 Patients may gain from price war
Will scrapping fee guidelines for doctors mean higher prices?
THIS week, a letter will be sent to all Singapore Medical Association (SMA) members informing them that they can no longer display the guideline of fees (GOF).
By doing this, the SMA is simply following the law of the land, spokesman Dr Tan Sze Wee said.
Last year, the SMA was informed by the Ministry of Health that the GOF may go against the Competition Act which came into effect on 1 Jan last year.
The SMA has decided not to recommend prices anymore as doing so would mean breaking the law.
So it is letting the market forces decide:
1. How much you should pay a doctor or specialist in private practice.
2. How much they can charge for drugs.
3. How much they can charge for court appearances.
But this throws up questions. Will it be good for the patients, or will it result in rising medical costs?
Most people interviewed by The New Paper think it will help the patients.
The reason: They can go to a doctor who charges the least.
SHOP AROUND
Mr Steven Chua, 32, a civil servant, said: 'There might be more price wars among doctors to get more patients, then we will benefit.
'And if I find one doctor's fees too expensive, I can always shop around for a more reasonable one.'
The talking point came about after the SMA announced that it would be abolishing the 19-year-old GOF.
The SMA, however, noted that the withdrawal of GOF will mean that patients' interests might not be better served, especially amid the rising concerns of increasing and unaffordable healthcare costs.
Some people are worried as well.
Said Ms Susan Lee, a businesswoman in her 50s: 'Who will stop doctors from charging what they want? The popular doctors may start charging more and people like us will not be able to afford their higher fees.'
But the SMA will urge members not to vary pricing practices drastically in the short term because that may lead to unnecessary increases in healthcare costs.
The SMA also expects its doctors to tell patients, before consultation, the fees which are likely to be incurred for consultation, investigation and treatment.
Most doctors we spoke to said patients may be the ones who will ultimately benefit.
FINAL SAY
Although there will be less transparency, patients will have the final say because they can always go to a doctor who charges less.
Doctors will then feel the need to keep their fees competitive.
Also, patients can always check bill sizes at the Ministry of Health website to ensure that their doctors are not over-charging.
The SMA will also be conducting a survey to find out the various fees (such as consultation) at GP clinics.
The results will be announced before the next annual general meeting.
Professor Low Cheng Hock, a former president of the SMA and past master of the Academy of Medicine, said that doctors must now adhere to 'invisible guidelines'.
'Private doctors must have their own ethical guidelines that are not too far off from what the hospital bill size website shows up,' he said.
Then patients will be able to accept the fees.
'But patients must also realise that private doctors will charge a little more,' he said.
Dr Heng Tung Lan, consultant obstetrician and gynaecologist at East Shore Hospital, said that today's patients are very smart.
'They already compare prices before they come to me for treatment,' she said.
She added that even with the GOF, many doctors did not follow it.
'I charge a lot lower than the recommended rate. I know other doctors who charge much higher.'
But the flip side is that doctors will be free to charge what they think their skills are worth and there will be no watchdog body to control them.
So should healthcare be considered as just another consumer product?
Case's executive director Seah Seng Choon said: 'We expect consumers to shop around so that they will get better value for money. They should call up clinics before going to see a doctor. The onus should be on the consumer to check and be discerning.'
He thinks it is unlikely that doctors will overcharge as they will lose patients in the long run.
He said: 'We get fewer than 20 complaints a year. Most of the complaints are disputes in pricing (where) doctors say one price, then charge another at the end of the day. (There is) a failure to itemise and break down each medicine prescribed.'
All this is a far cry from the early 1980s when newspapers here called for a schedule of fees so that there would be standard fees for all.
And it would seem that with competition, patients could well end up winners. | 
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