SINGAPORE: Patients can soon look up a recommended range of medical fees to help them decide where they should go for a procedure.
The Ministry of Health (MOH) will appoint a committee by early next year to come up with fee benchmarks.
This is part of the ministry's approach to ensure a sustainable healthcare system in the long term as the nation grapples with manpower constraints and rising costs in the healthcare sector, said Heath Minister Gan Kim Yong at a meeting with journalists on Tuesday (Nov 28).
“This will allow the service providers, the doctors, to have reference, a sense of what is the reasonable range of fees they should be charging," said Mr Gan.
"This benchmark will also allow patients to make informed decisions with regard to the type of services they would like to consume.’
He said that there will be a range of fees that take into account factors such as the complexity of a medical case and the varying expertise of doctors.
At present, the public can go on MOH's website to find out what patients pay for certain medical procedures at the various hospitals.
Mr Gan also said he does not believe the move is anti-competitive as the fee benchmarks will be set by a committee comprising public and private healthcare institutions and government officials.
This input from various stakeholders is meant to reflect actual practice on the ground and the committee will then determine what is considered a reasonable range.
The fee benchmark will be rolled out in phases from next year and will cover most of the medical procedures. The committee could also appoint special working groups to look into the various specialties.
The fee benchmark is meant to be a reference point and not a guide that practitioners will have to adhere to, he said. Even after the fee benchmark is introduced, a doctor can still charge above the recommended range. But should he face disciplinary action, it will be used as a point of reference by the Singapore Medical Council.
“This fee guidance will also be useful as a reference to the insurance companies and patients,” said Mr Gan.
"CHALLENGING" TO COME UP WITH BENCHMARKS
The move to introduce medical fee benchmarks is not new - it was part of a list of recommendations in 2016 by an industry-led work group, the Health Insurance Taskforce, to improve the transparency of medical costs and tackle any over-charging by providers.
In response to media queries, the Life Insurance Association, which had led the call for such a recommendation a year ago, said that medical fee benchmarks are a key step to enhance the transparency of medical costs in Singapore and will provide the market a baseline to assess what are reasonable charges.
Dr Fatimah Lateef, a member of the Health Government Parliamentary Committee, said the move will lead to a review of fees by public and private healthcare institutions and allow consumers to do what she called "comparative shopping".
However, she warned that coming up with the range of fees will not be an easy task for the committee. They will have to look at costing in the local sector, as well as the regional and international costing since Singapore is a medical hub,
“The committee is going to have quite a challenging task looking at these. And with the figures that will be published, it's something that will be valid for several years so therefore we want to make sure it is robust and competitive as well," said Dr Fatimah.
She also anticipated a spike in complaints by patients in the initial period after the fee benchmarks are rolled out. She said the public must realise that there are numerous factors which affect cost.
“There are going to be charges which fall outside the range. This doesn't mean that the practitioners who charge those fees are wrong or unethical so we should look at this on a case by case basis with some flexibility," said Dr Fatimah.
This is a view echoed by private practitioner Dr Desmond Wai who cited complications that might arise during surgery as a possible factor.
However, he said the move will relieve patient anxiety on charges especially when it comes to more expensive procedures.
However, there could be a possible downside.
"Some patients may also feel that if a doctor is charging at the lower end, maybe his skill is also at the lower end. Of course, that is not true. How much a doctor charges has no direct relation to how good or bad he is. If a doctor is good but his fees are at the lower end of the range, he might decide to move it up to at least the middle, or even the high end, so patients won't feel his skills are not up to par," said Dr Wai.
When approached, Parkway Pantai which manages Mount Elizabeth and Gleneagles hospitals, said they have been publishing historical prices of common procedures on their website since 2013.
“We also later introduced fixed price bundles for many common procedures like endoscopes and cataracts. These bundle prices, which include both hospital and doctor fee components, help provide consumers with greater certainty and peace of mind over their hospital bills,” said Mr Phua Tien Beng, Acting Chief Executive Officer, Singapore Operations Division, Parkway Pantai.
The Singapore Medical Association, which represents the majority of medical practitioners in both the public and private sectors, said that apart from fee benchmarks, other important initiatives would include educating the public and insurance product redesign, to help mitigate rising healthcare costs in Singapore.