Push for medical fee guidelines is a move back in right direction

In 2007, when the Singapore Medical Association (SMA) had to withdraw its Guidelines of Fees, so as not to contravene the Competition Act, it did so most reluctantly. I was the SMA president then.

Dr Yik Keng Yeong, in his letter (Let free market mechanism set doctors' fees; Jan 23), questioned the need for doctors' fees to be put under the spotlight of the Health Ministry's Fee Benchmarks Advisory Committee.

Would this undermine competitive forces and the free market economy, he wondered.

The defining characteristics of an honourable profession include: a group of people who have undergone extensive education and training and, hence, possesses special knowledge and skills and is recognised as such by the public.

The profession applies this knowledge and skills in the interest of others, and it adheres to ethical standards.

The medical profession has all these defining characteristics and, therefore, should not live by the bread of economics alone, lest the profession becomes a trade.

Competition and the free market are but means to an end.

The ultimate end of any public policy is the creation of greater societal well-being over the long term, such that all stakeholders can co-exist in a sustainable way.

The stakeholders here are the patients, healthcare establishments, healthcare professionals, and insurance and managed care companies, among others.

In the last 10 years, without the SMA fee guidelines, things have been "running amok". This cannot be good for stakeholders and Singapore.

There are limits to economic theory, free market or otherwise, especially when applied to healthcare.

A certain set of misguided values and beliefs were in play when the SMA guidelines were outlawed in 2007, resulting in the miasma of the last 10 years.

The current initiative to have fee guidelines and benchmarks is but a return to the correct trajectory which we had enjoyed before.

Wong Chiang Yin (Dr)

A version of this article appeared in the print edition of The Straits Times on January 25, 2018, with the headline 'Push for medical fee guidelines is a move back in right direction'. Subscribe