Surgical fee guidelines a good job half done

The recently published fee guidelines for more than 200 common surgical procedures by private surgeons in Singapore could not have come a day sooner (Opting for private surgeon? See fee guidelines; Nov 14).

Many, even specialists in the private sector, have felt that recent price trends have not been sustainable and that Singapore is beginning to lose its competitive edge in this area to neighbouring countries.

Whether regional patients return to our shores in substantial numbers remains to be seen, but the latest move can only be good if we are serious about Singapore being a centre of medical excellence - a mantra seldom mentioned nowadays.

However, the surgeon's fee is but only a portion of the patient's total hospital bill. How does knowing only this portion allow for realistic financial planning for any patient coming into our private hospitals?

Why leave this task half done? Surely private hospitals have a critical role to play in this journey towards an excellent yet sustainable Singapore healthcare.

To this end, I propose the following:

For the most common surgical procedures - for example, the top 10 procedures of each speciality - the Health Ministry should require all major private hospitals to have all-encompassing fixed-fee packages.

This will introduce real competition and offer real choices for patients and payers (employers and insurers).

With the surgeon's fee kept at reasonable levels by the recent fee benchmarks and the hospitals' fixed-fee packages, patients and their families can be confident of avoiding shocks on the day of discharge, barring unexpected complications or transfers to intensive care units.

Other components of the total fee - for instance, an anaesthetist's fee - are usually predictable as a percentage of the surgical fees.

Only if this is achieved and uncertainty alleviated will Singapore's private healthcare truly be able to enlarge the pie and be ready to compete with our fast-improving regional competitors.

We may just be able to make it, but time is of the essence.

Huang Shoou Chyuan (Dr)

A version of this article appeared in the print edition of The Straits Times on November 23, 2018, with the headline 'Surgical fee guidelines a good job half done'. Print Edition | Subscribe