Sunday, April 29, 2007

Leeds United: The last Fan in Singapore, I must be! Hic!

BBC Sports 29.4.07
Leeds 1-1 Ipswich
Ipswich's late equaliser has virtually relegated Leeds, who trail Hull by three points and have a vastly inferior goal difference with one game to play.
It is still mathematically possible for Leeds to stay up, but they would need to win their last game by at least eight goals, and for Hull to lose. read on... but be warned it is sad

My comments

Hi World,

“The last Leeds fan in Singapore, I must be” Master Yoda would have said if he were me!
(Yoda is a member of the Jedi Council)

Anyway, if anyone were me ( or is it if anyone was I?), one would not have been a Leeds United fan!

Only a masochistic loser and supporter of lost causes and a sentimental fool would ever contemplate supporting any club as woeful as Leeds.

How on earth did I end up being a fan of the Whites ( whose strip incidentally is a copy of Real Madrid’s). I think Leeds even give Singapore’s MIW’s a bad name! How terrible is that?

Many moons and just as many hairs ago, in the 70’s, Leeds United was a great team under the inimitable Don Revie , and only a few years ago, I could have rattled off the names of the 70’s team.

I think that great team consisted of David Harvey, Norman Hunter, Johnny Giles, Eddie Gray ( and another Gray), Jackie Charlton, Allan Clarke,Billy Bremner. Fill in the blanks for me if you can, some other die-hards- who must be just as drunk and drowning in rivers of sorrow.

And to think that only a few seasons ago, David O’leary brought the young team consisting of Smith/Viduka/ Kewell/Woodgate/Robinson/Kelly/Harte/Dacourt/Redebe/Bowyer et al all the way to the semi-finals of the European Champions’ League.

Now after selling off all that can be sold, and being relegated from the English Premier League into the second-tier Coca-Cola Championship League ( and who are they kidding? The Championship league is the Second Division and changing the name and euphemism is just trickery and self-delusionary), Leeds United will now be relegated into the third-tier First Division (the old Third Division)!

It is so shameful! So pathetic! When my friends talk about Man U or Chelsea or even Liverpool getting into or missing out on automatic Champion’s League place etc, in the back of my mind, I can only be green and absolutely filled with jealousy and pretending that that is so unimportant and inconsequential!

I, the born-loser, promise, from henceforth, that I will not surf the net on every single Saturday night (GMT) or Friday or Sunday or even weekdays to check the “live score” page of the BBC sports page for the minute-by-minute commentary of Leeds’ matches , nor check official and unofficial Leeds United websites about banal and boring news about who has been injured or is recovering from injury and which second-rate player Leeds has managed to loan from some EPL team.

Remember Rauol Bravo? who was bought ( or on loan) from Real Madrid and played worse than any S-League player but when he returned to the La Liga, suddenly found his playing form again?

Anyone got a Prozac? I want to down it with Vodka!

Boo Hoo Hoo

Dr.Huang Shoou Chyuan

Wednesday, April 25, 2007

Alan Johnston: BBC Journalist

Text: Family's letter to Alan Johnston

As part of an international day of action appealing for the release of BBC journalist Alan Johnston, his father, Graham, read out an open letter to the journalist from his family.

"Hello old son,

I don't know if you will see this but I just felt that I wanted you to know how distressed and sorry we all are that you were taken.

You had warned us frequently that the chances were always there that you would be kidnapped and we were prepared in a way for this to happen. Nevertheless when it came, it was still a considerable shock.

Now, you have not to worry about us. Your mum and Trini and I are hanging in there and trying to keep a stiff upper lip. The support we have had from your friends and colleagues at home and abroad has been phenomenal, especially the BBC who have cosseted us and to whom our profuse thanks go for keeping us abreast of the situation.

There are so many people worldwide all hoping and praying for your release, not least of which I'm sure, are the vast majority of the Palestinian population, many of whom have told us they are ashamed that you were kidnapped. We know how much you enjoyed your work there.

