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Discussion on medical over-charging. This article was published in The Star.

URL is http://www.littlespeck.com/content/healt...110313.htm

Medical cost: Bigger than huge
Accumulated S$24.8m bill for one patient: Is it a unique phenomenon or an ill-prelude for things to come?
By Seah Chiang Nee.
Mar 13, 2011

(Synopsis: Hard hit by rising healthcare costs, Singapore’s elderly cringe whenever a private practitioner charges a mega-fee, wondering if it will set a new benchmark for all.)

AN accumulated S$24.8mil medical bill charged to a single patient has become a sensation in this city of rising millionaires.

It has rocked the senses of Singaporeans who are no strangers to tales of individual wealth and lavish spending in recent years – as well as big-money scandals.

The latest blew up when top transplant surgeon Dr Susan Lim billed a member of Brunei’s royal family S$26mil (including Goods and Services Tax) for seven months’ breast cancer treatment.

The family of Pangiran Anak Hajah Damit, the cousin of the Brunei Sultan and sister of the Queen, who succumbed to her illness in 2007, complained about the bill.

This brought the Singapore Medical Council (SMC) into the scene. It first held an informal hearing then decided to hold a formal investigation into the issue of overcharging.

Dr Lim, who gained fame when she performed the first successful liver transplant in Asia, has applied to the High Court for a judicial review to stop this inquiry.

It was, of course, the S$24.8mil medical fee that numbed the minds of Singaporeans, who are themselves badly hit by rising healthcare costs.

The lawyer for the Medical Council said that the bills of other doctors who had helped Lim were significantly marked up.

She inflated a third party specialist’s bill of S$400 to S$211,000.

Another’s bill of S$500 was inflated to S$93,500, and a third doctor’s charge of S$3,000 was blown up to S$285,100.

These reports pose a special concern for Singaporeans, especially the elderly, whose healthcare is strained by bed shortage and price increases (in the past six years, the cost of Class C hospital wards, the cheapest, have risen by 30%).

Several years ago, a private medical group billed a Singapore family S$700,000 for treating an aged woman – then reduced it by half after she passed away.

Singaporeans are worried that every time a private specialist doctor charges an astronomical fee, it will set or re-set new benchmarks for ordinary citizens.

Overwhelmingly, Singaporeans consider Lim’s fee was excessive despite the patient’s considerable wealth and her demands to be treated in Brunei by no one but Dr Lim.

Each time the surgeon would have to leave behind her practice, sometimes for days, to travel to Brunei.

“This must be a world record. In some countries, S$24.8mil is enough to buy an entire hospital,” observed a housewife.

“That could pay for several houses in Canada!” a surfer exclaimed. With the money, Lim could also purchase one of several small companies listed in the Singapore Stock Exchange.

When SMC investigated the fee, Lim offered to discount it by half, and later reduced to just over S$3mil.

Opting to maintain ties, Lim then offered to entirely waive the fee if the Brunei government would give her “a letter of good standing”. This was turned down.

Not surprisingly, many specialist doctors backed her, arguing this was purely a commercial deal in which the government should not have interfered.

This mega-dollar scandal adds to a growing list of financial scandals including cheating in recent years.

“At most, one can raise a question of ethics,” said a retired doctor.

The quick wealth and lavish spending of this 10th richest city in the world (based on per capita GDP) has become more evident. In some ways it is succumbing to a money culture.

Sales of Rolls Royce cars shot up by three times last year. A plate of yee sang (raw fish) and toppings can cost S$2,000 during the Lunar New Year.

One indirect result is believed to be runaway materialism.

In recent years, mega-million dollar scandals have risen from prominent civil servants, senior executives and even a top Buddhist monk and a Catholic priest.

The biggest scandal involved a former CEO of the National Kidney Foundation, T.T. Durai, who was jailed several years ago for corruption.

His trial revealed his lavish spending from funds collected from the public to help subsidise dialysis for needy kidney patients. He was paying himself S$600,000 a year, and he and his wife travelled first-class.

In 2004, Catholic priest Joachim Kang was jailed for four years for embezzling S$5.1mil from his church.

Then the authorities began investigating 18 individuals linked to the City Harvest Church, including its founding pastor Kong Hee and his wife Sun Ho for alleged misuse of funds.

A preacher from the New Creation Church, which boasts an income of S$55.4mil a year, was reported to be paying himself S$500,000 a year – until controversy spread and he stopped accepting the money.

The large Buddhist community, too, was rocked by a scandal when top monk Rev Ming Yi was sentenced to 10 months’ jail for misuse of funds.

The court delved into the lifestyle of the high-living monk, who owned three properties, loved luxurious cars and spent lavishly on branded goods like Montblanc and Louis Vuitton.

The saffron-robed reverend explained bluntly in court: “The world has changed… (It’s) no longer like what it was in the past.

“If people earn more, they will spend more. Many religious people, not just myself (sic), are very different now.”

Dr Lim is unlike these. She is not charged with any wrongdoing other than overcharging.

How pervasive is medical overcharging? I believe the practice is relatively confined to a few specialists who cater to the super rich.

The majority of doctors operate clinics to treat the average Singaporean family at relatively modest cost.

(This was first published in The Star)

The ending of the article doesn't make sense. The writer seems to be starting with the medical fees then going to materialism and then ended by saying most doctors charge normal fees.

No head or tail.....???
If you know who Seah Chiang Nee is, then the article will make sense.
http://www.littlespeck.com/about/theEditor.html

I suppose his background will mean that his article is more likely to lean towards the negative side of Singapore(or more precisely, Singapore Government Tongue)

I suppose The Star probably will not employ him to sing praises of Singapore Government...Big Grin

Its perfectly ok if he writes the negative side of things, but his article is jumping all around , with the opening paragraph saying the cost of medical is high and people are worried that they will be overcharged and then he moves to talking about materialism which is the cause and then ends by saying that in general most doctors charge normal fees.

Huh???
He needs to be both negative and balance mah..Tongue.

It is an art to throw a negative light and yet be seen as balanced.
I'm with Flinger on this one.

From the title, I think most people, as MW evidently did from his brief takeaway, would take it to mean that the focus is on the Susan Lim saga and how that would tie in to medical costs in SG and probably medical costs or the general costs of living in SG.

Why he brings in the materialism and grossly over and self-paid religious leaders is beyond me.
He could be trying to take (very subdued) pot-shots at another set of people? I don't know.

Either way, I think this guy's column needs more work.