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Public must speak up against commercialisation of healthcare Print Email
Thursday, 02 June 2011

Patrick Kee

There are several observations about the healthcare system in Singapore that I wish to share with Singaporeans.

Firstly, we need to deal with the greed in the pharmaceutical and medical professions. We have commercialised medical care and patients and diseases have become ways to make money. Medicine has become a business rather than a vocation.


We need to encourage the public to speak up against the commercialisation of medicine and to recognise the danger of the fee for service system turning doctors into crooks.

The Ministry of Health has the responsibility to be a role model of health care as a social responsibility rather than being part of a system that turns medical care into a business enterprise.

In this regard, a much higher percentage of the taxes collected must be channelled into health care for our citizens. This is the only way to ensure universality and affordability of health care.

Secondly, we need to recognise that the essence of a democratic society is a caring and sharing co-operative. We pool our resources for the common good - that is the primary objective of our taxes.|

Thirdly, it is important to recognise that different areas of health care require different forms of health financing:

a. Maternal and child care services - these should be free and funded by the government from the taxes as these are health promoting.

b. Primary health care services - these should be paid through a system so that the cost of running these services will be shared by all in the community.

It is only with a prepaid system that the doctors can focus on health promotion activities instead of earning money through dispensing of medications for coughs and colds which are often unnecessary. The patients can then pay only for the medications that they need.

c. Hospital services - the cost of running the hospitals must be paid from the taxes. The cost of services at point of use can be paid through medical insurance and the premiums can be lower.

d. Hospice care - caring for the dying. No one can abuse such services and such services should not be dependent on charity. Funding for such services should be from our taxes as well as from donation from appreciative family members of the care receivers.

e. Home care for the nonambulant chronic sick - these services should also be funded in the same way as hospice care.

We also need to recognise the importance of our environment and family service centres in contributing to the health of our nation. It is important to understand that providing more medical services does not necessarily promote the health of our citizens - in fact we may be creating a more neurotic society - kiasu and kiasi - that is so fearful of dying that we forget how to live.

Dr Patrick Kee is a medical doctor specialising in palliative medicine. He is a director of TLC Home Medical Services Pte Ltd and is also a member of the SDP's Healthcare Advisory Panel.

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Comments (12)
  • Prime Citizen
    i agree with you DR Patrick Kee.

    Preventive medicine is saving more lives than the present mainstream approach of drug-based sick-care.
  • vipersonic
    The reason why healthcare should not be commercialized is because healthcare is a fundamental human right. Commercializing it will lead to the greedy and dirty tricks played by companies in the other sectors.

    One fine example would be the recent report on how cancer was cured so easily by a group of researchers using a non-patented drug. Because the drug isn't patented, the drug companies couldn't make money off it, and therefore it wasn't brought to light sooner.
  • Jufrie - Spot on
    Can't agree with you more Dr. Kee.
    Just look at the fleet of luxury vehicles driven by specialist doctors when you next visit a pte hospital. Some are even overcome by greed and charge millions of dollars for their services but tried to wriggle out when caught.
    To some the hippocratic oath has become meaningless.
    The government must discourage such commercialisation before things get worst.

  • Prime Citizen
    http://theinnozablog.blogspot.com/2010/12/i-bribed-swedish-professor-to-enhance.html

    We need to know behind the scene of what and why the ruling party is going about in national health care policies. Until the citizens take ownership of national healthcare syst and national budget , most of us will continue to suffer in silence as an injured lamb.
  • Buwakasha
    Sorry man, this article is kind of twisted. It makes the taxpayer pay for all the good stuff. I want the good stuff too, but you'll have to pay for it. I'm against having GST go up to 25% to fund all this free healthcare and free benefits that the doctor wants.
  • Buwakasha
    "because healthcare is a fundamental human right"

    This statement is utter nonsense. Healthcare is a service you get just like any other. Freedom of speech is a fundamental right, healthcare is not. In order for you to get healthcare, someone has to sacrifice his/her time and effort to provide it for you.
  • Buwakasha
    "One fine example would be the recent report on how cancer was cured so easily by a group of researchers using a non-patented drug. Because the drug isn't patented, the drug companies couldn't make money off it, and therefore it wasn't brought to light sooner."

    The reason behind why the drug can't be used is because of the FDA. The FDA requires that one proves the efficacy of the drug before it can be approved. If the drug isn't patented, no one would be willing to pay for those tests which cost billions to do. Get the FDA out of proving efficacy and the drug would be on the shelves already.
  • Prime Citizen - Ongoing Medical conspiracy?
    Maybe Dr Patrick Kee can have one dedicate blog at SDP to deal with healthcare or sick-care scandals in our nation. Then all netizens can share their bits and pieces and we see the calrity behind the tip of the iceberg under our present nation health ministry. How about that?

