Any abuse of state health schemes has to be
nipped in the bud to ensure it does not undermine the cost-effective delivery
of useful programmes.
In the case of the Community Health Assist Scheme (Chas),
patients who are eligible for a government subsidy benefit from the convenience
of being treated at nearby private clinics, which later claim the subsidy from
the authorities.
This ease would be eroded if additional
layers of bureaucracy are found to be necessary to thwart the black sheep of
the medical profession from cheating.
If Chas is tightened sharply, it could
put some lower-income and pioneer-generation patients back in the queues at
polyclinics. Such bunching would not only be inefficient but also lead to less
income for the 1,500 private clinics now on Chas.
These clinics treated 650,000
Singaporean patients last year and received $167 million from the State.
Regrettably, the dishonest acts of a minority
are vitiating the reputation of their medical brethren for providing reliable
service to subsidised patients. A number of clinics are being probed for making
false or excessive claims for subsidies, and two have been suspended by the
Health Ministry. Some procedures were not done at all, yet claims were
submitted for payment. In other cases, excessive claims were made from
patients' Medisave accounts, without their approval or knowledge.
These are astounding revelations - in
particular, the deliberate acts of fraud uncovered at some clinics. Criminal
conduct demeans a profession that is generally held in high regard and should
be vigorously addressed by the Singapore Medical Council and Dental Council.
Meanwhile, weak administration, such as sloppy record-keeping, suggests a slide
in professional standards that should not be tolerated if private clinics are
to continue participating in government schemes. To root out subsidy cheats,
firm action must be taken both by professional bodies and the authorities to
deter practitioners from offending.
The broader ethic of prudent health-cost
management is vital if subsidised schemes and the universal coverage provided
by MediShield Life are to remain sustainable over the long term. A cheating
streak among practitioners could lead to ballooning costs if extensive tests
and complex procedures are foisted on patients instead of simpler ones. Another
ploy is to falsely classify an unapproved procedure in order to make a claim.
Rising health costs will impact state health budgets and push up the premiums
of compulsory basic health insurance. Everyone will lose out as a result if
such irresponsible acts are not curbed.
Patients have a role to play, too, in
checking abuses by routinely asking for itemised receipts. It is not uncommon
for private clinics to provide receipts only on demand. Such loose practices
offer opportunities for improper claims to be made.
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