Many want standard fees for subsidised treatment

PHOTO: Many want standard fees for subsidised treatment

SINGAPORE - Most people here want fees for subsidised patients to be standardised, rather than have each public hospital or polyclinic group set its own rates - the way it is being done now.

Although their services are essentially the same, fees charged by such places can vary by as much as 50 per cent.

And for 87 per cent of the 349 people who took part in an online poll by The Straits Times last week, following recent fee increases at Khoo Teck Puat Hospital, this makes no sense.

Four in five who wanted a standard fee said it would be fairer to patients.

About 18 per cent said it would make navigating the public health-care system less confusing.

Only 47 people preferred to let competition dictate prices, with a handful among them hoping that higher fees would translate into better service.

Today, public health-care institutions are allowed to charge what they want, subject to approval from the Ministry of Health (MOH), which says it allows them to set their fees based on their operating costs.

A check by The Straits Times failed to turn up a subsidised health-care service which costs the same between different institutions.

When queried on the different rates, MOH said that it keeps fees affordable by providing up to 80 per cent subsidies.

It added that it "keeps watch on fee adjustments and price variations across public health-care institutions, and works with them closely to ensure that fees remain affordable and are adjusted only when necessary".

"We will be increasing outpatient subsidies for specialist care and for drugs, and there will also be additional subsidies for the pioneer generation.

"This will help to reduce fees for subsidised patients and keep them affordable," said an MOH spokesman.

While the help for the pioneer generation will reduce their out-of-pocket payment for polyclinic and hospital specialist outpatient clinic charges, they will still pay different rates at different places.

MOH did not respond to queries on whether it was fair to patients to allow institutions to set their own fees.

Dr Lam Pin Min, chairman of the Government Parliamentary Committee for Health, agreed that a standardised fee system would work better.

Different fees could affect patient choice, he said, with patients choosing cheaper options.

This could "undesirably result in overcrowding at certain polyclinics and hospital emergency departments", he noted.

Professor Euston Quah, head of economics at the Nanyang Technological University, said subsidised fees in Singapore were probably "market-driven in terms of supply and demand".

"I suspect that the demand could be much higher in some entities and this would put pressure on prices or fees to go up," he said.

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