Showing posts with label governance. Show all posts
Showing posts with label governance. Show all posts

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.

Enjoy!

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





Friday, March 23, 2007

Poor politicians and civil servants

Hi friends,

I am sure all of us do not want our civil servants and political leaders to go hungry.

Or be tempted to line their pockets with ill-gotten gains like corrupt third world politicians that we hear about ad nauseum.

But no right-thinking person looking at the salary-scale of our ministers and civil servants will likely feel that they are hard done by.

If I am not wrong, our politicians get many times the salaries of first world politicians. The main argument for such astronomical remunerations has been that these American and European presidents and ministers get rewarded after they leave office. They even write books, give talks to rich audiences and get invited to sit on exotic company boards! Shocking!

I wonder if ex-Singapore politicians do any of the aforementioned after they leave office?

Cheers

Dr.Huang Shoou Chyuan

Addendum:

My rebutal to the YoungPAP's views on this policy (see below)- these comments were from my comments page

Hi youngpap,

It is regrettable that the PAP/government is not able to persuade the ablest and best to serve the people on the platform and basis of public service. Instead the only way to secure these loyalties is the time-honored method – Greed and the love of money! There is NO sacrifice unlike what we have been told.

Idealism in any form is dead and buried in Singapore and pragmatism and “looking after oneself” is the name of the game. If even the young people of the Youngpap cannot see the false dichotomies and fallacies in the govt’s logic, we the people of Singapore do not have much to look forward to when these young people go on to be our future leaders.

It is the realm of “groupthink” when you the YoungPAP all begin to believe that Singapore is unique, our leaders are unique and that they should be uniquely rewarded. That we are so vulnerable that to have an independent media would cause our collapse and that to have freedom of expression and other freedoms like freedom of association and assembly would lead to our inevitable demise. Ironically, I hope in time to come, when the young people of Singapore ( including you in the YoungPAP) see more of the world, you will realize that some values like fairness,equality, freedom are universal and we should not be afraid to have them.

There is much that is good and admirable in our system, but self-serving and selfish policies like this when our own political leaders use the system to reward themselves beyond reasonable limits is not one of them. I hope some in the YoungPAP will see the insanity in this and begin to form your own individual opinions of some of these unfair policies.

Dr.Huang
(end of rebutal)

YoungPaP's post on this issue

http://youngpapblog.blogspot.com/2007/03/bill-gatesgeorge-sorosmother-theresa.html

Bill Gates+George Soros+Mother Theresa - How Much $$

Posted by elaina olivia chong at 4:56 PM

Money is the proverbial carrot. No matter how many people put themselves on the moral high ground, Money still talks for most others. If you want to get a job done you can’t do well yourself, pay some one well to do it well. If you want to get a job superbly well done, pay superbly more. Similarly, if we want Singapore to stay on the “Best Of” world list for a lot of things, we jolly well got to pay top dollar for the best people who can keep us right up there.

I can’t see why some forumers in our local chatrooms are questioning Ministerial pay rises and pegging our Minister’s pay to those in other countries. Spore isn’t like many other economies like the States, Britain or even Hong Kong where their economies can still remain alive even if their politicians are not making the best decisions. Not only are these economies self sufficient, they have people resources - to the extent where Supply far Exceeds Demand for geniuses at the top.

In many of these first world nations (whose Ministers’ pays have been “pegged” to ours), their economic engines are matured and almost self-piloting. These governments have inherited the fruits of their political forefathers and are now able to concentrate on improving the social and non-economic welfares of its peoples and say, spend time to build international relations with countries like us.

This government put Singapore, a country with no resources, with no historical ties or allies to begin with, on the world map in less than half a century. But will this last forever?

It takes more than a few good men to make a tiny red dot like Singapore a shining star it is today. Not an easy feat, and is not a task that every man on the street can do. Only the very best in the 4-5million we have, can.

Everyday is a new challenge for Singapore to stay competitive and ahead of economies thousands of times our size. If Ministers at the top stop what their doing; or aren’t clever enough to devise policies to keep us ahead of the global league, our economy will crumble. There’s no two ways about it. Some one has got to do it and able to do it very well.

Today, we have the PAP with a number of good men. Will we have the same people tomorrow and always? I’m not sure. I find it rather myopic and sadly presumptuous for so many of these forumers to assume that Singapore is forever going to be where it is, and that we will forever have exceptional geniuses willing to throw their lives to keep Singapore on its feet.

How many of our capable Singaporeans are willing to turn away high paying expatriate positions overseas? And choose instead, to stay home in Singapore, hold arms to protect and ensure the economic comforts for our families and posterity?

