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2-Cent Rant

Are Doctors Charging More Than They Need To?

Food for thought.

 

Singapore’s medical inflation rate (15%) easily beats the medical inflation rates of other countries. This is not something to be proud of, neither is it something we should ignore. When your medical inflation rates are about 5 times your general inflation rate, it is a major cause of concern.

How will Singaporeans be able to afford healthcare in the future with the costs increasing at such a rate? The question we ask is: how much are doctors the reason for this inflation? Are doctors charging more than they need to?

Read Also: Medical Inflation At 15%: Why That Spells DISASTER

When we look at the relationship between suppliers and consumers in an economy, it is usually reasonable to say that there is a balance of autonomy; in the sense that the supplier decides the best price for the service/product he delivers and the consumer decides whether to pay that price. All is fair.

When applied to a healthcare service/product, a doctor is the “supplier” of healthcare and patients are the consumers of the service. Healthcare is relatively price inelastic in demand, meaning the increase in its cost does not affect the demand as the health of the patients cannot be compromised. Hence issues emerge between the patient and the medical professional, as the balance is skewed towards the provider of healthcare.

Yes, Doctors Might Be Charging Too Much

  1. Insufficient Data & Information

 Our internet-savvy generation is able to log onto their computers and google for more information on medical fees. Technology allows patients find out more about various treatment options and other information pertaining to their illness.  However, there is a lack of credible and accurate information provided to patients both online and offline.

There is growing disparity in medical costs. It’s possible to go to different private doctors for the same illness but be quoted different prices. One doctor might think your condition requires antibiotics (which costs more) but another doctor might think just a flu medicine is good enough. As the clinical judgement of doctors vary, the treatment prescribed varies and consequently the cost incurred.

  1. The Insurance Factor

Many patients are covered by health insurance. Doctors know this and often check with patients upon treatment if they have insurance and how much it covers. Knowing that the patient’s medical bills are being covered by insurance may lead to doctors recommending a more costly treatment.

Should our insurance policies be kept unknown to doctors? Should our financial situations be withheld from doctors? Would this then make a difference in the treatment suggested?

On the other hand, if this information is kept from the doctor, they might not be able to administer the appropriate and paint the most cost effective scenario to the patient. It is possible that knowing the patient’s insurance and financial situation, doctors are able to prescribe better services to patients knowing that someone else is also bearing the costs.

For example, a surgeon could think an implant is better (e.g. better results, lower risks) where in normal circumstances even if the implant is offered, uptake might be low due to the hefty costs. But knowing the patient is covered by insurance, the implant becomes a very viable option.

At the end of the day, it is down to the professional ethics of these doctors.

  1. A Service We Cannot Do Without

Doctors provide us an essential service, to treat us and cure us of our illnesses. Their expert knowledge and service is one we cannot do without. This gives greater power to overcharge at the doctor’s discretion.

How will we know if our doctors are charging too much? As non-experts in the medical field, patients are fully dependent and at the mercy of a doctor’s decision on the type of treatment we should undergo as well as how much it will cost.

Without a fixed fee or strict regulations in place, it is more of an ethical obligation for doctors to keep fees reasonable and not overcharge.

  1. Unnecessary Tests Ordered

There are many unnecessary tests and procedures in the medical field that not only fail to add value to a patient’s treatment but also causes harm (i.e. exposure to radiation).

Perhaps it might be harsh to deem some tests as unnecessary or excessive. But was there really a need to do the extra tests (and pay the extra cost) if they were simply to confirm and validate the doctor’s diagnosis? Could these extra tests been avoided based on the doctors’ clinical judgement that the test would do very little to help the treatment of the patient.

No, Our Medical Fees Are More Than Justified

  1. Guidelines Are In Place

Most doctors are obligated to follow the guidelines established by a committee of respectable members of the medical profession (i.e. Singapore Medical Association). While the guidelines do not outline an “objective” or fixed number for every single procedure/service, the medical profession is strictly regulated in this aspect.

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To be deemed to not be in line of the values plagued by the healthcare professional, doctors may face heavy penalties such as the suspension in practice, fines and an inevitable tarnishing of reputation.

  1. No Two Patients Are Exactly The Same

Illnesses are exhibited in patients differently. The effect and severity of an illness differs from patient to patient. Not every patient responds to treatment the same way. Some have after-effects both foreseen and unforeseen. This is also why treatments suggested and total cost will vary for similar illnesses.

Before you decide on your treatment, you can check prices online to get a rough estimate as well as to find out more about the recommended treatment. Getting advice from your doctor friends and family members would also help you in making a decision on your treatment.

It is difficult to pre-determine the cost of treatment, especially with the complications that could arise. How can we set a fixed fee or fixed guideline to how doctors charge patients for their medical conditions when responses to treatments are not entirely identical?

  1. Improvements In Medical Science And Technology

Improvements in technology have caused medical fees to rise, especially with new treatments available. The increased medical costs could be influenced by facilitation of the provision of healthcare. For example, hospital facilities, expensive new prosthesis, implants, drugs and more.

It only makes sense that the cost for doctors to bring in the expensive treatment/machines are shared by patients that use it as well.

  1. Doctors Need To Earn a Living Too

Hospitals, public and private clinics do not run charities. A doctor is simply doing his/her job just like you are doing yours. They have a responsibility to provide quality consultation and treatment for their patients. Like you and I, many of them have their own families to take care of.

Certification to become a doctor doesn’t come easy. Before a doctor comes out into the professional medical field, to gain the expertise and knowledge they go through 5-7 years of study plus an intern year. Their certification comes with a cost to them in terms of finances as well as opportunity costs, especially when they choose to specialize. Their expertise, knowledge and experience is also one we pay the extra bucks for.

For professionals in the medical field, especially in a private practicing body, there is a need to balance sustainability and profitability in deciding the fees accorded to various services. This decision is often said to rely on the moral compass of the professional.

  1. Paying For The Intangibles

When we pay our medical fees, we’re not simply paying for the diagnosis, medicine and treatment. When choosing which doctor to see, we’re often paying for the intangibles such as the doctor’s experience, expertise, convenience, care and quality of service.

Prices are driven by supply and demand. It is easy to see why some doctors might charge more than others. A specialized doctor with years of experience would be in high demand, hence you might need to pay higher fees. Sometimes we go back to a specific doctor even if they charge a little bit more because of the trust you have in them and the relationship you have formed with them.

These are factors which cannot be monetized and are also reasons why some people are willing to pay more for that extra human touch.

As a patient, you have the choice of choosing public or private medical institutions to get treatment. Of course there are benefits to choosing a private institution; you might not need to face a long queue and can consult a more specialized doctor. But you’re not obliged to go to private institutions or specialists, we have polyclinics for a reason!

Ultimately, doctors should have the patient’s health and best interests in mind. Medical fees should be determined according to the guidelines in place as well as a doctor’s moral compass. Giving patients the appropriate treatment they require and charging them based on what should be charged holds the greatest importance.

 

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