Serious Medical Tourism Crumbles

winnipegjets said:

That's not how it should work. Is everyone entitled to healthcare or only the rich is entitled to it?

Click to expand...

Having worked as a doctor in both Singapore and Canada, I'd say there is no pleasing everyone. It is actually a very Asian mentality to want things done immediately. Eg MRI, CT scan, specialist consult. The rich would say I can pay for it so why can't I see the specialist today? (In Canada there is no private health care arm so everyone is queued according to need). In Singapore the poor would accuse doctors of being money minded and only see the rich and don't give two hoots about the poor, leave them with foreign trained doctors etc.

Can't please everyone. As a doctor I do believe that rich man or poor man, we doctors should treat both the same. In that sense Canada's system suits me best. But yet I end up having to explain (sometimes heatedly) with rich obnoxious PRC or Hongkie patients about why they cannot have their CT scan tomorrow.

On the other hand, it is true that in general NOBODY wants to pay for healthcare. They want great healthcare but nobody wants to foot the bill. Not the government, not the patients. So in Singapore they try to leave it to the free market to dictate prices. MOH forced the Singapore Medical Association to scrap the Guidelines on Fees which was actually meant to set a LIMIT to how high fees go and not set a minimum. Let them compete........ah....but with Dr Susan Lim's case the courts have rule that there is an "ethical limit". So that tells you, they hope free market equals cheaper and cheaper.....sorry in healthcare it doesn't work like that. When you are worried about your loved one you would do anything to get them back. Do Singapore doctors fear monger to get patients to pay up? Have you heard any friend or relative recount how an oncologist would say "Try the chemotherapy there is a chance. 1% is still a chance. Don't do chemo means ZERO chance. You don't try means you let your father die". With that kind of talk, little wonder why people get pissed with doctors and feel guilty about not being able to "afford" to save their loved ones.

The reaility is that certain treatments are worth trying. Some aren't. Who is best to know? The doctor.

Hence the best way to make doctors work impartially is the universal health care system. However the rich hate it for obvious reasons. At the same time, serving the rich is actually more lucrative and less work.

Then there is the whole "Medicine is a vocation" debate. Ie doctors should not be in this for money they should be more charitable etc.

Then people say Pay peanuts get monkeys for doctors.

There is no end to this.

Medical Tourism is purely for profit. I have suggested before that Public Govt Hospitals in Singapore NOT compete with the Private sector for Medical Tourism or private patients. Why do they want to compete? For what? Money? I say have a tax on all Private hospitals. The tax helps fund the public hospitals. No longer ask public hospital CEOs about profits (yes public hospital and every polyclinic also got to show PROFITS believe it or not).

Public don't compete with private lah. Otherwise might as well NTUC it.

Public serves the people, the poor. Private fleeces the rich (they have no qualms paying anyway) and they know how to do it. Govt Tax the private hospital to get $$. Win win. I think Beng Teck Liang is trying to say Public please don't fight with Private lah. Doesn't make sense right? It is like Singapore govt opening NTUC Hotels to compete with Shangrila, Marriott etc. Why you want to do that?

NaturalAristocratNoHeart said:

If that's the case why did 69.9% vote for PAP at the last GE?

Click to expand...

sigh. Everyone who posts this question already knows the answer. So why ask? The question you should ask really is whether you want to stay on the sinking ship knowing that the Captain has the support of the majority dumb asses.

Big deal, they were previously earning 1-2m anually, now these doctors earn 500-800k, they need help? seriously?

lifeafter41 said:

Yes, isn't it ironic that when old Singaporeans uncle or aunties talk to these Doctors, they need a translator, and if the nurse happens to be from another country, chicken and duck talking Liao.

Is it really that difficult to train more local Singaporeans to be doctors? Why must MOH import from other countries.......just don't understand the rationale.

If every need that x number of years for training, they should have plan for it then taking the easy way out and import from other countries........

Maybe there is the cost involved to train locals.....but give it a good 10 years, there won't be much Singapore core to talk about......

Click to expand...

Greedy pappies want to take short cuts for everything.
And now you see how fucked up we've become. Some things you just can't cut corners

Narong Wongwan said:

Greedy pappies want to take short cuts for everything.
And now you see how fucked up we've become. Some things you just can't cut corners

Click to expand...

Agree that some things cant cut corners.

If only pap is wise enough to know that, SG wont be in so much trouble

Narong Wongwan said:

Greedy pappies want to take short cuts for everything.
And now you see how fucked up we've become. Some things you just can't cut corners

Click to expand...

Wait till you see how the Papigs chase the next band wagon.

winnipegjets said:

That's not how it should work. Is everyone entitled to healthcare or only the rich is entitled to it?

