Two issues contributing to over-servicing in healthcare

Recent discussions on reining in healthcare costs have centred on the recommendations of the Health Insurance Task Force, the reintroduction of medical fees benchmarks and the abolishment of full riders (Keeping insurance premiums affordable, Dec 1, 2017; Fee guide helps treat health costs; Dec 7, 2017; MOH move will help curb huge premium increases, March 8; and Diagnosing the cause of rising costs, March 25).

But it seems as though two other solutions which could help tackle the problem of over-servicing are being ignored at this critical juncture.

First, the issue of separating the prescribing and dispensing of medicines seems to have been quelled after robust debate more than a decade ago (Separate drug dispensing: Educate the public first, by Madam Halimah Yacob; Sept 26, 2007).

This topic seems to have been effectively consigned to oblivion now, despite the fact that several countries, like the United States, Australia and South Korea, have successfully implemented such a system.

The second issue is whether healthcare firms should be publicly listed.

Unlike other for-profit sectors, listed healthcare firms face the irreconcilable conflict of whether to put patients or shareholders first.

As revenue-maximising enterprises, the daily, recurring temptation of recommending more tests or longer stays, suggesting the more-lucrative surgical procedure over medical interventions, and referring a patient to multiple specialists under the same corporate umbrella will be tough to resist and even more difficult to detect or police.

There are no easy solutions to manage these two problems.

But if healthcare players are genuinely concerned about doing the right thing rather than doing things right, no stone should be left unturned in tackling overcharging, over-consumption and over-servicing in healthcare.

The time to act is now.

Li Ze Zong

A version of this article appeared in the print edition of The Straits Times on April 04, 2018, with the headline 'Two issues contributing to over-servicing in healthcare'. Print Edition | Subscribe