Improved healthcare for subsidised patients

'....I do know many private specialists who have big hearts ( and I am proud to call them "friend" )and who treat poorer patients at reduced rates ( or even waive charges). Sometimes we put on leotards and become Robin Hoods. We in private practice, often try to find ways to beat the Private hospital system in order to reduce patients' charges. The more obvious means include pleading with the hospital for discounts ( for patients) or even going to cheaper hospitals. Other ways cannot be divulged publicly.....' The above is an extract from Dr Huang Shoou Chyuan's blog, nofearsingapore.blogspot.com. He has written an appeal in the media's forum and copied to MOH to suggest on cost reduction and improvement in medical practice. If we have more medical professionals to step out to stamp this ridiculous and incessant rise in medical fees, they will definitely make an impact. For a start, private hospitals can price some services or ward charges lower than govt hospitals to show that it can be done. This will definitely rattle the conventional wisdom that medical cost must always go up. A case in point is Perfect Dental Clinic in Ghim Moh. I believe its charges are very competitive and should be a role model for all dental clinics to emulate. If he can charge at those competitive rates, why can't other dental clinics do so with the same facilities and qualifications for the same treatment? Private hospitals should take the lead to cut cost and blow its trumpets loudly. This is a social service and a social cause that they can together do for the average citizens.


Anonymous said...

Private GPs and private dental clinics have tried to charge lower rates few years ago. But complaints by other doctors have resulted in action by the Singapore Medical Association etc to rein in those undercutting others by charging cheaper rates. How can medical cost go down when the profession is operating like a cartel?

nofearSingapore said...


Let me put the whole SMA Guideline on Fees (GOF) thingy in the correct perspective.

SMA has had a GOF for many years ( I think there were 2 editions) and it served as a guideline to mainly prevent abuse as the healthcare industry consists of a very unequal relationship. On 1 side- doctors who have specialized knowledge about the patient’s body and ailments – on the other side the patient who is vulnerable and trusts the doctor to tell the truth ( the whole truth and nothing but the truth).

So if the ENT surgeon tells the patient that the tonsils need to be removed and the operation costs $10000 ( because the doctor is the world’s best ENT surgeon). Unless the patient has the presence of mind to exercise his rights to get a second opinion, he may just believe that surgeon that $10K is the accepted market price ( it is not).

And if the doctor has quoted $1 million and the patient has agreed to it, there is no way the SMC ( Sg Medical Council) can accuse the doctor of over-charging as it is strictly a “willing buyer willing seller” transaction. Because there is no such thing as a guideline. Because some &%$* civil servant at some Anti-Competition agency wants to put his smart theories to work.
The &%$* civil servant does not know that the healthcare industry is not the “Perfect Competition” situation that he learnt at Economics 101. It is not buying a packet of salt- he cannot shop around and pick from the shelves like he can at NTUC or Cold Storage!

So, the SMA was not the people who were being stupid- it was the civil servants ( the usual culprits). In fact the SMA was trying hard to stop them from removing the GOF!

About Private hospitals pricing below the govt hospitals – that’s another story…


Anonymous said...

Some doctors are medical professionals.

Some doctors are medical professional businessmen.

Some doctors are experimenters(patients are their guinea pigs)

Some doctors swear by the Hippocratic Oath

and some go by the Hypocrite Code.

Private Hospital charging less than Public(Privatised) Hospital(for similar treatments),

only goes to show the word 'subsidy' or 'subsidized' got to be properly scrutinized. Examine, I mean.


redbean said...

hi dr huang. your proposals show a sincere intent to do something to improve the lot of the people. this is very creditable. agree there are many issues and ways to go about it and the medical professionals are the best people to do it. the key issue is the heart. what is it that they are looking for and what is the purpose of medical profession?

my main point is that it is natural for everyone to want the best medical service but not everyone can afford it. the whole patient population and the medical profession can be segmented to cater for the rich and commercial interest and the not rich who still need to be treated. there is the govt responsibility to the people and to medical professional to earn a good living.

i do not profess to be able to give any good suggestions as it is a big issue and requires in depth knowledge and expertise to resolve it. a lot of effort is needed and with a big heart.