Angry Doctor

Friday, April 06, 2007

Confidence Goods 6

Somebody hold angry doc back, because this really makes him angry (emphasis mine).

Competition Commission partners CASE to monitor pricing

SINGAPORE: Price-fixing by companies or industry associations may soon be a thing of the past.

CASE, the consumer watchdog, will get extra help from the Competition Commission of Singapore (CCS) to take action against businesses which charge uncompetitive prices.

CCS is a regulator of price-fixing and it announced on Thursday that it will support CASE to monitor and possibly take violating companies to task.

After the Singapore Medical Association (SMA) withdrew guidelines on 1 April, doctors can now charge patients freely, according to their business costs.

In a letter to its members, SMA said it had been advised by its legal advisors that its fee guidelines contravened the Competition Act.

At an off-camera briefing, the CCS said although it has not accused SMA of price-fixing, the association’s fee guidelines, which had been in place for the past 20 years, can stifle market forces and harm consumers by reducing choice.

And these guidelines send a signal to market players, in this case – the doctors, to price their services in a narrow range, even if it does not eventually lead to price-fixing.

The commission expects visits to the doctor to be potentially cheaper in the long run.

All that is left to do is to wait for the market to adjust to the new changes.

But should there be cases of overcharging, the CCS will work with CASE to monitor and correct any exorbitant rise in doctors' fees.

CASE Executive Director Seah Seng Choon said he looks forward to working with the commission to facilitate solutions to consumers' complaints on uncompetitive pricing and practices.

Following SMA's recent withdrawal, Healthway Medical Group, which has a network of 40 clinics, has said it has no plans to raise its fees and will maintain it within the withdrawn guidelines.

Sure it may be cheaper to see a doctor after the guidelines are withdrawn, but this is not about the guidelines anymore. Rather, it is about the insinuation that the idea behind the guidelines was cartelism, and that the CCS was the good guy here protecting all patients from us greedy doctors who have been conspiring to overcharge them all along.

Cheaper does not always mean better, and unlike with a cup of coffee or a plate of chicken-rice the consumer here cannot always tell the quality of the goods he has received. Choice means little when consumers cannot discern quality, and market forces do not always work to the benefit of consumers.

The guidelines may have been an attempt by SMA at price-fixing, but as angry doc understood it they were never conceived as a means to maintain consultation fees at an artificially high rate and to benefit the doctors at the expense of patients, but rather as a common reference point to reduce the prevalence of undercutting amongst GPs, which was threatening to compromise the quality of care being given.

To blindly pursue free market, consumer choice, and lower prices without understanding that medicine is a confidence goods is to do all parties concerned a disservice.

Or, as Colonel Jessep would put it:

"You put people's lives in danger. Sweet dreams, son."



  • How much cheaper can it get? How much cheaper WILL it get, since some doctors are charging $8 meds+consult. If this is what the public will get them to the position of a world class medical hub...

    By Anonymous Anonymous, At April 06, 2007 9:22 am  

  • Healthcare costs in Singapore is "dirt cheap" in the developed world already, as so represented by the influx of foreign patients coming here to seek treatment.

    The public should be educated that health is no small thing - one should be paying for services to get better.

    One must also have the mindset that cheap price = cheap goods.
    (find me good $2 chicken rice that I can eat to my fill =p)

    But then the problem is that if there is one black sheep is the community, the public likes to cry foul over every single individual. One bad doc = all docs bad. How come the public never say 1 bad chicken rice seller, all chicken rice sux?

    The is a need to match services to prices, and not expect a free or cheap meal catered to one's requirement. Healthcare professionals are also like anyone on the street - they need to reccuperate their cost of treatment and earn some bread home to feed the family and improve their services as well.