Your fellow local journalists are doing a magnificent job holding demonstrations calling for your early release. There is so much sympathy for your plight around the globe and we are overwhelmed at such support, all of which helps to buoy us up during the past seemingly interminable four weeks.

I would like to say something to those who are holding you. You have family. Please think about what this is doing to my family

I would like to say something to those who are holding you. You have family. Please think about what this is doing to my family, including in particular the distress and deep concern Alan's mother and sister have had to endure for all these long weeks. As I have said before please let my son go now, today.

Alan, all our heartfelt warmest fondest love is sent to you from all your family and in the fervent hope that you will be released unharmed. Chin up my son, Trini, Raymond, Alastair and as always your ever-loving mum and dad."

Other activities in support of Alan Johnston:

Demonstrations for BBC's Johnston

A rally for kidnapped BBC reporter Alan Johnston has been held by the National Union of Journalists in London.

The union demanded that more resources are devoted to secure the release of Mr Johnston, 44, who was abducted by gunmen more than six weeks ago.

Earlier, a rally was held by journalists at the main crossing point between Israel and the Gaza Strip.
Members of the Foreign Press Association in Israel gathered on both sides of the Erez checkpoint.
The London vigil, backed by the International Federation of Journalists, was held outside the Palestinian General Delegation office.

NUJ General Secretary Jeremy Dear said: "We will not cease until Alan is free to rejoin his friends and family and resume his life as an internationally respected BBC journalist." read on...

My comments:

Hi Friends,

I am deeply touched by Graham Johnston’s letter.

It reminds me that at the end of the day, what is most important to all of us is family and true friends.

I could not help being impressed by how much Johnston’s employer, BBC, is moving heaven and earth to try to get Alan home. I am sure they have already tried the soft approach and when that failed, they are now rallying public opinion to exert pressure on the kidnappers to get him freed.

I remember some time back, one of SPH’s journalists also got into some trouble with a powerful Asian nation. My impression was and still is that SPH’s attempts to secure his release dwarfs considerably compared to BBC’s efforts.

This unfortunate journalist is still incarcerated and languishes in jail having been convicted as a “spy” and news about him has all but disappeared from the radar screen.

I sincerely hope that both of these journalists get back home to their loved ones soon.

If so, I am sure that Johnston will be the most loyal BBC employee ever but I am less certain of Mr. Ching Cheong’s feelings towards his employer ( or is it ex-employer).

Alan Johnston and Ching Cheong, God Bless and See you soon!

Dr. Huang Shoou Chyuan

Monday, April 23, 2007

A Danish reply says: Today, I received an interesting comment from a reader all the way from Denmark. Here is his well-researched and insightful response, reproduced in full.

"I read with interest Mentor Minister Lee Kuan Yew’s remark in Singapore’s Parliament that Denmark, Finland and Switzerland can afford mediocrity in the remuneration of their ministers.

I shall restrict my observations to Denmark and Finland.

These 2 Nordic countries reward their leaders, in both the private and public sectors, somewhat less handsomely than Singapore. Despite this, I would suggest that both countries’ governments are by no means mediocre, and neither have they evinced any indication of being able to afford it.

Finland has managed to weather the collapse of the Soviet Union in the early 90s, a market for 20% of its exports, in no small part due to its successful transformation from a resource-based to a knowledge-based economy. Its leading multinational, Nokia, is the market leader in the mobile telecommunications industry, with a global market share of 36% in the manufacture of mobile phones (Q42006) and revenues of €41.121 billion (2006). While most of the credit for this success story can be attributed to the Finnish private sector, Finland’s government had a significant role to play in creating the optimal framework for the flourishing of the technology sector. From the mid 1960s onwards, there were special efforts to expand higher education, with a law on higher education passed in 1966, the result being that Finns are some of the most well-educated people in the world.

