Sunday 31 August 2014

CHAS scheme: MOH monitors claims by clinics

DR QUEK Koh Choon ("Emphasise ethics in health care"; Aug 15) and Mr Alfred Wong Kwok Wai ("Prevent abuse of subsidy scheme"; Aug 16) raised the concern that some clinics on the Community Health Assist Scheme might mark up their charges for patients claiming CHAS subsidies.

The CHAS scheme has allowed general practitioner (GP) and dental clinics to partner the Ministry of Health (MOH) in making subsidised primary care more accessible to lower- and middle-income Singaporeans within the community.

Come next Monday, all 450,000 pioneer generation Singaporeans will also enjoy subsidised GP and dental services at the CHAS clinics.

MOH agrees that as members of a respected profession, doctors are expected to adhere to the highest standard of professionalism and always act in the best interest of their patients.

The Singapore Medical Council's Ethical Code and Ethical Guidelines state that doctors cannot abuse the doctor-patient relationship for personal gain. Indeed, the vast majority of our doctors do observe this code and guidelines closely.

Aside from the ethical issues with overcharging, the CHAS claims submitted by clinics are monitored by MOH. Clinics have been and will continue to be called upon to account for any exceptional claims.

Prices charged differ from clinic to clinic and from patient to patient, depending on the condition, treatment provided, medication prescribed and length of consult.

We encourage clinics to display their common charges such as consultation fees prominently, and to address any price concerns that patients may have, especially with regard to the type of medication prescribed and its cost. This will make the charges more transparent to patients.

MOH will continue to monitor the situation. Members of the public can contact us on 1800-ASK-CHAS (1800-275-2427) for more information and to provide feedback.

Lim Bee Khim (Ms)
Director, Corporate Communications
Ministry of Health
ST Forum, 30 Aug 2014

Emphasise ethics in health care

I COMMEND Dr Tang Kok Foo for highlighting the reasons for soaring private health-care costs ("Reasons for soaring private health-care costs"; yesterday).

He cited the free market in health care as one of the factors. This is certainly a cause for concern. Although such a system has its merits, it can be abused.

I am appalled to learn from patients that some doctors and dentists are still charging hefty fees under the Community Health Assist Scheme (CHAS). From the patients' point of view, their treatments are not being "subsidised", and they are in no position to know whether the medication and treatment they receive are really necessary.

Doctors leaving the public sector for the seemingly "greener pastures" of private practice are creating a vacuum in public hospitals.

Although CHAS allows for subsidised rates for patients referred to specialists in public hospitals, the lack of specialists and the heavy patient load mean patients can be seen only after several months. Those in urgent need of treatment have no choice but to turn to private specialists.

There is a need to emphasise to health-care practitioners that compassion and integrity are essential in the practice of medicine and dentistry.

If they are in it just for the money, then there is always the risk of breaching ethical standards. Any system can be compromised if the motivation is not altruistic.

Quek Koh Choon (Dr)
ST Forum, 15 Aug 2014

Prevent abuse of subsidy scheme

THE Community Health Assist Scheme (CHAS) seeks to spread the patient load of polyclinics to private clinics, through the provision of subsidies.

Are there any measures in place to monitor whether clinics on the scheme are genuinely serving the community, or earning extra revenue from the subsidies given to patients?

My 81-year-old mother, a wheelchair user, visited a clinic in her HDB estate recently to seek treatment for itchiness on her body.

The bill before subsidy for consultation and three types of medicine came up to $56.

I checked with some doctors and they felt the charge should not be so high.

Did the clinic mark up the charges, knowing its post-subsidy bill would be more or less at the market rate? This would defeat the purpose of CHAS.

I urge the Health Ministry to institute measures to monitor doctors on the scheme, to ensure they do not mark up their charges.

Alfred Wong Kwok Wai
ST Forum, 16 Aug 2014

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