Click to expand...

You are entitled to healthcare that is within your budge or insurance plan.

If everybody demands and expects free healthcare, then the system collapses. Pretty soon, most of us won't get decent healthcare even if we can pay for it.

Hospitals and doctors occasionally provide free healthcare, but it is a gesture of kindness, not an entitlement.

Sometimes, kind gestures gets misread as a birthright.

Government want a piece every action.

The Government since Andrew Chew introduced part payment to cover some cost with payment% to rise in stages, it assumed that it will be model that best serves the nation. I note that they also followed the HDB subsidy model and the Tertiary Education subsidy model. In these models, the citizens will be clearly told how much the government is paying for it. I remember Old Man made NUS Bursar's Office to set up 2 rows of tables. Each student will collect the subsidy cheque, turn around and walk 4 steps of so and hand it to another team that will accept it. It was a performance to tell that the Govt and not you was paying for it ( the tax raised from the citizens was not mentioned). The fact the nation was investing in the young bright minds did not dawn on them. When I heard about it I laughed. The health care is the same.

This model made the government complacent as the assumed that they can fiddle with the %. They should have gone down the path of making citizens take up health insurance with the govt making co-payment for the premium. If they had planned this decades ago, the middle income and the rich would have been covered to a large extent and those vulnerable and the lower income can be covered by the state. There was also another factor, Singapore is one of the few countries where Employers provide health cover and this too led to complacency. Its fine if there is close to 100% employment. Not anymore.

Its was poor planning.

scroobal said:

The Government since Andrew Chew introduced part payment to cover some cost with payment% to rise in stages, it assumed that it will be model that best serves the nation. I note that they also followed the HDB subsidy model and the Tertiary Education subsidy model. In these models, the citizens will be clearly told how much the government is paying for it. I remember Old Man made NUS Bursar's Office to set up 2 rows of tables. Each student will collect the subsidy cheque, turn around and walk 4 steps of so and hand it to another team that will accept it. It was a performance to tell that the Govt and not you was paying for it ( the tax raised from the citizens was not mentioned). The fact the nation was investing in the young bright minds did not dawn on them. When I heard about it I laughed. The health care is the same.

This model made the government complacent as the assumed that they can fiddle with the %. They should have gone down the path of making citizens take up health insurance with the govt making co-payment for the premium. If they had planned this decades ago, the middle income and the rich would have been covered to a large extent and those vulnerable and the lower income can be covered by the state. There was also another factor, Singapore is one of the few countries where Employers provide health cover and this too led to complacency. Its fine if there is close to 100% employment. Not anymore.

Its was poor planning.

Click to expand...

The big flaw in this model is that the pap can arbitrarily price the service and product. It is subjective unlike a cost price model which is objective and cant be manipulated. This flawed model has been abused by the pap at the expense of Singaporeans.

The next big issue is the flawed Medishield Life scheme

nayr69sg said:

Having worked as a doctor in both Singapore and Canada, I'd say there is no pleasing everyone. It is actually a very Asian mentality to want things done immediately. Eg MRI, CT scan, specialist consult. The rich would say I can pay for it so why can't I see the specialist today? (In Canada there is no private health care arm so everyone is queued according to need). In Singapore the poor would accuse doctors of being money minded and only see the rich and don't give two hoots about the poor, leave them with foreign trained doctors etc.

Can't please everyone. As a doctor I do believe that rich man or poor man, we doctors should treat both the same. In that sense Canada's system suits me best. But yet I end up having to explain (sometimes heatedly) with rich obnoxious PRC or Hongkie patients about why they cannot have their CT scan tomorrow.

On the other hand, it is true that in general NOBODY wants to pay for healthcare. They want great healthcare but nobody wants to foot the bill. Not the government, not the patients. So in Singapore they try to leave it to the free market to dictate prices. MOH forced the Singapore Medical Association to scrap the Guidelines on Fees which was actually meant to set a LIMIT to how high fees go and not set a minimum. Let them compete........ah....but with Dr Susan Lim's case the courts have rule that there is an "ethical limit". So that tells you, they hope free market equals cheaper and cheaper.....sorry in healthcare it doesn't work like that. When you are worried about your loved one you would do anything to get them back. Do Singapore doctors fear monger to get patients to pay up? Have you heard any friend or relative recount how an oncologist would say "Try the chemotherapy there is a chance. 1% is still a chance. Don't do chemo means ZERO chance. You don't try means you let your father die". With that kind of talk, little wonder why people get pissed with doctors and feel guilty about not being able to "afford" to save their loved ones.

The reaility is that certain treatments are worth trying. Some aren't. Who is best to know? The doctor.