The Finnish government was also instrumental in pushing for the promotion of GSM as the European mobile telephony standard, based on the Nordic countries’ experience of NMT, an earlier, pan-Nordic standard. The early adoption of GSM in Finland provided the platform for Nokia’s global breakthrough. Decades before the global liberalization of telecommunications markets in the 1990s, Finland’s telecoms market had already been liberalized, and thus had possibly the world’s most competitive market for telecom operators and equipment makers. Credit for this is in no small part due to the role of the Finnish government. Finland devotes a higher percentage of its GNP to research and development than most countries, and the role of the government has been critical, especially in the early 90s, where public-funded research increased despite recession.

In the case of Denmark, the government made the decision in the 1970s to intensify research into renewable energy. Important research was carried out at Risoe, the government research centre, into wind energy. It took political courage to subsidize feeder tariffs for wind turbine-produced electricity. That decision has paid off handsomely. Today, Danish-based companies have a global market share of ca. 50% in the manufacture of wind turbines, an industry with global annual growth rates of 30%, and estimated revenues of €10 billion (2006, est.). Indeed Denmark’s Vestas has recently set up engineering and research facilities in Singapore.

In more general terms, I would submit that both countries’ systems and governments are not mediocre, and are like Singapore’s, acutely aware of not being able to afford it. Rather than Europe being there to catch Finland and Denmark should they falter, both countries have been net contributors to the European Union budget since their accession. Mediocrity is not a hallmark of either society either. In the last 30 years, both countries, despite their small populations, have produced individuals who have won Olympic gold medals, Oscars and Nobel Prizes. They have produced New Economy pioneers, for example Finland’s Linus Torvalds, the creater of Linux (an open-source operating system and competitor to Microsoft’s Windows) and Denmark’s Janus Friis, co-founder of Skype (a peer-to-peer telephony application).

In conclusion, both countries’ positions as globally competitive economies and high-achieving societies have been attained against the backdrop of low corruption levels, and high levels of trust between citizens and government, and seemingly despite high taxes and comprehensive welfare states. This has not required stratospheric levels of remuneration of government leaders and officials.

Mr. Gregory GlenHolstebro, Denmark"

My comments:

I realize that there is often a need to remind ourselves how much we have achieved in a short time span and that things could have been worse. (On the other hand, it could also have been better).

Praises are usually accorded by others and if offered we should accept them with grace and humility.

What I tell my children to always avoid is self-praise. What is worse than self-praise is the elevation of self by denigrating and belittling others. Even worse ( lagi worse ) than this is the mocking and ridiculing others on less than “fair” basis ( there are other words that come to mind but since I do not have lawyers on retainer contract I better avoid them) in order to put one self on a pedestal. (Talking about Singapore)

Mr. Glen gives us a different perspective from those we read and hear day in and out and in and out and…

My next phone will be a Nokia and I will eat Danish pastry tomorrow. Very nice.


Dr.Huang Shoou Chyuan

PS: I forgot to get mr.biao's permission., can I use your letter for my post?

Thursday, April 19, 2007

Education & Children- Food for thought

April 19, 2007
Parents should allow their kids to follow their hearts and not their brains
By Heng Cho Choon

