I have read with growing concern the recent discussions surrounding health insurance and Integrated Shield Plans (IPs).
Healthcare is an important part of the compact between a government and its people.
Senior health correspondent Salma Khalik cautioned all to realise the seriousness of this issue, and to arrive at a comprehensive solution that keeps the interests of the customer first (Issues that need attention in health insurance review, April 16).
I wanted to share my experience of some unintended negative consequences that my family saw happen in the United States, when too much discretionary power was handed over to insurers.
It led to even higher costs, and worse outcomes, for consumers – especially affected was preventive healthcare.
Insurers’ first brief is to manage costs, not achieve the best medical outcomes for their customers. To give them too much power is to tip the balance in a very dangerous direction.
It is laudable to manage increasing claims costs. But I am disappointed by some measures envisaged by IP insurers, especially the decision to have a panel of doctors that their customers must go to, given that private doctors account for only 21 per cent of all doctors on the panels of many IP insurers.
The continuing relationship between patient and doctor is important for medical outcomes, and should not be ignored.
Chronic illnesses such as diabetes need to be managed over long periods of time.
To suddenly be told that they may no longer go to the doctor of their choice can be very upsetting to people already feeling ill.
Why have selective panels at all? Maybe cost reimbursement could be capped instead.
I understand that some doctors’ fees are higher than the norm. But I cannot believe that almost 80 per cent of all doctors in private practice here are like that.
For patients who opt for private healthcare, the main reason is often to be able to see the doctor of their choice, or at least the same doctor each time, to ensure continuity of treatment.
My family and I lived for many years in the US, where insurers’ panels have led to a lot of friction.
Insurance firms appointed case managers, who were usually not doctors themselves, yet whose pre-approval was required for doctor-recommended tests like MRIs and CT scans.
Doctors were frequently quizzed about the need for certain tests or procedures, resulting in suspicion between doctor, patient and insurer.
And doctors had to drastically increase their personal liability insurance owing to the fear of litigation, and had their medical decisions questioned constantly by non-professionals. All this led to higher costs for all.
Insurers also put patients on non-curative painkillers for weeks before approval for diagnostic tests was considered.
This destroyed the trust between doctor and patient, and many of my American friends would just not see any doctor until they became very sick.
I would be very sad to see the same happen here.