Hence the best way to make doctors work impartially is the universal health care system. However the rich hate it for obvious reasons. At the same time, serving the rich is actually more lucrative and less work.

Then there is the whole "Medicine is a vocation" debate. Ie doctors should not be in this for money they should be more charitable etc.

Then people say Pay peanuts get monkeys for doctors.

There is no end to this.

Medical Tourism is purely for profit. I have suggested before that Public Govt Hospitals in Singapore NOT compete with the Private sector for Medical Tourism or private patients. Why do they want to compete? For what? Money? I say have a tax on all Private hospitals. The tax helps fund the public hospitals. No longer ask public hospital CEOs about profits (yes public hospital and every polyclinic also got to show PROFITS believe it or not).

Public don't compete with private lah. Otherwise might as well NTUC it.

Public serves the people, the poor. Private fleeces the rich (they have no qualms paying anyway) and they know how to do it. Govt Tax the private hospital to get $$. Win win. I think Beng Teck Liang is trying to say Public please don't fight with Private lah. Doesn't make sense right? It is like Singapore govt opening NTUC Hotels to compete with Shangrila, Marriott etc. Why you want to do that?

Click to expand...

The issue is not so simple as you say according to a very senior professor in public hospitals whom I speak to recently. The private sector had it coming and they deserve iit according to him.
they abuse the system for their own selfish benefits for many years. People like Dr Susan Lim overcharging millions was just the tip of the iceberg according to him. for every susan lim there is at least another 100 other susans who overcharged albeit not so outrageously but still alot.
they had it good for many years and became very arrogant and started to talk down to malaysian and indonesian doctors.
Why should doctors in public not treat private patients he asked? in the past the private sector doctors would hint that public sector doctors are not good as they treat the poor and cannot afford or not good enough for the private sector. Moreover the private sector now wants their selfish cake and eat it. when public hosp were over crowded did the private sector offer to help see the poor at subsidised rates???hell NO. in fact they wanted government to palm off the excess to them and pay the private sector the full bill ie pay the sudsidised portion to them ie full private rate for the poor at tax payers expense. win-win situation for them , lose lose for the tax payers and government.
now the indons have stop coming and the pie has gotten snmaller as the asean region have catched up and now they want the public hosp not to see private patients ie essentially hand over the private pool to them on a silver platter.
If it happens my professor friends says he and all his colleagues would quit on the spot and join private sector and forget about being compassionate and benevolent.
And then there would be not enough experienced doctors in public hosp to teach the juniors and treat the VVIPs. already the public hosp doctors are over worked and grossly under paid and now these private sector doctors want to be extremely selfish and bully the government /public sectors doctors for their own financial gains. all these private sector doctors do not teach nor contribute at all to society and yet drive their porsches and lambos and now talk cock according to my professor friend who understably is fed up with some of his private sectors colleagues.
He also told me another classic example of self centered private sector doctors and private hospitals CEOs . remember SARS? when it happened not a single private sector doctor esp the Mt offered to help. in fact they wanted to palm off all their fever patients to tan tock seng hosp(kiasi according to him) and wanted government to pass over the non sars patients to private hospitals and ask government to foot the full private bills 100% ie pay them the subsidy and all. My professor friend says this is bullshit of the highest form. also alot of them were very arrogant and started to talk down to indonesian doctors, public doctors and there was a backfire when the indonesian doctors stop referring patients to singapore. please go and ask the public sectors senior doctors all these details before defending these private sectors docs who are in it for the money only. so I says bullshit to most of them selfish bastards esp this Beng Teck Liang. they asked for it. when times were good they did not botehred to help. now in bad times they are trying to steal the public sectors private patients pool. call a spade a spade. . go and think about it and ask around before defending these people who are nothing but cowards and selfish businessmen.
in fact in australia and USA, the best and most experienced doctors are in public hospitals like Mayo clinic and St Vincents sydney and all these public hospitals accept private patients for reasons outlined above. all his comments make sense and I support him.

scroobal said:

We have been fleecing the regional customers because their own country medical infrastructure was bad. Many now have good private hospitals and related service providers. The Malaysians and the Thais stopped coming to Singapore nearly 20 years ago. Indonesians now have good care back home. Even the Australians who work in the region prefer to return to their country as they have state cover.

Its a repeat of our Shopping centres which use to draw the rich and famous from all over South East Asia. Not anymore. Not only Mugabe and family who cannot go anywhere except China, HK and Singapore.

Click to expand...

Just to correct one point. A lot of Indonesians are actually looking at Malaysia as an alternative.

ckmpd said:

1. Medical Tourism Crumbles

2. Education Hub Failure

3. Retail paradise Failed

4. Innovation Collapse

5. Financial Hub Deteriorating

That's story of pap's kpi

Click to expand...