Online forum Straits Times

I WAS attracted to the Review article, 'Einstein: The patron saint of distracted schoolkids' (ST, April 13), in which the writer advocated the importance of imagination and creativity.
Be that as it may, it may be pertinent to note that Einstein's road to success was paved with cobblestones of failures for in 1895 he failed an examination that would have allowed him to study for a diploma as an electrical engineer at the Eidgenossische Technische Hochschule in Zurich.
Nonetheless, he went on to win the Nobel prize in 1921 for his theories in Theoretical Physics and especially for his discovery of the law of the photoelectric effect.
Sim Wong Hoo's theory of NUTS (No U-Turn Syndrome) may be food for thought for our Ministry of Education officials as our schoolkids and civil servants have grown used to the entrenched culture of NUTS.
In the US, when there is no sign on the road, it means that you can make a U-turn. In Singapore it is the reverse. When there is no sign on the road, you are not allowed to make a U-turn. When the authorities allow you to make U-turns then they will put up signs to give you that right.
The end result is that the social behaviour of Singaporeans is unique for their mindset is one of unquestioning conformity to higher authorities before taking any action. The tenet, 'If it ain't broke don't fix it', is pervasive in our society.
The recent triumph of the United World College in the 'Arena' debate series clearly shows its superiority in elocutionary skills. Its students out-talked the best debaters from Raffles Institution and Hwa Chong Institution as they were able to think out of the box and were fast and furious in their rebuttals.
Steven Paul Jobs, the co-founder and CEO of Apple, is now the largest shareholder of Disney and is considered a leading figure in both the computer and entertainment industries.
In 1972, Jobs graduated from high school and enrolled in Reed College in Oregon but he dropped out after only one semester. When years later he was invited to give a speech at Stanford University he spoke frankly about his opinions on entrepreneurship, work and life. He reflected on what kept him going through challenging times.
'I am convinced that the only thing that kept me going is that I loved what I did. You have got to find what you love.' He spoke of the importance of 'following your own inner voice'. The message is that parents should allow their kids to follow their hearts and not their brains.
Enrico Fermi won the 1938 Nobel Prize in Physics for his work on induced radioactivity. He once said: 'There are two possible outcomes: If the result confirms the hypothesis then you've made a measurement. If the result is contrary to the hypothesis, then you've made a discovery.'
Our school kids should be taught to formulate their own hypotheses and learn to question what they have learnt from the teacher and their textbooks.
Heng Cho Choon
My comments:
Dear friends,

I read this nice and succinct letter to the online forum page by Mr. Heng.

It more or less encapsulates what I feel about education and Singapore life.

I have already ranted about this topic before, so I will just spare you guys the agony this once.

But not before quoting Mark Twain:

"I have never let my schooling interfere with my education."


Dr. Huang Shoou Chyuan

Thursday, April 12, 2007

Enigmatic PY at Spring Singapore

By Vernon Lee (

The man who's instrumental in creating Singapore's biomedical sciences and petrochemicals industry now wants to focus his energy on nurturing today's local small and medium enterprises into tomorrow's MNCs.

Making his inaugural address as Chairman of Spring Singapore at a business event, Mr Philip Yeo, says SMEs can expect more initiatives from Spring to help them grow and venture abroad.
Mr Yeo outlines clearly the mission of SPRING: to bring hope and give help to SMEs.

Speaking to an audience of mostly senior executives of local enterprises, Mr Yeo terms Spring as the "enterprise development agency" for SMEs.

The ultimate goal he envisions?

To graduate today's SMEs nurtured by Spring, into tomorrow's MNCs who will be partners of the Economic Development Board.

Towards the goal, Mr Yeo says SMEs can tap into various help schemes in the areas of financing, overseas markets development, management, and capabilities and technology enhancement.
But he says the government can only do so much to help local enterprises.

To speed up the growth of SMEs, Mr Yeo says bosses of these enterprises must embrace a core value of successful MNCs: grooming the young to assume key management positions.
Ultimately, Mr Yeo says Singaporeans and local enterprises must also have a sense of "hunger" for success.

"At the end of the day, if you're not hungry to grow, you'll never grow. And hunger is a very important factor. If people are not hungry; they're comfortable, they're happy, 9 to 5, marry your wife, two kids, a car, an apartment, that's it. I mean it's very comfortable. The greatest fear I have is our people will not be hungry. You go to China, everybody's hungry. You go to India, everybody's hungry. Wherever you go, you're fighting against hungry competitors. So we need to nurture that sense of hunger in our young people."

Meanwhile, Mr Yeo reveals that he's in discussion with the heads of EDB, A*star and IE Singapore to streamline the responsibilities of the various agencies.He adds that Spring needs to mobilise the resources of the other agencies in order to focus on its main role of enterprise development.

My comments:

Dear Friends,

Many bloggers have misgivings about Mr. Philip Yeo.

PY: The Enigma

Like him or loath him, one cannot ignore him. Especially as he continues to amaze us by recently "popping up" in blogosphere and giving as good as he got.

I am sure that even those who are skeptical about A*Star’s strategy will be struck by the passion and tenacity with which PY defends his “baby”.

