Introduction of Fee Benchmarks

Name and Constituency of Member of Parliament

Dr Lim Wee Kiak

MP for Sembawang Group Representative Constituency 

Question No. 1626 

To ask the Minister for Health (a) what is the Ministry's rationale in introducing fee benchmarks for medical procedures; (b) how is this new guideline aligned to the spirit of fair competition; and (c) whether the Ministry is aware that the benchmarks may cause doctors who are charging lower fees to charge higher fees.

Name and Constituency of Member of Parliament

Assoc Prof Daniel Goh Pei Siong

Non-Constituency MP 

Question No. 1667 

To ask the Minister for Health whether the removal of the Singapore Medical Association fee benchmarks in 2007 has led to the inflation of medical costs in the last decade and how will the Ministry's fee benchmarks be independently derived so as to prevent anti-competitive price-fixing.

Answer

1.    The introduction of fee benchmarks is part of a larger strategy to keep healthcare costs affordable and sustainable as we prepare for an ageing population in Singapore.  This is a shared responsibility and requires a collective effort from all stakeholders.  Individuals have to take good care of their health and make informed choices when they seek treatment.  Healthcare professionals play a key role in providing quality care that is appropriate to the patients’ needs and charge reasonable fees for their services.  Government and healthcare institutions need to continue to improve productivity and look for ways to deliver greater value for patients.  Employers and insurers can help to manage increases in healthcare costs by encouraging prudent use of healthcare services by their employees and policyholders.

2.    The Singapore Medical Association (SMA) first introduced its Guidelines on Fees (GOF) in 1987.  It withdrew the GOF in 2007 after it was informed by the Competition Commission of Singapore of anti-competitive concerns.  There was no significant change in the average annual healthcare inflation rate in the decade preceding and following the 2007 withdrawal of SMA GOF, which were 2.4% and 2.6% respectively.  Recent policy measures such as the Pioneer Generation Package, MediShield Life subsidies and the Community Health Assist Scheme (CHAS) have helped to reduce the healthcare inflation rate to about 1.2% between 2013 and 2016.

3.    Over the past years, the Ministry of Health has been publishing historical transacted hospital bill sizes and operation fees for common medical procedures to enhance transparency of healthcare charges.  The introduction of fee benchmarks will take this further by providing all stakeholders a useful reference.  We believe this will encourage appropriate charging practices and provide useful information for patients and payors to make better informed decisions on their care options.

4.    The fee benchmarks will be set by the Ministry, with advice from an independent Committee that comprises stakeholders representing the medical community, providers, patients and payors from both the private and public sector.  The benchmarks will be reviewed and updated regularly, with references made to historical transacted data.

5.    The fee benchmarks are not intended to restrict competition, as doctors are not prohibited from charging lower or higher fees if they wish to.  The fee benchmarks serve as references for the public to assess whether the fees charged by a healthcare professional are reasonable.  The Ministry will however continue to monitor the charging practices in the healthcare sector.