Daily Lessons from Life 22 August 2014 - Health Ministry to publish total operation fees for public hospitals only

MH17 Updates - 20 of the dead flown home this morning with the whole of Malaysia falling into silence for 1 minute to pay their respects. A sad day. A grim reminder of what war or armed conflict can sometimes take away innocent lives and seemingly NOTHING can be done to the murderers! RIP.

"Health Ministry to publish total operation fees for public hospitals only - Aug 22, 2014 The Straits Times

SINGAPORE - The Health Ministry (MOH) will start publishing total operation fees for public hospitals only, Minister of State for Health Lam Pin Min said on Friday.

In his speech during the opening ceremony of the 10th Asia Pacific Congress in Maternal Fetal Medicine, he acknowledged recent concerns on the impact on healthcare costs due to the way some doctors practise and charge for their services.

"The recent public feedback has reminded us that, as members of a respected profession, doctors are expected to adhere to the highest standard of professionalism and always act in the best interest of the patient," he said.

"The Review Committee set up by the Singapore Medical Council raised the issue of determining ethical and reasonable medical fees. The matter of the ethical duties not to overcharge will be part of a wider draft ethical framework that is presently being prepared and that will be shortly sent to all SMC registered medical practitioners for their inputs."

Dr Lam added that MOH is also reviewing how best to provide more useful information for patients and the medical fraternity.

Dr Lam announced that from next month, MOH will be publishing on its website the 'Total Operation Fees', which is a component of the total hospital bill comprising the 'Surgeon Fee', 'Anaesthetist Fee' and 'Facility Fee' in Singapore's public hospitals.

In public hospitals, as most doctors are paid a salary by the hospitals, there is no direct link between the Total Operation Fee and doctors' salaries. Therefore, the data will not be further broken down into the various components, including what would have been called "doctors' fees" in the private sector.

He said that nevertheless, publishing such data for both unsubsidised and subsidised patients in public hospitals will serve as a "useful point of reference on procedure-related professional fees which are applicable to both public and private sector healthcare providers."

Dr Lam also said that MOH will also be working with the public hospitals to set up Medical Device Committees to ensure rational selection and utilisation of new medical devices, similar to the existing Pharmaceutical & Therapeutics Committees for drugs."

Another MISSED OPPORTUNITY to seize the initiative from the CITIZENS?

Lessons for me are:

1. as a first world standard government, there is this expectation that it CAN anticipate what NEEDs to be done! Maybe this is unrealistic;

2. these concerns are NOT NEW. Many writers to many of the government, public press and cyberspace forums had mentioned the need to understand what make up the total costs of hospitalisation, especially the public ones. For the private ones, honestly, the good hospital should be charging whatever the patients can bear! So, for Mr Lam to mention that the government WILL publish a bit more breakdown in public hospital bill is PROBABLY NOT going to be appreciated. The response could well be: why did you NOT do it earlier? However, the attempt to differentiate between the subsidised and unsubsidised patients' costs is a bold move to be lauded. MP Inderjit Singh once commented he was appalled at how beds in public hospitals were given to unsubsidised foreign patients instead of catering to the need of the citizens first!;

3. the medical fraternity will have to ask itself this question: how much reward a medical doctor should get is considered 'reasonable'? If we go by the 'free market' forces theory, it is again: to charge as much as the patients can bear! Much like what the very expensive, even by the reckoning of the member of the Brunei Sultan, Dr Susan Lim's charges. Money is no object as the doctor is ONE and UNIQUE to THAT particular patient!

It will be a tough question to answer even though many medical doctors do not pay themselves a million dollar a year. With the ministerial pay being benchmarked at X% to the top 5, or was it 6, professions in Singapore where doctors is one of them, it will be hard to have the TOP doctors' total compensation or rewards to come down without affecting the ministerial pay setting! Maybe this is not so desirable to have medical doctors only getting a total compensation package of S$300-500k/year when 'traders' in the banking industry gets multi-million dollar deals!

What is reasonable? You answer it!