PY, who had various babies before A*Star ( I am not hinting at sowing of wild oats and I say here that I know NOTHING about his personal life) is well known for his no-holds- barred manner of speaking and had raised many eye-brows and ruffled many feathers en-route to where he is now. Woe to him who chooses to criticize any of these babes without solid supportive data at hand.

PY is undoubtedly self-assured, cocky even. Somehow his cockiness seems more palatable to me now then in the past. Then he was just one of them MIW’s ( men-in-white) . Now he seems more human and actually has a character unlike many of the rest. He believes in what he does and he is not afraid to show it.

PY’s task at Spring Singapore

Enough of praising PY.

PY has an unenviable task of jump-starting the Spring Singapore where he is keen to nurture SME’s into tomorrow’s MNC’s.

This task,already mammoth in proportion , is made gargantuan, by the crowding out of the domestic economy by the Temasek-linked companies (TLC).

With all sincerity, I hope that PY is the man for the job.

Hunger: How to learn it

"At the end of the day, if you're not hungry to grow, you'll never grow. And hunger is a very important factor. If people are not hungry; they're comfortable, they're happy, 9 to 5, marry your wife, two kids, a car, an apartment, that's it. I mean it's very comfortable. The greatest fear I have is our people will not be hungry. You go to China, everybody's hungry. You go to India, everybody's hungry. Wherever you go, you're fighting against hungry competitors. So we need to nurture that sense of hunger in our young people."

Jokes aside, I feel that my children are less “go-getter” than I. They take things too easy and their only answer to my constant prodding is that I should not be so “kanchiong spider!”

They do not seem to realize that there is no free lunch ( esply from the PAP government).

I try to put my kids in challenging environment and situations, but when they stick out their hands for help, my heart just goes soft and mushy and I become “sugar daddy” once more!

How to make them hungry when they get everything they need? Sigh!

Can entrepreneurship ever be taught? Will our society really give entrepreneurs a chance?

Our whole social fabric is so risk-averse: Throughout the food-chain: Political leadership/education system/cultural and the arts. There is no appetite for failure. One strike and you're out ( worse than baseball!).

Children are taught by teachers and parents that they should study hard, go the well-trodden road to the academic scholarships and land the govt job- better still political office. Then tadada... Golden ( not just iron) rice bowls!

The recent civil servants' pay rise and Ministers' pay bonanza seems to confirm the wisdom of this thinking!

I have no doubt that the active young bloggers (defined as below 35) whose blogs I read daily here have what it takes to survive in the new globalised age. These include Aaron/Wayne/SiewKH/Gerald/Charissa/Cobalt. I dare not mention others as I may get their ages wrong! (people like Mr. Wang etc)

I am not so confident about the rest of the young people as Singapore’s educational and other institutions (National Service) seem to have succeeded only in producing an orderly, obedient but unimaginative population.

With such young people entering the work-force, it seems a tall order to have an enterpreneural class resembling that in HK and Taiwan.

PY, I wish you best of luck in Spring Singapore.

If you succeed, you deserve the money being dished out by our treasury to the other undeserving fellows.

Dr.Huang Shoou Chyuan

Thursday, April 05, 2007

Vintage Catherine: Be mindful of the affective gap

Be mindful of the affective gap
By Catherine Lim, For The Straits Times (5th April 07)

I HAVE followed with intense interest the current debate on increasing ministerial salaries to match those of the highest earners in the private sector. And I have noted the impassioned arguments from both sides: the Government insisting on its necessity if top talent is to be recruited to ensure good leadership, and the public expressing its reservations, doubts and unhappiness.

I would like to go beyond the emotion and the rhetoric, and see the issue in the larger context of the PAP model of governance, in particular its special brand of pragmatism in solving problems. It is a hard-boiled pragmatism which even the severest critic will concede has contributed greatly to the Singapore success story. And one which, paradoxically, even the strongest supporter will concede is liable to harden into inflexibility.

