The committee set up by the Ministry of Health (MOH) to work towards improving the healthcare insurance system represents timely intervention in the dispute between private sector doctors and Integrated Shield Plan (IP) insurers over the exclusion of many specialists from their panel of doctors for policyholders. What the disagreement has brought to light is the need for a neutral arbiter, in the form of the ministry, to ensure that the interests of the public are upheld in this tussle between insurers and doctors. While each side believes it has valid arguments, the public cannot be held hostage by their contending views, not least because the IP is too important to fail. About 69 per cent of people here have an IP to supplement the basic coverage provided by MediShield Life, which is mandatory for citizens and permanent residents. The interests of IP holders must therefore prevail.
Essentially, the ongoing dispute is bounded by two arguments. The Singapore Medical Association (SMA) has complained of highly exclusive panels where many IP insurers have only about 21 per cent of private specialists on each panel, and also of opacity in the selection criteria for doctors to be included as preferred providers on panels. The position of the Life Insurance Association Singapore (LIA) is that panels help keep fees of healthcare practitioners in check because doctors sign enforceable contracts and are legally bound to charge within the agreed fee range. It believes that the underlying concept of a panel is to use the insurer’s bargaining power to negotiate preferential rates from healthcare providers in exchange for higher volumes. But many specialists question the need to have a panel to control their fees as there are MOH surgeon fee benchmarks to guide prices. Doctors also take issue with the fact that the panels are formed to control prices, with no regard for quality.