VINCENT LEE: The report says all this (making co-payment mandatory for full-rider health insurance) is because people abuse the scheme but a lot of times, the insurance company policy is what causes this to happen.
Take my real life example.
My child is sick with very high fever and virus infection. I bring my child go see PD (paediatrician).
I was given 2 option by the doctor”
Option 1 : bring home and monitor and come back next day for review and blood test
Cannot claim insurance and pay per visit a few hundred (expected at least 3 trip)
Option2 : admit the child into hospital for observation
100% claim eveything back by insurance
As a parent, if possible we would all want option 1 because we don’t want to let our child stay in hospital and would like to bring them home and take care of them on our own but with the cost of treatment, we are forced to choose option 2.
Insurance companies should re-look into their own policy.
I use the cheaper option, I incur less then S$1000 but everything I’ve to pay on my own.
I choose the more expensive option I incur close to S$10,000 and it’s 100% claimable.
This is the real reason why we choose the more expensive option not the example stated by the MP. I believe his example are super rare example but my real life example is happening every day in the clinic.
If the insurance policy is changed and when given the option of out-patient treatment by the doctor, we are still able to claim, I strongly believe most people would choose the cheaper out-patient treatment.
The current policy is unless hospitalised, cannot claim. That is the main reason why cost goes up.
Another item that show be looked at and investigated is why the patient needs such expensive treatment.
We are not doctors and we get nothing out of all these expensive treatment, as a patient this is what are looking for:
1) we want to get well
2) we want to pay as little money as possible out of our pocket
3) we hope the treatment is as painless as possible
99% of us will simply follow the doctor’s advice and even if explained to us what is the procedure about and how to do it, we are still not knowledgeable enough to make our own decision and will simply follow whatever advice the doctor gives us.
Doctor and hospital need to be ethical and not give unnecessary treatment in order to earn more. So if a patient incur so much on unnecessary treatment, is it the patient that is asking for it or is it at the advice of their doctor?
If i’m sick and my doctor tell me this.
Sir, you have XXX, there is this treatment available for you. It cost $XXX but don’t worry, it’s 100% claimable and I think you should do it.
What do you think would be a normal person reply?
I know my reply would be “ok”
The new policy will address some of the issues but I don’t agree with the way it is being handled. I believe it has to be fair and over-prescription will still be an issue because doctor and hospital are not penalised.
This is what I suggest: the full rider benefit should remain but it needs to have certain restrictions tied to it
1) When a patient is given the option for either out-patient or hospitalized for observation, if the patient choose out-patient he can still claim. This would reduce the number of hospitalization cases and also help to free up bed space
2) The doctor will recommend the type of treatment and if the patient ask for treatment not recommended it will not be subsidised and the patient will need to pay for the cost of that particular treatment. This would make the patient think twice about asking for buffet type of treatment
3) In the event of over-prescription the doctor is held liable for the cost of treatment. This would make the doctor accountable and they will not anyhow prescribe treatment.
I believe this would be fairer as genuine patient is not penalize and everyone is accountable for their decision and the only people who would complain are the people who abuse the system.
