On Friday (20 December), the Straits Times (ST) forum published a letter written by a man called Lim Chuan Poh. The man penned his unhappiness upon finding out that the fee for a magnetic resonance imagining (MRI) scan at Changi General Hospital (CGH) was so much higher compared to a private imaging clinic.
Mr Lim explained that the doctor at CGH’s orthopaedic department who he consulted on 16 December, said that he needed a MRI scan to determine the severity of a “suspected rotator cuff tear”.
However, the earliest appointment for the scan at the hospital was only in late March, and he was quoted S$1,450 for it.
Since Mr Lim’s shoulder pain was causing him severe discomfort and sleepless nights, he decided to do the MRI scan at a private clinic instead. He said that he was given an almost immediate appointment and the cost of the scan was less than S$600, including goods and services tax.
“I am puzzled by the difference in charges between CGH and the private imagining clinic I went to. What is the basis for CGH charging so much more for a similar service?” he asked.
He continued, “My concern is whether, besides the MRI, general hospitals are over-charging patients for other services. I hope the hospital and the Ministry will look into reviewing healthcare charges”.
This is not the first time a case of higher treatment price at government hospitals compared to private clinic has been reported
In July this year, TOC wrote an article about how an individual’s consultation fee at a National Healthcare Group Polyclinic was much higher than of a private clinic.
Based on the image above, the receipt on the left from a National Healthcare Group Polyclinic shows a final bill of S$13.20 after deducting the government subsidy of S$34.90. That means the total price for a consultation before subsidisation is actually S$48.10.
On the right is the consultation fee incurred when visiting a private clinic with no subsidies – S$29.90. That’s about 38% lower that the full cost of a consultation at a so-called public healthcare facility. While the final total is much lower after the subsidy, the initial fee is much higher at the polyclinic.
Separately, blogger Philip Ang Keng Hong took to his blog in July 2019 to point out that there’s no such thing as public healthcare subsidies after he found out that the consultation fee at a polyclinic is higher than a private general practitioner (GP).
The blogger said that he had first-hand experience regarding this when he underwent a minor surgery for a cyst removal.
According to the public healthcare system, Mr Ang said that he was first required to consult a polyclinic GP in order to get a referral letter to see a specialist, and this costs him S$13.
Weeks after that, he explained that as a subsidised patient, he had to pay another S$37 to consult a specialist at CGH to schedule an operation. And after the operation was over, he will have to pay an additional S$275, which is only the estimated cost.
Based on these figures, it appears that a subsidised patient will have to pay a total of S$325 for the minor surgery.
However, Mr Ang ended up doing his minor operation at a private clinic after his appointment at CGH got cancelled. He ended up paying only S$280 at the private clinic, which is significantly lower than the amount he would have paid at CGH as a subsidised patient.
According to ValueChampion, Singaporeans pays very high out-of-pocket costs for healthcare even after taking into account every subsidy and insurance coverage available. In fact, out-of-pocket costs make up almost 37% of the total healthcare expenditure in Singapore – that’s almost three times higher than the high income-country average and 1.4 times higher than the East Asia & Pacific average.
Despite such difference in cost, the Ministry of Health (MOH) has consistently maintained that healthcare is affordable thanks for the 3Ms – MediSave, MediShield and MediFund – which helps keep out-of-pocket medical costs low for individuals.
In fact, MOH has said on their Facebook page that “Singapore has come a long way as we work to build a healthcare system that is accessible, affordable and provides quality of care.” The website notes that the healthcare system in Singapore is designed to ensure that “everyone has access to different levels of healthcare in a timely, cost-effective and seamless manner.”