Time for MOH to go Naked

Just 3 days back I posted an entry about how polyclinic bills should go naked.

Today a letter written to the Straits Times Forum basically validates that my assessment of sentiment on the ground is correct!

Hmm....maybe the government should hire me as an MOH advisor. No need to spend more money with all those REACH programs to listen to the ground. Just hire me!

Anyway here's what Mrs Tan has to say :

Polyclinics should review flat-rate pricing policy for drugs

I refer to the reply "Polyclinics' flat rate for drugs benefits chronic patients" (ST, Dec 2) by Ms Chan Soo Chung, general manager of National Healthcare Group Pharmacy.

Ms Chan stated that with the $1.40 flat rate pricing policy for essential drugs at polyclinics, "the majority of chronic patients who need to take more expensive drugs on a long-term basis will benefit from the flat rate".

I do not think this statement is accurate. The flat rate price applies only to "essential" or generic drugs which on average cost only a few cents per tablet. It does not apply to the "more expensive" patented medicines.

To demonstrate this, Ms Chan cited the example that a common diabetic medication that requires the patient to take six tablets a day over ten weeks would have cost $21 without the flat rate policy. This works out to five cents per tablet. I do not think any "expensive" patented drug will be close to this price.

The flat rate pricing policy inadvertently allows the polyclinics to "profit" from the sale of cheap "essential" drugs. For example, a week's supply of an "essential" drug that costs three cents a tablet and taken once daily should cost 21 cents, but with this policy, the same quantity of drugs costs $1.40 instead, which translates into a "profit" of $1.19 for the polyclinics.

And given that polyclinics dispense largely such essential drugs, I wonder how much money they make each year from such drugs.

The polyclinics' $1.40 flat price policy has been questioned in the Forum page every year since 2001. While the polyclinics may argue that the excess money from "essential" drugs is used to subsidise other services at the polyclinics, I do not think this is right.

The two healthcare clusters receive government funding and if the funds are insufficient, they should resolve the matter with the Ministry of Health. The patients should not be penalised as a result of their inefficiencies or inability to manage their budgets.

Cheap "essential" drugs, if priced at their actual per tablet prices, can mean savings for polyclinic patients, especially the elderly. I urge the two clusters to relook at this flat rate pricing policy at the polyclinics.

Mrs Tan Qui Boon

To summarize the main points:

1) "The flat rate pricing policy inadvertently allows the polyclinics to "profit" from the sale of cheap "essential" drugs."

You see, Singaporeans do not like this. Nobody wants to pay for healthcare DIRECTLY. While keeping the bill transparent but with strategic areas covered is one way to hoodwink the largely blind Singaporean, it is still too obvious. Raising taxes to get hte people to pay and fatten the coffers and then using that money to "subsidize" (it's still their own money anyway) the drug costs would be a far better option.

2) "I wonder how much money they make each year from such drugs."

See? Most Singaporeans think the government healthcare sector should be a "no-profit" organization. MOH, you better tell people the truth. Are the Polyclinics making money?

3) "While the polyclinics may argue that the excess money from "essential" drugs is used to subsidise other services at the polyclinics, I do not think this is right."

Once again. The spirit of giving is simply not here in Singapore. And I guess we are just learning from the best in the business. The best way is still to make people pay up first then use the money help them later. That way it is so convoluted it doesn't make a difference if you were naked or transparent!