Universal healthcare should not encourage waste

The relationship between patient and doctor is an unequal one due to asymmetry of information ("Policyholders with riders run up higher treatment bills"; Oct 14).

Much of the prognosis and treatment is based on the doctor, who possesses specialised knowledge.

This may give rise to opportunistic practitioners who prescribe excessive medicine, tests and treatments out of pecuniary motives, especially in a commercial setting.

With a healthcare system where insurance picks up the tab, practitioners may be incentivised to "write their own cheques".

Some medical equipment can be costly. This may encourage indiscriminate and unnecessary use in order to hasten a good return on such high fixed costs.

Amid cost-and-benefit considerations, hospitals may also cherry-pick what ailments to treat so as to maximise shareholders' value.

Meanwhile, policyholders contribute premiums to be insured against the risks of falling ill. They are enticed to riders to further secure themselves against all health risks.

With an "it's all paid for" mentality, insured patients are encouraged to opt for the most expensive treatments.

With rising healthcare costs, it is a matter of time before insurance dries up, leading to an increase in premiums for all ("Health insurance premiums set to shoot up"; Oct 16).

Ultimately, healthcare is made less, not more, affordable to the masses, affecting universal access to an essential public good in the long run.

To sustain universal healthcare, the system should not encourage waste. There should be in-built mechanisms to guard against indiscriminate billing.

Mandatory limits on claims per year or over a policy life should be set. Patients who frivolously claim now when they are young should be barred from claiming more in their old age. This would make claimants prudent.

Larger co-payments should be required for patients to "feel the pinch" before deciding on expensive treatments.

Medicine should not be encouraged, albeit indirectly, to be practised as businesses.

While providing a universal shield against health risk is good, to make it work, we must first shield against our innate greed and selfishness.

Lee Teck Chuan