    By Blogger OJ - Da UNlicensed Pharmacist, At April 06, 2007 11:20 am  

  • i think the public sees medicine as a kind of priesthood. and the hippocratic oath supposedly absolves healthcare professionals from any right to make a profit and that we can live on the "gratitude" (yeah right, like anyone is grateful these days) that we get when our patients get well.

    like lky said, all they need for a cure is a good dose of incompetent doctors (minsters/govt/etc). then maybe, they'll appreciate the local doctors, and their low fees, more.

    that said, ST is giving the impression that doctors earn a lot. judging from what they say about balaji and ng eng hen earning $4.5million, and people like georgia lee and the other SGH ortho spending loads on their expensive clothing and attending high society fashion functions. it's no wonder people still see medicine and medical professionals as "well-paid". not commensurate for the amount of work we put in.

    By Anonymous Anonymous, At April 06, 2007 11:45 am  

  • The concept of price-fixing assumes the presence of a 'fair price' or 'fair value'. The problem here seems to be that the general public and the CCS are focussing only on the price of healthcare with little regard (or idea) of its quality, and neither seems to have an idea of what the 'fair price' is.

    By Blogger angry doc, At April 06, 2007 11:54 am  

  • Who the heck are the members of the CCS? Do they understand healthcare costs & quality of care? It's more than just dollars & cents. They seem to be raising the red flag already, & assuming that doctors tend to overcharge, or will do so now that there are no guidelines!!! It's so sad.

    The public needs some good ol' education about making good healthcare choices. Who'll step up to the plate? MOH? SMC? SMA? HPB?

    By Blogger aliendoc, At April 06, 2007 12:44 pm  

  • And we seem to have raised the white flag already, before the first shot is fired.

    By Blogger angry doc, At April 06, 2007 1:07 pm  

  • Now that doctors from UM and UKM in Malaysia, as well as doctors from China, India, Pakistan can practise in Singapore after a few years of supervision, competition wil heat up for local GPs.

    By Anonymous Anonymous, At April 06, 2007 8:40 pm  

  • I blame us the doctors for being so silly.

    Firstly while everybody accuses the majority of us as being a cartel and setting super high charges .......we in reality do the complete opposite. We are disunited and undercut each other, $5 consults for MHCs, $8 flat fee inclusive of meds and consult these are COMMONPLACE!!!

    And then we get wacked left right centre by the ignorant clueless public, CCS, CASE and MOH!!

    Hey if we're going to be wacked anyway the very least we could do is to be wacked for something we DESERVE!

    It's ridiculous man. I know people expect doctors to be like Jesus Christ (perfect I mean) but I never wanted to be the messiah when I chose to go to medical school!

    By Blogger Dr Oz bloke, At April 07, 2007 10:17 am  

  • The public does not care if doctors' income drop as a result of intense competition. In fact, they welcome it and so does the minister of health. Bringing in cheaper foreign doctors will intensify competition further.

    $8 for consult and medicine is ridiculously cheap and will draw crowds away from the polyclinics. That is exactly what the government desires. Whilst government spending can drop for such patients, GPs will have to work longer hours to maintain their income. Private clinics will have to remain open longer and over public holidays without raising charges. That again, is exactly what the government and public desires.

    Put it this way. Patients will be prepared to pay hundreds of dollars for botox injections but not $12 for their parents to be treated for a cold.

    What can we do? Switch to higher-value services? Get the GDFM and petition SMC not to allow foreign doctors to open clinics so they have to work as our employees? But of course, foreign doctors can and will acquire postgrad qualifications too. Maybe give up medicine and re-train as an investmant banker instead? The future is bleak indeed....

    By Anonymous Anonymous, At April 07, 2007 4:15 pm  

  • Yep I'm planning to do exactly just what you said in your last sentence. But not in Singapore of course :)

    GPs will go the way of local IT professionals. These days' it's hard to find an IT professional who isn't foreign. Try calling the tech support hotline for any company and you'll know what I mean.

    By Blogger Dr Oz bloke, At April 07, 2007 9:46 pm  

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