Wednesday, May 5, 2010

Publishing medical bills may narrow price gaps

Alicia Wong

SINGAPORE - Patients at private hospitals here could be paying twice as much for the same procedure, depending on where they seek treatment.

A day after Health Minister Khaw Boon Wan said private hospitals will be required to publish these bill sizes if they want to make Medisave claims, MediaCorp found that the difference in fees now range from some 15.4 per cent to 103.3 per cent.

For instance, 90 per cent of Mount Elizabeth Hospital (MEH) patients pay up to $8,600 for a 2.6-day stay in a one-bed ward when they give birth, compared to the $4,233 for a 2.1-day stay at Parkway East Hospital (PEH).

For day surgeries, 90 per cent of PEH patients pay up to $1,733 for gastroscopy, up to 60 per cent more than the $1,083 fee at Gleneagles Hospital, according to checks on the Ministry of Health (MOH) website.

The three hospitals are run by Parkway Holdings, whose medical specialists run their own practice and bill their patients directly.

Government Parliamentary Committee chairman (Health) Dr Lam Pin Min said the fee differential could be due to doctors pricing themselves according to their years of experience.

"Some want to be competitive so they price lower, others feel their experience allows them to charge more," he said, and added that this is where information on clinical outcomes will augment the publication of bill sizes. Consumers would then know how much they are paying for a certain success rate.

In cataract surgery, for example, where there is a price difference of up to $2,000 between MEH and PEH, Dr Lam, an eye specialist, said that another cost factor could be the type of intraocular lens used to correct vision.

Still, Mr Khaw's plan, which will take effect early next year, could narrow the price gap between private hospitals, which now provide data for only about a dozen treatments on a voluntary basis.

MOH data in 2003 showed that Changi General Hospital (CGH) charged an elderly B2-class patient with pneumonia $1,272, or 77-per-cent more than the comparable median figure of $720 at the National University Hospital. Now, NUH charges $129 more - an 11-per-cent difference - than CGH to treat pneumonia in the elderly with complications, in a B2-class ward.
Dr Lam believes the move will also bring down prices among private hospitals, similar to what happened when MOH published the bill sizes of public hospitals.
Lasik surgery, where average bill sizes dropped by more than $1,000 per eye, is often cited as a prime example of this.
A Mount Alvernia Hospital spokesperson said the impact of publishing private hospital bill sizes is "left to be seen", but the hospital will continue to provide the best care for patients while ensuring its services remain "comprehensive and value-for-money".

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