Forum: Other factors besides doctors’ fees that contribute to healthcare costs

We refer to Mr Francis How Chee Kuen’s letter, “

Holistic approach needed to tackle cancer care costs

” (May 2).

Finding a solution to this multi-faceted issue should be our paramount concern. Simplifying the issue by an unsubstantiated isolation of the cause of rising healthcare costs and insurance premiums to one party derails our collective mission to work together to serve our cancer-stricken patients.

Mr How wrote that “doctors have been charging high prices for their services, leading to insurers increasing their premiums”, and consequently “premiums will continue to rise if doctors overcharge or mark up prices”.

There are many factors that determine the fee that a doctor charges. In a 2007 circular to our members, we advised that the charges levied by doctors on patients should be appropriate and within reasonable limits dependent on a few factors, such as the skill-set, competence, experience and specialities of doctors.

It is unsubstantiated to attribute insurance premium increases to doctors’ fees when other factors that contribute to rising healthcare costs remain unchecked, such as the cost of drugs, hospital facility fees, and distribution costs of insurance plans.

Mr How gave an example of his client who was treated with a medication for which he was charged $5,000 a month at a public hospital. Based on information that we obtained, a large proportion of the charge could be attributed to the cost incurred by the hospital to purchase the medication.

Nonetheless, the absolute quantum that his client has to pay is considerable, and is aggravated by the fact that the medication is not subsidised.

We sympathise with his client’s situation and subscribe to taking a holistic approach to help patients with the high cost of their cancer medications. These include patient counselling on medication options, inclusion of more medications on the cancer drug list, as well as multilateral efforts to lower the cost price of cancer medications.

The last point is crucial for clinics in private healthcare institutions, which continue to be charged higher costs for cancer medications compared with their counterparts in the public sector.

Ng Chee Kwan (Dr)
President
Singapore Medical Association