Confidence Goods 10

Well, well.

CCS and CASE both replied to Ms Chen's letter today, but they have not answered her most important question.


Watchdog: Give patients fee data to make choices

I REFER to Ms Christine Chen Siew Mei's letter, 'How to decide if doc is overcharging?' (ST, April 16).

The Competition Commission of Singapore (CCS) will not issue guidelines on 'acceptable and normal charges', as this would constitute another form of fee guideline.

It should be noted that the Ministry of Health's guidelines under the Private Hospitals and Medical Clinics Act and Regulations require doctors to display their fees and other relevant charges prominently. Hence patients would know beforehand the fees payable.

CCS would also encourage bodies such as the Singapore Medical Association to collect and make widely available information on the fees charged by doctors, so that the public is aware of the range of fees charged for various medical procedures and treatments.

This would enable the public to know where a particular doctor's fee stands in relation to the fees charged in the market and make informed decisions about which doctor to see.

The CCS will work with the Consumers Association of Singapore to review the complaints that it may receive on doctors' fees. CCS will take action if there is any infringement of the Competition Act.

More information on the Competition Act can be found on our website at (link removed).

Chin Yen Yen (Ms)
Senior Assistant Director (Corporate Communications)
for Chief Executive Competition Commission of Singapore


Free competition will keep prices in check

I REFER to Ms Christine Chen Siew Mei's letter, 'How to decide if doc is overcharging?' (ST, April 16).

The Consumers Association of Singapore (Case) does not always require fees to be paid whenever consumers approach us. Consumers can seek advice via phone, e-mail or walk-in consultation at no charge.

Our officers will advise consumers on a case-by-case basis and highlight the various options of recourse.

Only when consumers request for us to represent them and manage their complaints would they need to join us as members.

As to the writer's concerns about overcharging, we believe that free competition will work against doctors who charge excessively. With free competition, there will always be a range of fees that doctors charge and consumers can choose the doctor that fits their budget.

Doctors who intend to charge a certain level of fee will need good reasons to do so. Doctors who price themselves out of the market may lose their patients to those who charge market rates.

We encourage clinics to practise transparency by displaying prominently the costs of consultation and other medical services at the entrance and at the registration counter. This will ensure that walk-in patients are fully aware of the charges before they seek a consultation and prevent disputes over fees.

Cost-conscious patients should call up a few clinics to enquire about the consultation fees.
We also expect doctors to itemise their charges, so that consumers are able to determine the cost of consultation vis-à-vis the costs of related products and services.

While we believe that fees will not differ significantly after the withdrawal of SMA guidelines, we will continue to monitor the situation and may conduct a survey of medical practitioners' fees in future.

Should members of the public have queries on any consumer issue, they can call 6463-1811 or e-mail (link removed)

Seah Seng Choon
Executive Director
Consumers Association of Singapore


CCS and CASE have both avoided answering the question: Do they have the expertise or domain knowledge to know the intricacies and complexities of pricing in the whole spectrum of health care?

Say you go to a specialist for a surgery, and the fees he quotes you is the top of the range of fees, and several times that of the private rate at restructured hospitals. Is he overcharging you? What if all his other patients who had previously undergone that surgery have paid up without complaints, and felt they had good value for their money?

Say you go to a GP for a problem, and he orders several blood tests, X-rays and scans, and does a biopsy for you, all of which are charged at the middle or lower part of the range. Is he overcharging you? What if many doctors would actually consider the tests he has done for you as redundant?

Without taking quality into account, a "survey of medical practitioners' fees" and "itemised charges" will not allow patients to make informed decisions about their healthcare spending.

Not only have CCS and CASE not answered Ms Chen's questions satisfactorily, their replies in fact raise another question: If CCS believes that free competition will benefit patients, why does it need CASE to monitor the fees?

Or, as Lt Kaffee would ask:

"If you gave an order that Santiago wasn't to be touched, and your orders are always followed, then why would Santiago be in danger?"