Deep Dive Podcast: Are generous health insurance policies inflating medical costs?
Are you likely to opt for a "buffet" of medical procedures if they are covered by your insurance policy? There's a catch, say our podcast guests.
The Deep Dive podcast looks at Singapore's health insurance landscape and discuss the "buffet syndrome" of claims.
Health Minister Ong Ye Kung recently said that rising medical claims enabled by insurance policies are leading to an unhealthy "buffet syndrome", which in turn increases costs.
Steven Chia and Crispina Robert sit down with Liaw Yit Ming, CEO of Foundation Healthcare Holdings and Christopher Tan, CEO of Providend, to break it down.
Here's an excerpt from the podcast:
Steven Chia:
We have this example of a heart bypass surgery. So in a subsidised Class C ward, the bill can be about S$6,400, right? If it's an Class A ward, you're talking about S$40,000. In private, that will jump to S$83,000.
Why is there such a huge disparity? You understand everybody needs to make some money along the way, but when is it too much?
Crispina Robert:
Even if I have very good insurance - (with) all the riders and my co-payment is very small - why would I pick that upper band?
Christopher Tan:
I'll just say that between the subsidised wards, the B2 and C in the public hospitals, if you go there, you've got to accept that you can't choose your doctors. You've got to take anyone that's assigned to you. I think that's key.
Many patients prefer to choose their doctors. If you want to do that, then you cannot go to B2 and C, so straight away there's a difference in cost. You must be prepared to pay more for the quality of care and quality of the room. Not many people can sleep very well in a B2 and C. Nowadays, you don't care about TVs and all that, but you want better quality of care and better quality of sleep.
Crispina:
You don't want to wait also ... Because there's an element of waiting?
Christopher:
Ironically, today, it's harder to get a single-bed ward in a public hospital.
Crispina:
This is the interesting thing. More than 70 per cent of us have integrated plans, which means we can walk into a private hospital to get treatment, but we don't. We choose the cheaper option of a B or an A ward in a public hospital.
Christopher:
Yeah, because there's also the post-hospitalisation to worry about, right? Because while I'm worried about the one-time payment, if mine is a chronic illness and requires follow up care for the next 12 months or 24 months, the insurance company covers up to 12 months, and after that, it's on you.
So, if you choose to go to a private hospital, the very expensive cost can be taken care of by the insurance, but what happens after 12 months? What happens after 18 months? People might go to a public hospital because of that.
Today, if you go to a (public) hospital, it's quite interesting, because if you want to go to a one-bed ward, it's harder because people have got insurance, so they will go for the one-bedder.
And then to your point that it's faster ... It's also true for acute conditions. For example, if my son wants faster treatment, he will go to a private hospital because he doesn't want to go to A&E and queue.
Steven:
I guess the question is also the fees we're charging. So, the examples we gave just now of the pricing from S$6,400 to S$40,000 to S$83,000, do insurance companies also work this out with the doctors to say, "Okay, this is the price we will agree on, if you go to this doctor, it'll be this price, if you go to the public hospital, it will be this price"?
Liaw Yit Ming:
To be clear, for the S$80,000 example you quoted, there are two parts to the bill. There's always a facility fee, a hospital bill, and a professional fee, which is a specialist bill. The specialist fee is controlled by insurers as well as the Ministry of Health's fee benchmark. The hospital charges are not controlled.
It depends, out of the S$80,000, how much is doctor's fees and how much of that is hospital fees. So when you say who controls, for me specifically, I control the specialist fees only; the hospital side I can't control.
