Forum: Open insurers' doctor panels to all specialists as long as fees are reasonable

Two recent changes in private hospitalisation insurance have drawn consumer reactions.

First, some existing Integrated Shield Plans (IPs) will require all policyholders to co-pay their bills (MOH welcomes insurers' move to adjust terms for full-rider IPs, Feb 17). Also, such co-payment will be capped only if policyholders go to an IP panel doctor.

One Forum letter writer pointed out that choices within IP panels are very limited (List of approved doctors too restrictive, Feb 19).

A doctor in his Forum letter spoke of his long-term patients needing to find a new surgeon, as he had been rejected when trying to join the panels (Long-term patients had to look for new doctor on insurers' approved lists, Feb 22).

Another letter proposed opening panels to all doctors, subject only to reasonable fees charged (Let doctors join panel if their fees are reasonable, Feb 26).

Are many affected?

As of late last year, each IP panel had only about 20 per cent comprising private specialists.

Some specialities were under-represented and one panel restricted selection of specialists by hospital practice.

In a recent survey of private specialists, the Singapore Medical Association (SMA) found that up to 34 per cent of respondents had been unable to join panels when they tried; 53 per cent of respondents had more than a quarter of their patients needing to change doctors because of panel issues; and 57 per cent had experienced inability to refer patients to an appropriate panel specialist.

This suggests that a significant number of "old patients" may now find their private specialist healthcare options more limited. They could suffer from reduced coverage of hospital bills, poorer pre- and post-hospitalisation benefits, or higher future insurance premiums, if they see a non-panel specialist. They cannot change insurers easily because conditions that had since surfaced would be considered "pre-existing".

Invest editor Tan Ooi Boon stated that "patients are the most vulnerable among all stakeholders", and that "patients who see doctors with reasonable fees that are within the Government's benchmark deserve full support too" (When cash is needed for those big hospital bills, Feb 28).

SMA welcomes the Life Insurance Association's assurance in this matter (Insurers' doctor panels being expanded; contract changes must be approved by MOH, Feb 27).

SMA recommends that panels be open to all specialists as long as they charge reasonably. This could be implemented for the benefit of patients without delay. Reasonable charges are already found in the MOH fee benchmarks.

Ng Chee Kwan (Dr), 1st Vice-President,

Singapore Medical Association

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