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Doctors have ‘ethical obligation’ to charge reasonable fees: SMC in wake of insurance

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SINGAPORE: Doctors have an important role to play in keeping healthcare costs “affordable and sustainable”, said the Singapore Medical Council (SMC) on Monday (Mar 19) in a circular to medical professionals.
It was issued in the wake of new rules announced in Parliament earlier this month, requiring patients to bear a minimum 5 per cent co-payment for new Integrated Shield Plan riders. This means insurance companies can no longer sell full riders, which entitled policyholders to pay nothing for hospitalisation and treatment, regardless of the size of the bill.
The Health Ministry had said that the zero co-payment feature resulted in a “buffet syndrome”, leading to over-consumption and over-charging of healthcare services.
Noting the recent scrutiny over “hefty and questionable insurance claims”, SMC reminded doctors of their obligation to charge “reasonable” fees and not subject patients to unnecessary tests or procedures simply because they hope to gain financially.
“Where patients are covered by medical insurance that guarantee they pay little or nothing towards their medical bills, they may be less likely to contest the fees charged by the doctor. However, patients’ acquiescence to a doctor’s fees does not absolve the doctor of the responsibility of charging reasonable fees.
“The doctor’s ethical obligation to charge fair and reasonable fees for services rendered operates over and above contractual and market forces and is not superseded by any agreement between the doctor and his patients,” said SMC, a statutory board that regulates medical professionals here.
AdvertisementAdvertisement“In addition, while there is no prohibition against a day procedure being carried out as part of a hospitalisation stay, doctors must not recommend hospitalisation where there is no clinical justification to do so and for the primary purpose of charging higher fees. Such conduct may constitute over-servicing and/or over-charging.”
SMC also noted that to keep healthcare costs in Singapore affordable and sustainable for patients, all stakeholders - medical professionals, insurers, policyholders, employers, patients, caregivers and the Government - have roles and responsibilities.
It added that the majority of doctors "strive to practise ethically and to build the trust of the public".
"But for the few who are found to have misconducted themselves by unethical charging and over-servicing and bring disrepute to the profession, disciplinary action will be taken against them," said SMC.
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