In the case of ministerial salaries, the PAP leaders' thinking seems to have gone along these lines: Singapore needs a good, strong government if it is to prosper or even survive. Hence, it needs to recruit top talent. Since there is competition for this from the private sector, it has to offer equally attractive salaries. It has to act quickly and decisively, otherwise the country will face a serious crisis of leadership, which can occur in three increasingly dangerous stages:

· Talented people will not be attracted to government service.
· Even if they are, they will soon be enticed away by the private sector.
· But even if they are not enticed away, they will resort to corruption as compensation for their inadequate salaries, and thus bring ruin to society.

Rounding up the austere dialectic is the urgent plea to doubting Singaporeans: Do you want Singapore to go the way of corrupt societies?

I would like to point out, respectfully, a basic flaw in this rationale. In keeping with the overall, hard-nosed realpolitik that has characterised PAP rule, it fails to take into account the affective factor that is present in any relationship, whether between individuals or ruler and ruled.

This factor comprises that special constellation of emotions, moods, attitudes and ideals which somehow elude being quantified and reduced to monetary terms. I first analysed its role in the relationship between the PAP Government and the people over a decade ago in a political commentary titled The Great Affective Divide, noting the emergence of a serious emotional estrangement despite the country's stability and prosperity.

Subsequently, I variously described the conflict in terms of the people's wish to see a greater role for Heart as opposed to Head, EQ as opposed to IQ, Heartware as opposed to Hardware, etc.

The policy regarding ministerial salaries illustrates this conflict. Its definition of the talent that is eagerly sought as ministerial material does not appear to take into account attributes beyond those of intellect. It assumes that what is good for the corporate world must be good for government, and that therefore there is a common target of talent out there, which both will compete fiercely for.

But in reality, the commonality of talent is only in those attributes of mind and personality such as great intelligence, far-sightedness, boldness of vision, creativity, determination of purpose, etc, that are the hallmarks of today's high achiever. Beyond this overlap, the emotional aspect comes into play.

And here, there is a dramatic parting of ways. For while the ideal political leader is imbued with nobility of purpose and altruistic instincts, the ideal CEO is impelled by the very opposite - raw ambition and ruthless drive. The first set of qualities is desirable for a life of public service; the second would be disastrous.

Indeed, a brilliant achiever without the high purpose of service to others would be the worst possible ministerial material. To see a potential prime minister as no different from a potential top lawyer, and likely to be enticed by the same stupendous salary, would be to blur the lines between two very different domains.

Next, the rationale goes against the very spirit of the social contract that it is supposed to protect. There is a compact, largely implicit, that governs the government-people relationship in every mature society in the free world, and it has as much to do with what is felt deeply in the heart as with what is worked out logically in the head.

By this compact, political leadership is less a salaried job and more a vocation, with all that this implies of selflessness and sacrifice on the part of the leaders, and trust, respect and regard on the part of the people. It is this reciprocity that defines a social compact and confers upon it a sort of sacrosanct quality. The ultimate reward for the leaders, whether or not they consciously seek it, is a revered place in the nation's history, in the hearts and minds of future generations. Hence, material reward is only secondary.

Nevertheless, no Singaporean with any practical sense of the real world would want to see a minister denied a salary commensurate with his status and dignity, or living less well than any prosperous Singaporean. If the average Singaporean still aspires to the famous '5Cs' representing the good life, he is only too happy to see a minister already well in possession of these.

But, at the same time, no Singaporean would expect a minister to feel disgruntled if he is paid less than the top CEO. If the disgruntlement actually causes him to leave his job, then he was not cut out for public office in the first place. Thus, to offer him a matching salary to enable him to stay would be to demean that office.
There is clearly a need to balance material needs and public service. The balance, in the view of many Singaporeans, has already been achieved with the existing ministerial salaries, if benchmarked against those of high-earners across a broad range of professions, and also against the salaries of ministers in countries such as Sweden and New Zealand, consistently ranked among the foremost, corruption-free democracies in the world.

The policy of increasing ministerial salaries may have the effect of upsetting this balance and, more seriously, doing away altogether with the compact of trust and respect. It will create a new affective divide, or reinforce any existing one, between the government and the people, and reduce their relationship to a purely impersonal business contract.

