USA provides Medicare to its elderly. It is a generous scheme, but it is too costly. And it has become very complicated. This kind of problem is felt by most countries in the world. And Singapore is no exception - except that in Singapore, the people have to bear a large part of the cost. And insurance is not a solution - as it can get out of control.
http://money.cnn.com/2011/11/01/pf/medicare_plans.moneymag/index.htm?section=money_topstories&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fmoney_topstories+%28Top+Stories%29
What is the solution? I will say frankly what I think - and it will not be popular. We have to manage expectation. We must realise that people will have to die one day, and that using expensive medicine to prolong life is not the answer - the person who is cured will suffer a lower quality of life and the treatment will bankrupt the family (or the state). The medical profession will be able to find new wonder treatments, but they will be too costly for the patients or the country to bear, and will make the medical specialists rich.
We must educate people to accept that there is a financial and practical limit to medicine, and to accept that life will have to end one day. If doctors think that they can cure the patient, they should only collect their fees on success, and not on failure. If this success fee is practised, many doctors will not undertake treatment that are not likely to succeed.
http://money.cnn.com/2011/11/01/pf/medicare_plans.moneymag/index.htm?section=money_topstories&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fmoney_topstories+%28Top+Stories%29
What is the solution? I will say frankly what I think - and it will not be popular. We have to manage expectation. We must realise that people will have to die one day, and that using expensive medicine to prolong life is not the answer - the person who is cured will suffer a lower quality of life and the treatment will bankrupt the family (or the state). The medical profession will be able to find new wonder treatments, but they will be too costly for the patients or the country to bear, and will make the medical specialists rich.
We must educate people to accept that there is a financial and practical limit to medicine, and to accept that life will have to end one day. If doctors think that they can cure the patient, they should only collect their fees on success, and not on failure. If this success fee is practised, many doctors will not undertake treatment that are not likely to succeed.
In that case, should euthanasia be legalised too, that is to intentionally end a life earlier to relieve further pain and suffering, with the consent of patient or the family, if the patient is not in a mental state to decide?
ReplyDeleteSorry Mr Tan , what you suggest is NOT feasible.
ReplyDeleteWhat is success? Who defines an outcome as complete success, partial success or total failure? This is not a black and white issue where the outcome is success or failure.
For instance, the girl who fell off the MRT and needs amputation. If we define the success as being able to re attach the limbs, there may not be any dr even to rescue the girl.
If we define the success as being able to walk again with prosthetic legs, then there is a problem. The patient may feign inability to walk so she would not have to pay.
There will be many GREY issues if we implement your "SUCCESS" fee.
What if the girl finds the surgery a success but the parents think it is not a success.
What if the family thinks the surgery is a success but the boyfriend thinks it is not a success.
To treat or not to treat? This is a controversial issue because treatment is not an exact science as different patients respond differently to the same treatment. The best doctor can provide is statiscal data of successes and failures.
ReplyDeleteI do not know how they train doctors these days. Some of them put more emphasis on nice cars and club memberships instead to serve and alleviate suffering. Generally, doctors I have met still have good ethics.
Using expensive medicine to prolong life is not the answer. The medical profession will be able to find new wonder treatments, but they will be too costly for the patients. Saving your life but killing your financial life. Oops, sometimes just increase hope of prolonging your life for a few years, months or even days. ??? ??? ???
ReplyDeleteI agree with Simon. Generally Singapore has many good ethical doctors as it aspires to be a medical hub.
ReplyDeleteI read somewhere in China, a patient has multiple heart stents and even a fool can tell it is way too many.
We have a medical watchdog here that is monitoring well to weed out black sheep which we find inevitably in every profession.
The fact that many foreigners esp Indonesian patients come here for treatment attest to our high standard of good medical practice.
Perhaps we should also have a watchdog for Chinese sinsehs where outcome can be very variable.
Hi Alan
ReplyDeleteYou may wish to know there is such a thing as Advance Medical Directive. Once you signed it, you give yourself the option not to prolong your life unnecessarily if further treatments will only prove futile.
Often, though, it will be the loved ones who will be unwilling to let go.
This is not an issue to deal with and it is not a black and white issue. To treat or not to treat and to accept treatment or not to accept? It is a difficult issue
ReplyDeleteI have a suspicion that the Medisave scheme funds the installation of high end facilities which are accessible to a sliver of the population at the top who also enjoy handsome discounts under various shemes. Just a gut feeling. The sad thing is that those who can afford appear to be subsidised by those who can’t.
ReplyDelete