recent years, there has been a rapid increase in healthcare costs due to an ageing population as well as over-treatment and overcharging in the private sector.

Coupled with the fact that patients must bear an increasing portion of healthcare costs, we have considerable financial incentives to seek less expensive care elsewhere, such as in the emerging economies of Malaysia, Thailand and India.

These developing nations actively encourage medical travel by offering fast-track visa processing for inbound patients.

Regional hospitals attempt to promote their high-quality treatment by seeking international accreditation or affiliation to renowned hospitals in First World countries. They also appear to be more upfront in their bill estimates.

In contrast, the bills provided by some private hospitals in Singapore are often perplexing and contain many hidden costs.

If a large number of patients head overseas for less expensive treatment, it will probably heighten competition among private sector providers here, which may bring overall prices down, especially in the medium to long term.

Edmund Khoo Kim Hock