Saturday, November 24, 2018

Surgical Fee guidelines a good job half done


Hi all,
The letter below was published in the Forum page of the Straits Times (23.11.2018)

Dear Editor, 

The recently published fee guidelines for more than 200 common surgical procedures by private surgeons in Singapore could not have come a day sooner (Opting for private surgeon? See fee guidelines; Nov 14).

Many, even specialists in the private sector, have felt that recent price trends have not been sustainable and that Singapore is beginning to lose its competitive edge in this area to neighbouring countries.

Whether regional patients return to our shores in substantial numbers remains to be seen, but the latest move can only be good if we are serious about Singapore being a centre of medical excellence - a mantra seldom mentioned nowadays.

However, the surgeon's fee is but only a portion of the patient's total hospital bill. How does knowing only this portion allow for realistic financial planning for any patient coming into our private hospitals?

Why leave this task half done? Surely private hospitals have a critical role to play in this journey towards an excellent yet sustainable Singapore healthcare.

To this end, I propose the following:

For the most common surgical procedures - for example, the top 10 procedures of each speciality - the Health Ministry should require all major private hospitals to have all-encompassing fixed-fee packages.

This will introduce real competition and offer real choices for patients and payers (employers and insurers).

With the surgeon's fee kept at reasonable levels by the recent fee benchmarks and the hospitals' fixed-fee packages, patients and their families can be confident of avoiding shocks on the day of discharge, barring unexpected complications or transfers to intensive care units.

Other components of the total fee - for instance, an anaesthetist's fee - are usually predictable as a percentage of the surgical fees.

Only if this is achieved and uncertainty alleviated will Singapore's private healthcare truly be able to enlarge the pie and be ready to compete with our fast-improving regional competitors.

We may just be able to make it, but time is of the essence.

Huang Shoou Chyuan (Dr)

Sunday, October 07, 2018

Silly hope that ST will not be like China Daily, Pravda or KCNA.

Yesterday was the last time I will be reading from a subscribed Singapore newspaper.

No right thinking person will read the China Daily expecting anything other than partial news that support the official line of the Chinese government. Ditto for Pravda ( Russian Federation) or KCNA ( North Korea).

The only reason we will feel angry when our only English newspaper appears biased and partisan towards the government ( which incidentally owns it in a not too complex shareholding structure) is that deep down somewhere in our hearts ( or brains) is that we thought that somehow the Journalists could be allowed to act and write as professional fair-minded Singaporeans (or maybe PRs).

I ( now I am getting personal) thought, naively now its clear, that the senior people that run the Straits Times ( now I have named the paper) have a conscience to do what is right for us. That they cannot be so blatantly biased or else I and others will get disgusted and not read their paper anymore. Well I was wrong and they were right.

They could and were and will be blatant and yet people like me , till yesterday, would buy and read with a glimmer of hope that is totally unwarranted. Hope that they will do the right thing. It wont happen anytime soon.

I have unsubscribed to the Straits Times. In investment terms we call this “cutting loss”.

Writing to the Forum Page ( and why I write) is also a rather unusual thought process. That is the subject of another post.

We live in difficult but exciting times.

Best wishes

Dr Huang Shoou Chyuan

Wednesday, September 26, 2018

Referendum for 377A repeal

Dear Friends,

We are told that repeal of Section 377A of the Penal code has the potential to divide Singapore and split us into 2 irreconcilable camps.

However keeping it unchanged is deemed a violation of the rights of a not insignificant percentage of Singaporeans. Repealing it, unfortunately, would offend conservative citizens who claim guidance from their ancient scriptures.

It was not too long ago when women could not vote and humans of colour had to make themselves invisible and use separate toilets, buses and their children attend inferior schools all in the name of these same conservative values.

These societal crossroads are now in the distant past.

And yet we are told and many believe that Singaporeans are mainly conservative and demand that the 377A remains on the legal statutes.

Is this even true? Has there been any real poll to confirm this?

Or is this potentially fake news?

There is one simple way to know if Singaporeans want to retain 377A as it is.

I suggest that the Singapore government carries out a referendum or plebiscite to  decide what Singaporeans want to do about 377A. This should be a non-binding vote carried out according to similar rules familiar to the Department of Elections ( eg compulsory etc) .

If the vote for pro-repeal wins or is close eg less than 10% difference then Parliament would be deemed to have the moral duty to do more than sit on its hands ( and tweedle its thumbs) and should start work on amending or repealing 377A.

However, it the vote is decisively  for retention, then the repeal camp must agree not to have any referendum till at least 10 years later. This allows the government of the day to carry out its mandate for the majority without upsetting the status quo..

If the government is not ready to take this risk, then a respectable NGO, or even the Workers’ Party ( which has been neutral on this) can take up the mettle on Singapore’s behalf.

I know there will some who argue against this as an example of “Ruling by Referendum” but don’t Singaporeans want to know how middle Singapore feels about this? I sure do!

Best wishes

Dr Huang Shoou Chyuan

Amended letter published in Straits Times Forum