MOH publishes total operation fees for 65 common procedures

SINGAPORE — Operation fees for common procedures at public hospitals, such as colonoscopy and Lasik surgery, were made public today (Sept 1), as part of ongoing efforts to help patients make more informed decisions.

The move will also “allow market forces to work more efficiently”, the Ministry of Health (MOH) said today.

Since 2003, the MOH has been posting on its website the total hospital bill sizes for common conditions in both public and private hospitals.

The latest move also follows increasing calls from both medical professionals and patients to revisit medical fee guidelines in the interest of transparency. It covers “total operation fees” of 65 procedures carried out at public hospitals, based on actual hospital bills and related fee breakdowns submitted by the hospitals over the first six months of the year. “Total operation fees”, which include fees for surgeons and anesthetists, form one component of the total hospital bill.

The data offers a range of fees for each procedure, from the 25th percentile and 75th percentile, and is broken down into unsubsidised and subsidised cases.

At the 10th Asia Pacific Congress on Maternal Medical Fetal Medicine held last month, Minister of State (Health) Dr Lam Pin Min had said that the publication of data on operation fees “will serve as a useful point of reference on procedure-related professional fees, which are applicable to both public and private sector healthcare providers”.

Healthcare policy expert Professor Phua Kai Hong, from the Lee Kuan Yew School of Public Policy, said the latest MOH move may be useful in controlling fees in the short term.

“But ultimately, we must understand that the healthcare market is not like a typical free market — consumers can’t afford to ‘shop’ for services when they are in pain,” he said.

Dr Jeremy Lim, Partner and Head of Asia Pacific Region, Health & Life Sciences, at consulting firm Oliver Wyman, noted that since the data published is related to public hospitals, it may not be a useful reference point for similar procedures in private hospitals.

“The cost structure in the private sector is very different and so direct comparisons would be challenging,” he said.

He cited two main differences: Doctors in private practice get their main source of income from professional fees as they do not have a base salary; and these doctors often “incur overheads independent of the hospital facility, such as clinic rental costs and staff salaries”.

Dr Lim also suggested that the Government offer “further information on how patients should interpret and use the data”.

Dr Chia Shi Lu, Chairman of the Government Parliamentary Committee (Health), said the MOH’s move is in response to calls for published fees to be broken down into components, which is the practice for some private hospitals.

However, he pointed to difficulties in “itemising” fees in public hospitals, where a single patient is sometimes attended to by different doctors. He added that all public institutions are training institutes, and some surgery sessions may be longer in duration.

“In private hospitals, if the surgery takes two hours (as compared to one), patients pay twice the cost. In public hospitals, this is not the case,” Dr Chia said.

He also noted that patients are “typically more concerned about the total amount they need to pay”, hence the data on hospital bill size — which the MOH has made public since 2003 — may better serve their needs.