Even in a society often described as aggressively materialistic and coldly efficient, there are, fortunately, Singaporeans who believe idealism has a place, and that the fire, passion and commitment of the Old Guard, who saw Singapore through the difficult early years with little hope of financial reward, are still alive in some young Singaporeans.

The policy on ministerial salaries will, at the least, breed weary resignation in Singaporeans: What's the use of giving one's views at all? And, at the worst, give rise to toxic cynicism: What's the use of teaching our young such values as caring and selflessness and sacrifice if each carries a price tag?

Catherine Lim is a freelance writer.

My comments:

Hi friends,

To me Catherine Lim is much more than a freelance writer. She is a freedom fighter.

She has more B*lls than all of us men put together!

I will not add any more comments for it may distract from her excellent and timely piece.


Dr.Huang Shoou Chyuan

Tuesday, April 03, 2007

Singapore Medical Association’s Guideline of Fees (GOF) Withdrawal: Patients now have less protection!

Withdrawal of SMA Guidelines of Fees (GOF)

Singapore, April 2, 2007 – The Singapore Medical Association (SMA) announced at its Annual General Meeting on April 1, 2007 that the Association is withdrawing its Guideline of Fees (GOF) with immediate effect. This decision by the 47th SMA Council was made after it received indications that the SMA GOF might run the risk of contravening Section 34 (2)(a) of the Competition Act and also after the Council had sought advice from five of its seven Honorary Legal Advisers.

The GOF was first introduced in 1987 with the aim to protect patients from being overcharged and to equip them with knowledge on medical procedures in hope that with improved knowledge there would be lesser cases of misunderstandings. It helped doctors with an indication of the current rates and how much to charge their patients. The guideline was the result of the collaboration of the Singapore Medical Association and the Association of Private Medical Practitioners of Singapore (APMPS) in response to the Health Ministry’s call for a guide on medical charges.

To date there have been four editions of the GOF (1987, 1992, 2001 and 2006).

My comments:

Dear Friends,

This is not a sick April Fool’s joke.

I found out about this from an email sent to SMA’s members only last night and it is all in the papers today.

The marketplace

There are various known relationships with respect to suppliers and consumers in the marketplace.

Those familiar with Economics 101 will know of Perfect Competition; Monopolies; Monopolistic competition; Oligopolies and others.

Perfect competition (PC): Eg Salt/sugar. There are many suppliers/ low entry and exit barriers/suppliers are price takers/homogenous products. Ie consumers have much choice and if supplier tries to be funny and raise the price even by 2 %, the consumer will buy from the next guy.

Monopoly: eg Singapore power / PAP govt ( serious!) : Only 1 supplier/price maker/ unique product/high entry and exit barrier. Take it or leave it. I say this product cost $1 million dollars- if you want you got to rob and steal and then buy it from me only.

Monopolistic competition/ Oligopolies: I do not have time to elaborate but these are variations of PC and monopoly.

Others: The doctor and patient relation is under this category.

Asymmetric Information: The doctor (supplier) in the relationship holds all the cards, as he has the knowledge that the patient ( consumer) requires . The patient depends on the advice of the doctor. If the doctor says that he requires a tonsillectomy, the patient usually has to accept it unless he makes an effort to get a second opinion ( or surfs the net).

Hence in a situation where there is unequal power relationship (eg with asymmetric info), self-regulation is crucial or else the consumer will get fleeced.

Self-regulators are usually appointed by or encouraged by the authorities to keep its members in line so that there is no profiteering nor exploitation of the public who do not know better.

The SMA’s Guideline of Fees was formulated for this very purpose. ( see above)

Beside consultation charges, surgical fees are also included in the GOF. The surgery fees are more of less grouped similarly to the Ministry of Health’s Table of Surgical Procedures (TOSP) (Groups A-G vs Tables 1-7) which determines how much of the patient’s Medisave can be claimed for the said procedures and hospital admissions.

