MOH to extend benchmarking of private hospital charges beyond professional fees: Ong Ye Kung

SINGAPORE: Singapore's Ministry of Health (MOH) intends to benchmark more private hospital charges beyond professional fees, said Health Minister Ong Ye Kung.

Speaking on CNA's Deep Dive podcast published on Friday (Oct 17), he said the benchmarking - which aims to guide pricing and help prevent overcharging of medical bills - of surgeon fees has been "quite effective" thus far, with most falling within range.

The hold-up for introducing more benchmarks, which would cover other costs such as of consumables like hospital gowns, has been the "sheer amount of work" involved, said Mr Ong.

"Every benchmarking exercise is a lot of consultation, a lot of data collection, a lot of communication," he added. "It may take a couple of years, but it's something we want to do."

Mr Ong first said in July that his ministry was "studying the possibility" of going beyond professional fees, by introducing more benchmarks for private hospital charges.

At the time, he was giving the Ministry of Health (MOH)'s perspective on insurer Great Eastern's suspension of its pre-authorisation certificates for admission to Mount Elizabeth hospitals.

Great Eastern said then that the move was part of "ongoing efforts to manage rising healthcare costs and ensure long-term affordability for all policyholders", citing its observation that over the past few years, "certain private hospitals have been charging significantly more for similar treatment".

Since 2018, MOH has developed and published over 2,800 doctor fee benchmarks that providers and insurers reference in order to set fees and review reimbursements.

The proportion of cases falling within benchmarks has since gone up from 80 per cent to 90 per cent, Mr Ong said in July.

The average annual growth in private surgeon fees also moderated from 3 per cent for the period of 2010 to 2018, to 0.4 per cent for the period of 2019 to 2023.

On Friday, however, Mr Ong also noted that benchmarks alone might not suffice as a measure. 

"I'm quite sure even if we do that, the market is so complicated - you regulate here ... the cost pops up somewhere else. Then we benchmark that, (and) it pops up in a third place," he said.

"So you're sort of chasing the tail all the time, right? Ultimately, it goes back to what I say - we need to correct the distortion."

Mr Ong noted that while generous insurance riders aim to give consumers "absolute peace of mind", they likely result in higher claims, with insurers then raising premiums to cover costs.

This desire for a peace of mind is "totally reasonable", but it has caused market distortion "such that it may not be worth it anymore", he added.

"Absolute peace of mind has become too expensive because the premiums keep rising."

STAYING HEALTHY A "SAFETY NET"

Most recently, Minister of State for Health Rahayu Mahzam also weighed in on the topic last month, noting that further regulation of healthcare insurers could exacerbate trends such as escalating costs and premiums, ultimately affecting policyholders.

She said private healthcare insurance was in its current "unsustainable state" not because of collusion or anti-competitive behaviour. 

"That usually leads to supernormal profits by market players at the expense of consumers," Mdm Rahayu said. "Here, insurers are either making losses or barely breaking even on their health portfolios. The situation is due to excessive competition that has gone wrong – another type of market failure."

On Friday, Mr Ong said on the CNA podcast that the authorities would do their best to loosen and untie what he has described as a "knot" between policyholders, insurers, doctors and hospitals - but everybody else must do their part as well.

"When we need to raise taxes, we tell you so, because we need the tax revenue to expand the healthcare system. We implement policies; encourage people to be healthy. So we do our best to make sure healthcare needs are catered to," he said.

"But communities, individuals, families, have a big role to play ... Actually, the fact is that we all still have very bad health habits. We don't have to deprive ourselves in order to live healthily, but there are actually very basic habits that we can adopt just to keep all the health risks at bay."

Citing regular health screening as an example, he added that while the government can provide a "safety net" in the form of public hospital subsidies and insurance schemes like MediShield Life, the other safety net is to simply stay healthy.

"It's the cheapest and the most cost-effective, and it requires more sacrifices when you're young, but the payback when you're old is huge," said Mr Ong.

"In the end, we have to understand our own needs. Understand that absolute peace of mind is very expensive - it's becoming more and more expensive. Talk to your financial adviser, and buy insurance that caters to your needs."