Casinos seems to be collapsing too

Cerebral said:

Just to correct one point. A lot of Indonesians are actually looking at Malaysia as an alternative.

Click to expand...

SG has priced itself out because of greed...talk abt killing the goose that lay the golden egg

Cerebral said:

Casinos seems to be collapsing too

Click to expand...

Yes...gambling is never a good thing to promote. I am glad it is collapsing. Gambling and prostitution shd never be condoned by a responsible govt

Satyr said:

This is the problem of trying to earn easy money instead of doing the hard work of actually producing something. Fun while it lasted. Didn't they figure out if someone can fly here he can one day fly elsewhere ? Ditto for casinos.

Click to expand...

Actually it was a good idea and would have helped if they spent time properly training the local doctors to higher levels. However, the ever greedy government wanted to fast tracked it and started importing success. That could also work if they have been selective, but that's where they failed. They brought in rubbish. The churn is also quite significant, and because the public and some private practice started promoting doctors to more senior position before their time, the quality drops.

Beyond that, the high real estate has also made all the fees too high.

So you have a triple whammy. High prices, lowered quality and stronger competition. Thats why it failed

scroobal said:

The Government since Andrew Chew introduced part payment to cover some cost with payment% to rise in stages, it assumed that it will be model that best serves the nation. I note that they also followed the HDB subsidy model and the Tertiary Education subsidy model. In these models, the citizens will be clearly told how much the government is paying for it. I remember Old Man made NUS Bursar's Office to set up 2 rows of tables. Each student will collect the subsidy cheque, turn around and walk 4 steps of so and hand it to another team that will accept it. It was a performance to tell that the Govt and not you was paying for it ( the tax raised from the citizens was not mentioned). The fact the nation was investing in the young bright minds did not dawn on them. When I heard about it I laughed. The health care is the same.

This model made the government complacent as the assumed that they can fiddle with the %. They should have gone down the path of making citizens take up health insurance with the govt making co-payment for the premium. If they had planned this decades ago, the middle income and the rich would have been covered to a large extent and those vulnerable and the lower income can be covered by the state. There was also another factor, Singapore is one of the few countries where Employers provide health cover and this too led to complacency. Its fine if there is close to 100% employment. Not anymore.

Its was poor planning.

Click to expand...

Old man always wanted people to know how much the state was "subsidizing" them. To tell them no free lunch. Singaporeans are amazing. They will simply accept that NS is the people subsidizing the state and their CPF is subsidizing fat cats.

Scroobal, in the past the Minister of Health would have to put up the budget for government hospitals for debate in parliament. This was always a headache for the Minister. Cut budget get criticized. Increase budget also criticized.

Yeo Cheow Tong was the one that pushed through the "restructuring" of the government hospitals. As the hospitals were now "private" entities there was no need to debate any budget anymore.

This is why you never hear anything about healthcare spending whether it has gone up or down or whatever.

numero uno said:

The issue is not so simple as you say according to a very senior professor in public hospitals whom I speak to recently. The private sector had it coming and they deserve iit according to him.

Click to expand...

I'm not defending the private sector. The private sector is full of crooks. Maybe we can discuss more about the so called "health care insurance" that people buy and how those private sector doctors bill the insurance companies. It is a scam. As some of you might have read about an orthopedic surgeon who didn't give the foreign worker any hospitalization MC after he did surgery on the guy, billed for an ORIF when it was a percutaneous pin. Happens frequently both in the private AND public sectors. That's another story I suppose. In Singapore cost of living is high, everyone is really concerned with making money.

There is no perfect health care system. I think the two tiered system encourages a lot of anger and unhappiness among the people. At the same time the doctors fleece the rich who also become unhappy. Only the doctors who enrich themselves might be "happy".

But the government sector also wants a piece of the pie so they are not much different either.

Speaking of professors........sorry I have not much respect for them either. Especially those working in NUH. I've worked with them. They know why they are still in NUH. Prof this prof that. Rubbish. All writing toilet papers for journals for the sake of maintaining their quotas. They force the juniors to do the work to keep them where they are.

I worked for 15 years in Singapore as a doctor. Had I done my medical studies and residency in Canada and worked the same number of years, I would have retired by now barely in my 40s. Unfortunately I slaved away in the stupid Singapore system and earned much less.

Oh well at least I am out of it now. Another 10 years in Canada and I'll be retired. Better late than never.

you r right... goto TTSH, they ask me to get injection for influenza when i have cardio problem.. it's like a car wash, they stop you to ask if you want vaccuum, extra car wax or a blow job.