Types of surgeries are grouped according to degree of complexity. A range of fee is then suggested for each of these groups. It is not a price-fixing attempt and only serves as a guide. Doctors are allowed to go above or below it.

Implications for patients with withdrawal of GOF

From now on, when asked about charges, doctors can tell their patients with a straight face (and with hand on heart) that there is no guideline.Period. The fee is such and such and that he does not know whether his charges are high or low with respect to other similar specialists.

The patient would then have to decide either to seek a second opinion and then go through the whole process of consultation again or else accept the doctor’s offer for treatment and hope that he has not been overcharged.

In the event that a patient does complain to the Singapore Medical Council (SMC) that he feels that he has been overcharged, SMC is in no position whatsoever to decide whether the charge is reasonable or not, short of surveying all the specialists doing that particular surgery and then get the mean/median or any other statistical method that it feels will help determine the fairness of the charge.

In the past, SMC just picks up the latest GOF and if everything else in the complaint have been dealt with, will usually reply to the patient that yes or no, the fee was unreasonable or reasonable as the case may be.

PTC and other regulatory bodies

Public Transport Council is an example of a regulatory body set out to protect the consumer who is at the mercy of companies who run our public transport system. I know some skeptics who think the PTC behaves like a cartel with official sanction.

Even oligopolies in the communication industry (Singtel/M1/Starhub) are regulated in some ways by their respective regulatory bodies.

Although SMA ( as contrasted to SMC) is a voluntary association of doctors, which de-facto had taken on some self-regulating functions of the medical profession.

With SMA surrendering this role, SMC will be hard-pressed to come up with some measure to assess the fairness of the doctors’ pricing of services.

At the end of the day, I can only say that there is less protection for patients as there is now worse asymmetry of information. Some doctors may be wringing their handsin anticipation, thinking that there is now no longer any need to follow any guidelines and they can charge as high as they think the patients are willing to pay. Maximise the consumer surplus ( as economists will say)

My honest opinion is that the SMA's decision is ill-advised and hasty. And wrong!

( Author's note (7.30 am 4th April)- SMA President Dr. Wong Chiang Yin has clarified in the Today Newspaper: "It was, in effect, a choice of scrap the guideline now — or cough up $200,000 for a decision from the Competition Commission of Singapore that might simply lead to the same result.

Getting guidance alone from the Competition Commission to file paperwork would have cost $20,000, while getting a decision would have cost the non-profit organisation $30,000. In addition, the SMA would have had to cough up some $150,000 in legal fees."

In view of the new fact, I agree that the SMA was between the rock and a hard place and has no choice but to act as it had. The conspiracy theorists are having a field day! More exciting than Kieffer Sutherland's "24"!)

The GOF is not a cartel's attempt at price-fixing. We do not monitor members' pricing policies ala OPEC. There is no collusion and the doctors do not meet in dark alleys and smoky corridors conspiring to fix the consumers. Far from it. The GOF actually serves as a psychological barrier to doctors who want to charge fees far in excess of the guidelines as when they are put under the microscope ( eg SMC/ Insurance companies), they would have to justify why they are an outlier!

Sigh! Try to be good doctor, also difficult. Maybe should just mind my own business and make the big bucks whilst the sun still shines.

Addendum 3rd April 07 9pm:
Ways of resolving assymetric information includes:

1.Mandatory disclosure- useful only if information can be objectively verified
( also not useful if I tell the patient my price for Procedure A is $1000. So what? There is no way to compare unless he goes and call up another 10 doctors to find out their prices)

2.Regulation of conduct- eg "cooling off" period. But we don't force patients to decide on the spot anyway. At least I don't. We are not selling "timeshare" !

3.Regulation by self ( doctors association) or by higher authority- but that is the exact thing that SMA has decided against.

The question is : Can we ask SMC ( being a govt-appointed body) to take over the function of a price watchdog?

Another question: Does the Law Society still have a recommended scale of fees for legal services? So bodies like PTC is ok but SMA's GOF not?

Dr.Huang Shoou Chyuan