Why would doctors support task force's suggestion?

The Singapore Medical Association (SMA) wrote that it supported the recommendation of the Health Insurance Task Force (HITF) for compulsory "co-insurance and deductibles so that patients engage medical services with due consideration to the cost of the service and recognise they have a stake in the decisions made" (Co-payment merely one tool to sustainable healthcare; March 14).

This is based on the assumption that patients have a relatively large degree of freedom to choose from a variety of treatment options.

This would be accurate if the organisation was referring to garden-variety medical services, which many practitioners offer.

In reality, however, patients have very few options or no choice at all in situations involving specialists' care.

These are usually the high-cost procedures that they buy riders for - to pre-emptively ensure that they can afford the enormous costs.

In obtaining specialists' care, patients are dependent on the expert knowledge of the physician in deciding which medical procedures to follow and would not necessarily adopt the less costly one if the treatment outcome was less certain.

SMA also agreed that "when IP riders were available, they were very attractive options because they provided good value for when the patient needed medical treatment" and that it does not think that "patients wilfully abuse medical services for monetary gain".

Accepting these as reasonable conclusions, why would members of the medical profession support the HITF's recommendation of doing away with 100 per cent insurance cover with riders and adopting compulsory co-payment and deductibles?

I am baffled.

Thomas Lee Hock Seng (Dr)

A version of this article appeared in the print edition of The Straits Times on March 17, 2018, with the headline 'Why would doctors support task force's suggestion?'. Print Edition | Subscribe