They can now charge as much as they think they can squeeze out of patients. Charges tend to vary, depending on the patients' addresses, whether they have medical insurance policies or are dressed expensively or wear jewellery. Foreign patients are more likely to be overcharged because they have no time to shop around. I know first-hand of an Indonesian patient who was charged $100,000 for a simple laparoscopic removal of a gall bladder, a procedure that usually costs $10,000 in the private sector. There have been enough cases of shameless profiteering to earn some private hospitals here a bad reputation.
Public-sector doctors cannot overcharge because their fees are fixed by the Ministry of Health. Many of us in the public sector have had friends, both local and foreign, ask us for advice about which doctors in the private sector they should consult. They know that without medical information, they are unable to tell which are the good doctors, professionally as well as ethically.
The current situation, with some specialists in the private sector overcharging, is bad for Singapore. The Government hopes to promote medical tourism. But news of overcharging spreads very quickly abroad. Unless action is taken soon, greed will kill the goose of medical tourism before it has had a chance to lay any egg, let alone golden ones.
Overcharging is also bad for Singapore's medical fraternity. Young doctors watch what their seniors do and will overcharge too when they enter private practice. As it is, there is already an erosion of medical ethics here - not only because of overcharging, but also because of superfluous referrals to other specialists who are one's personal friends, unnecessary and expensive investigations and even some unnecessary procedures that carry risk of harm to patients.
Medicine as a profession is a calling, and medical care cannot be treated as a mere commodity. If the medical fraternity does not act soon to cajole or coerce the black sheep among us to stop taking advantage of patients, Singapore's reputation will suffer and all its doctors will be tarred by the same brush. If we delay reforming the system, its faults will become more difficult to reverse.
Reviving the GOF would provide one solution to the problem of overcharging. It is not a perfect solution but, as with many other problems in life, there is no perfect solution. We know that the GOF will work - because it did.
The writer is Director of the National Neuroscience Institute. Think-Tank is a weekly column rotated among eight leading figures in Singapore's research and tertiary institutions.
This story was first published in The Straits Times on Oct 15, 2008.
