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First tranche of medical fee benchmarks slated for release in second half of 2018

SINGAPORE — In the second half of this year, a 13-member committee looking into fee benchmarks for medical procedures and services is set to release its first round of benchmarks for common medical procedures such as surgery for cataract and appendicitis.

Patients waiting for their names to be called out at a polyclinic. TODAY file photo

Patients waiting for their names to be called out at a polyclinic. TODAY file photo

SINGAPORE — In the second half of this year, a 13-member committee looking into fee benchmarks for medical procedures and services is set to release its first round of benchmarks for common medical procedures such as surgery for cataract and appendicitis.

The fee benchmarks, announced by Health Minister Gan Kim Yong in November, will allow patients to make more informed choices when seeking treatment and nudge healthcare providers, such as doctors, to charge more appropriate fees.

The committee will decide on a reasonable range of charges, taking reference from past transactions.

On Sunday (Jan 21), Senior Minister of State for Health Lam Pin Min announced the membership of the committee on the sidelines of a community event in Anchorvale Community Club.

Helmed by Dr Lim Yean Teng, a senior consultant cardiologist in private practice, the committee will span representatives from the medical community and healthcare providers, unions and non-profit organisations, among other groups.

Members include former Singapore General Hospital chief executive Ang Chong Lye, a senior consultant ophthalmologist; Temasek Foundation International chief executive Benedict Cheong; vice-president of the National Trades Union Congress central committee Karthikeyan Krishnamurthy; and former Senior Minister of State for Foreign Affairs Zainul Abidin Rasheed.

The committee will hold its first meeting in the next month or two, and will meet monthly for a start. It is expected to carry out its work over two or three years, added Dr Lam.

It will look into setting fee benchmarks for common procedures.

Presently, the Ministry of Health (MOH) website provides information on the fees  forked out by patients who undergo some medical procedures — including colonoscopy, and surgery to remove the gall bladder and appendix — from the 25th to 75th percentile. They are broken down by subsidised and non-subsidised cases, for instance. 

For example, the total surgical fees for the removal of the appendix with drainage range from S$547 to S$925 (subsidised), and from S$2,504 to S$3,858 (non-subsidised). In private hospitals, the procedure costs between S$12,738 and S$16,867. 

Dr Lam said such common surgical procedures — which make up 80 to 85 per cent of those carried out by hospitals — will be, as a start, the focus of the fee-benchmark advisory committee.

“We expect the first tranche of the recommendations to be rather straightforward because we've quite a lot of empirical data to support the work of the committee,” said Dr Lam.

It will then move on to less common procedures, for which it can draw on experts in hospitals, and even look into services like consultation and laboratory fees.

Stressing that the benchmarks are meant to provide a basis for healthcare providers to charge reasonably, Dr Lam said: “For doctors who charge above the benchmarks, they must have a strong justification because each case is different; the complexity as well as the duration of the operation or consultation may differ.”

The data will be published on the Ministry of Health website and distributed to all private and public healthcare institutions and practitioners.

Dr Lam urged Singaporeans, in making healthcare decisions, to consider not only the cost of treatment but also the type of treatment and specialist that will suit their needs best.

In November last year, Health Minister Gan Kim Yong announced that a committee would be appointed by early this year to devise fee benchmarks that give a recommended range of charges.

The range of fees will account for factors including the complexity of medical conditions.

The set-up of the committee follows feedback from practitioners, especially doctors, who have been looking to the MOH for guidance on fees. This came after the Singapore Medical Association removed its guideline on fees in 2007 after being told it could be violating competition laws. Its appeal to the Trade and Industry Ministry failed, and the Competition Commission of Singapore issued its final decision in 2010 that the guidelines were anti-competitive.

In 2016, the Health Insurance Task Force also recommended that the MOH provide guidelines on medical fees.

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