Last Saturday (21 December), The Straits Times (ST) forum published a letter by a man named Ian Lee Chi Meng who was shocked to find out that the National University Hospital (NUH) Eye Centre charged his mother more than S$23,000 for her cataract operation and subsequent clinical follow-up.
In his letter, he explained that his mother was first diagnosed with cataract last July at Ngee Ann Polyclinic, before being referred to the National University (NUH) Eye Centre so she would be able to receive subsidised treatment.
“She was diagnosed with the condition after a visit to Ngee Ann Polyclinic last July and from then on, my aged parents obtained referrals from Queenstown Polyclinic to benefit from subsidised treatment at the National University (NUH) Eye Centre,” he said.
However, it’s important to note that there’s no such medical institute as Ngee Ann Polyclinic in Singapore, but there’s an optometry centre situated in Ngee Ann Polytechnic.
Upon receiving the bill, Mr Lee said that his father was very upset as he felt that they were being overcharged by NUH.
Mr Lee also noted that he could not come to “any resolution” with NUH about the charges, even after months of discussion.
Mr Lee said that NUH informed the family that his mother had lost her subsidised patient status after she opted to select a higher-grade lens. However, he highlighted that his mother picked such a lens because she was advised to do so as well as to avoid wearing reading glasses after the operation.
If that’s not all, the elderly woman was denied the subsidised rate because she “elected to choose her own doctor”, Mr Lee said.
“Having been referred by a polyclinic for her visit to NUH, how would my mother know which doctor to choose?” Mr Lee asked.
Additionally, NUH also told the family that financial counselling was given to them and Mr Lee’s mother signed all the consent forms correctly.
“We thought the forms signed were routine indemnity forms for the operation. My mother would not have knowingly signed forms to exclude herself as a subsidised and be treated as a full-paying private patient instead,” Mr Lee asserted.
He added, “The estimated costs to be incurred and presented to us did not come close to the full charges paid so far. What was not addressed was how much every subsequent follow-up visit to NUH would cost, and at private patient rates too.”
Seniors eligible for subsidies
In a separate ST forum dated 13 December, Chan Beng Seng, the Group Director, Subvention of the Ministry of Health (MOH), said that seniors from the Pioneer Generation (PG) and Merdeka Generation (MG) are “eligible for subsidies when they are referred to public specialist outpatient clinics (SOCs) not only by polyclinics but also by Community Health Assist Scheme (Chas) general practitioner clinics.”
In fact, these subsidised patients at the SOCs can enjoy up 75% subsidies for outpatient care. Additionally, PG and MG elderly individuals can also receive additional subsidies for subsidised services and medications.
He continued, “PG and MG seniors who are already private patients at the public hospitals’ SOCs can approach the SOC staff to apply to switch to become subsidised patients if they wish to enjoy the additional PG and MG subsidies. The quality of care provided to subsidised patients, who are assigned doctors, is no different from that for private patients.”
Mr Chan went on to say that MOH will “continue to ensure that healthcare remains affordable for Singaporeans”, and that they will not be “denied appropriate medical care due to an inability to pay.
Singapore National Eye Centre promised to reduce charges for complex procedures
Being charged high at public hospitals or centres is not something new in the country. Earlier this year, the nation was shocked to find out that Medishield Life only paid S$4.50 for an elderly man’s S$4,477 post-subsidy bill.
The elderly, Mr Seow Ban Yam received a bill that amounted to over S$12,000 for his cataract operation on both eyes at Singapore National Eye Centre (SNEC). After government subsidies, the bill came up to S$4,477 and the elderly man paid S$3000 of that out of his Medisave account.
Mr Seow had an impression that MediShield Life would cover 90 per cent of the remaining S$1,477. To his shock, the national insurance only paid out S$4.50 after it said that it imposes a S$2,800 cap on the procedure he underwent.
This means that the maximum reimbursement for such a procedure each year is S$2800 + plus actual ward fees of S$205. This totals to S$3,005 and out of this amount, S$3,000 has to be taken from patient’s own CPF funds. This leaves only S$5 that is claimable by insurance. Hence, MediShield Life paid 90 per cent of that S$5 – amounting to a paltry S$4.50.
Following this incident, SNEC promised to review and make adjustments to its charges periodically for complex procedures. It noted it will cut its charges to strike a balance between cost recovery and patient affordability. The cost for most common procedures, such as cataract and glaucoma surgery, are closely monitored to ensure patients can pay with Medisave and make minimal cash outlay.
SNEC recognises that it could do more often cost reviews to close the prevailing gaps between cost burden of patients and what it charges for the hospital to survive financially.
“With the latest review of SNEC’s charges to better align a wider range of procedures with Medisave and MediShield claim limits, patients requiring complex operations of higher surgical table codes will see reduced charges, including that which Mr Seow underwent,” SNEC’s Chief Operating Officer, Ms Charity Wai, said.
In March, SNEC announced that it has reduced fees for 20 procedures by 15%-25%, and this could save people several hundred dollars.
Its spokesman told The Straits Times that the cut in fees will affect about 14,500 procedures done yearly at the eye centre.
He added that the drop in prices was possible by “reviews of care models, improvements to operational efficiency and regular adjustment in MOH funding support in accordance with changes in cost of care provision”.