SINGAPORE - The die is cast and the Ministry of Health (MOH) has made it clear that, going forward, new riders for Integrated Shield Plans (IPs), that fully pay the patient's portion of the bill, will no longer be allowed. Several health economists are now saying: "We told you so."

Experience from other countries has shown that when patients pay nothing, bills soar. When that is coupled with no guidelines on how much doctors can charge, the bills can be astronomical. Singapore, too, has seen this at first hand.