Friday, March 09, 2018

The buffet syndrome in health care services

The health minister used the term "buffet syndrome" to describe the unnecessary and over-comsumption of health care services. He blamed the patients for this behavior. He thinks that the patients like to consumer the services because it is free, i.e. paid by insurance or largely subsidised by the government.

The minister is mistaken. I am not referring only to the current minister, but to the previous ministers. This mistaken belief had been prevalent for three decades.

I have not found any evidence of patients who like to consume health care because it is free or largely subsidised.

The over consumption is largely due to doctors and hospitals. They are running a business. If they can get the patients to consume more, they earn a larger income or profit.

Some doctors and hospitals will prescribe more treatment to generate the income and profit. I am not suggesting that all doctors and hospitals behave in this manner. But the anecdotal evidence does suggest that this is quite prevalent.

To overcome the over comsumption, attention should be focused on the doctors and hospitals, rather than the patients.

The patients do not have a choice. They depend on the doctors for advice on what is necessary. Even if they ask for a second opinion, it does not help much in most situations.

Asking patients to make a co-payment does not solve the problem. Most patients will buy insurance, known as a "rider" to cover the co-payments.

Restricting the scope fo the rider will also not solve the problem. Most patients are not able to make the sensible choice.

To stop the over-consumption and explosion of health care cost, the ministry of health has to step in. They have to set system to prevent the over consumption of services and the over charging for these services.

We can study the system adopted in Japan. Each year, the ministry of health negotiates with the doctors and hospitals on the cost of providing each type of treatment. This negotiation produces charges that are adequate for doctors and hospitals to cover their expenses and earn an adequate income and prevent the over charging for these expenses. It also ensure that the charges are reasonable from the perspective of the patient and the government, which bears 70% of the cost.

As there is sufficient demand for the services, there is no need for the doctors and hospitals to generate unnecessary demand to increase their income.

I believe that there is a system for the ministry of health to audit the provision of the services. i do not know if this is the case. It should be possible for this kind of audit to be carried out.

Tan Kin Lian

1 comment:

Steven Neo said...

This has been in the minds of many many innocent policy holders who are affected. MOH is either reluctant to antagonise the doctors and hospitals or simply blaming consumers as an easy way out.

Blog Archive