One of the ways and I'm not saying it is the only way, is to pay for them and pay them very well . To help keep them in Singapore, attract them into civil service or the PAP where they will join the “economic militia” and keep the Singapore flag flying high for a very long time

The life of a Minister is not attractive. How many are willing to sacrifice every evening either at Meet the People Sessions, chairing Review Committees and carrying another baby in a HDB kopitiam even on precious weekends?

A platoon with the acumen of Bill Gates, risk appetite of George Soros and the heart of Mother Theresa, I would think. And the compensation? Priceless. Haven’t we all heard this all too often, “Pay Peanuts Get Monkeys".

All that matters to me is for Singapore to stay ahead of the game becuase I choose to stay here. We sorely need more than a few Good Men to continue serving at the top so that our economy will continue its bull run. With a flourishing economy, Ministerial pay increments will pale in comparison to the prosperities and fortunes Singapore will be able to bring to its people. Because then, the man on their street will get his pay raise too.

Changes to Civil Service salaries to be announced on April 9

Channelnewsasia Mar 22

Civil service salaries are set to go up and details of this will be announced in Parliament on the 9th of April.

The salary review will be explained by Mr Teo Chee Hean who is the Minister-in-Charge of Civil Service matters in the Prime Minister's Office.

This was revealed by Prime Minister Lee Hsien Loong at the Administrative Service dinner on Thursday.

In his speech, Mr Lee said the government is also reviewing salaries for the political, judicial and statutory appointment holders.

He added that it is critical for Singapore to keep their salaries competitive so that the country can bring in a continuing flow of able and successful people to be ministers and judges.

The Prime Minister arrived at the Administrative Dinner with a clear message for his audience.

He said Singapore's Administrative Service is the core of the public service as it plays a central role in bringing about first class governance for the country.

And for the public service to remain an attractive employer, it must keep pace with the private sector.

The Prime Minister noted that salaries in the private sector have been progressing, with many good and well-paying jobs created in the last two years.

And demand for Singaporeans is not just coming from the local economy.

Mr Lee said: "We know from head-hunters that the entire top managements of some of our agencies are being targeted. The Middle Eastern countries are particularly interested. They have studied Singapore's success story. They want to tap our people to join them and replicate the miracle, and money is no object.

"Even foreign workers who have worked in Singapore shipyards here are in demand in the Gulf. We even received a feeler from one Middle Eastern country to buy the whole of JTC! All this will have an impact on the Public Service."

Mr Lee explained that there are two private sector salary benchmarks for the Administrative Service.

The lowest Superscale grade is where officers in the early to mid-30s enter the senior ranks.

For this group, the benchmark has climbed again but not for the second benchmark which is for the most senior Permanent Secretaries.

For this senior group, the yardstick is based on two-thirds of the median income of the eight top-earning professionals in six professions.

The private sector benchmark now stands at $2.2 million.

But in the Administrative Service, the salaries for this category has remained the same as the level in the year 2000.

It stands at $1.21 million, which is 55 percent of the private sector salaries.

Mr Lee said: "This is an urgent problem. We have experienced on previous occasions the painful consequences of responding too slowly when the private sector surged ahead. For example in the early 1990s, the Administrative Service lost entire cohorts of good officers. This showed up in the age profile of the Service - broad at the young and older age groups, but narrow at the mid- to late-30s range. We took many years to recover from the loss. This must not happen again.

"This is why the government is currently reviewing Civil Service remuneration schemes. The review will cover the Administrative Service as well as other services that are lagging behind the private sector, because every service is important, and each must be able to attract and retain good people."

Mr Lee reminded the Administrative Service officers that what they do affect how Singaporeans work, live and play.

And if everyone does their job well, the result will be a Singapore that everyone can be proud of. - CNA/ch

Link:

1.Today - http://www.todayonline.com/pdflive/2303FPG003.pdf

2. Perpective of other countries' politicians' salaries (rana.typepad.com)

3.Onlinecitizen.com

4. David Marshall's thoughts about Public Service and Noblesse oblige

Some baffled bloggers below

5.http://cobaltpaladin.blogspot.com/2007/03/minister-pay-hike.html

6.http://zyberzitizen.wordpress.com/2007/03/26/mindboggling-numbers-mindboggling-salaries/

7.http://twostepsfromtwilight.wordpress.com/2007/03/25/cut-the-crap/

8.http://1moresg.wordpress.com/2007/03/25/a-man-like-that-is-hard-to-find-but-i-cant-get-him-off-my-mind/

9. http://xenoboysg.blogspot.com/2007/03/queer-sensibilities-of-singapores.html

10.http://mrwangsaysso.blogspot.com/2007/03/sweet-talking.html

11.http://www.yawningbread.org/arch_2007/yax-726.htm