As you know, the hospital bills have been getting bigger and bigger. Private medical insurance premiums have been climbing rapidly over the last 2 years.
In any case, all 6 insurers lost money on their medical insurance pot. That meant claims were more than premiums!
So how to combat medical inflation in Singapore?
The Ministry of Health (MOH) started working on this issue several years ago as to why health insurance premiums was rising so rapidly.
It's detailed report was released in 2016, highlighting possible causes and solutions. This new fee benchmark helps to tackle the issue of over charging especially by private doctors.
How does the new MOH benchmark regulate hospital fees?
There was a case where a lady ran up a bill of more than $70,000 to remove a small breast lump. The procedure generally costs $5,000 in the private sector.
With this new benchmark, surgical fees will be more accountable.
From my interpretation, fees can still be outside of the benchmark if the doctor can justify it with experience, complexity, special material, extra monitoring etc...
But I definitely think more accountability will help to keep medical inflation low.
It adds on to the previous rule change for the riders of Integrated Shield Plans (IPs)
This previous step was taken in March2018.
MOH changed the rules to disallow 100% riders to be purchased by the public.
Why?
It was discovered that claims for treatment at private hospitals were 60 per cent higher than people with the same IP but no rider.
It was not that people claiming were old and sick, they were generally younger and healthier.
This suggested one thing: If it's fully paid by my insurance, anyone will choose the expensive treatment!
I had a friend who did a knee anterior cruciate ligament ACL reconstruction at Mount Elizabeth.
His fees came up to be $21k plus! But it was fully paid by AIA (his insurer).
I'd suggested for him to consider doing it with SGH. The bill will still be fully paid and he can get a few hundred dollars in daily cash compensation! He flatly rejected the idea....
The MOH is giving insurers until April 1, 2019, to come up with new riders that include the co-payment and cap. At that point, no full riders for IPs can be sold.
To prevent people rushing out to buy full riders, new policies have to switch to the co-payment style by april202.
I agree that co-payment should improve personal responsibility to choose appropriate and necessary treatment. This should help in slowing healthcare costs not only for those with such riders, but for all of us.
On a side note, the MOH has not mandated any change for the 1.1 million people who already have full riders for their Integrated Shield Plans (IPs).
The problem of "over diagnosis" may still persist
In some published cases of over diagnosing, there was a patient that made claims for 12 nose scopes in a year!
And there was no clear medical need to do so.
There were another case where a patient was admitted for one problem and was then seen by a host of other unrelated specialists. Extra scans and tests were done.
The bills chalked up to $25,000 for a hospital stay that was less than 24 hours!
A surgical fee benchmark and a co-payment scheme still may not solve this problem because any patient would be scared of turning away recommended treatment.
In conclusion
The new MOH surgical fee benchmark should go a long way to help. I am glad that steps are taken to combat medical inflation.
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