    1.we have Sound Body with Susan Lenox addressing the ongoing medical conspiracy where the criminals in Big Pharma tell government how to legislate you into their unclean clutches. Susan offers natural solutions to the medical monstrosity that is strangling us all.
  • Tan Tai Wei
    This is probably not a "case in point", but an exception. It is a case I knew personally.

    Soneone's wife was diagnosed with cancer, and referred to this medical oncologist at Mt E medical centre. Immediately, the clinic asked for a deposit of $500 (pre-inflation amount, at that time).

    The doc saw her twice a day for three days, and then referred her to a gynecologist. When her husband asked the clinic, he was told the deposit had all been used, presumably for the visits.

    When at the gyne, and only then, they were told, by the gyne and not by the oncologist, that the oncologist was on holiday leave, and the gyne had been asked by him to administer the first dose of chemotherapy, even before the tests results solicited of the gyne. He was already somewhere in America with his family when the gyne's tests were being made.

    Now, any layman would know that the first diagnosis and prescribing of chemo especially need close expert monitoring, which the patient had paid for. Yet, this oncologist was going on holiday, and yet accepted the referral of this patient at that time, and did so without telling the patient and husband.

    He returned from leave and continued the treatment. Now, the husband's employers would pay a large percentage of medical bills should she get the treatment as an inpatient of a hospital, rather than at the oncologist's private clinic. So he asked the oncologist, after a while, to ward her at MT E Hospital for the periodic chemo. He told him a lie to prevent that (for when she was so referred, he would not earn from dispensing the drug, and the hospital would). He said that "hospital drugs were ineffective, as they were kept unused for long, while his drugs were fresh" (just the opposite of the truth, surely. Hospitals treat more patients and are used by more oncologists than any one oncology clinic!)

    Much later, losing confidence in him and to get some relief from the cost, the husbamd asked for her to be transferred to a restructured hospital. The oncologist warned against that, saying he knew of cases where the patients ended dying at such hospitals.

    And whilst attending to his wife at that clinic, he became aware of another patient who was refused treatment because he could not provide guarantee that his employers would bear the fees. He was actually turned away at the clinic.

  • Tan Tai Wei
    One more thing about this oncologist.

    At that time, Mt E Hospital had set up its own oncology centre.

    The husband of my above story was there when this episode occurred.

    A phone call came from the Mt E Hospital Oncology Centre appealing for the nurse of the clinic with a particular expertise to go and demonstrate her skills to staff at the Centre.

    The oncologist refused, and, noticing that the husband of that patient was listening, told him that that was "business", as Mt E Hospital was trying to rob him of his patients.

  • Prime Citizen
    The PAP is setting the climate for more expensive treatments till even our public healthcare services also lose the vision to care for the common citizens at home , all in the name of Excellenct Medical Hub. I hate all those 'this hub' that hub as though Singaporeans so hard up to be first class in all fields. So sad to read the above episode. We need to voice out louder and more effectively to save many more Singaporeans from harmful medical politic (for more money$)
  • Jillan - Lousy Singapore Medical Services
    The worst performing ministry is the Health Ministry under minister Khaw Boon Wan.

    Waiting time of 2 to 3 hrs at the Polyclinics is ridiculous and unacceptable. And after seeing the doctor, you need another 1 to 2 hours waiting for your medication so the total wasted time is close to 4 to 5 hours.

    Don't forget that when parents are sick they need at least one of their working children to accompany them and this is an additional wastage in productivity impacting our GDP.

    Under the 10 year tenure of Health minister Khaw he has drastically reduced medical expenses to impact the well being of Singaporeans with many dying as a consequence.

    He is just acting as an accountant curtailing cost without knowing the damaged he has done. An accountant salary is all he deserved instead of the multi million salary just to put up signages all over waiting areas saying your waiting time is 2 to 3 hours before you can see a doctor and another 1 to 2 hours for your medication which is a no brainer.

    The wasted time in manpower is more than enough to build ten large hospitals and provide medical education for thousands of doctors. The number of medical students for universities has been so drastically cut creating a shortage that will take years to catch up.

    When public outcry surfaces on the underperforming health system, he has no choice but to bring in hordes of medical doctors from third world countries as a stop gap measure and this will only lower our medical standards and compromise public health. Hopefully such doctors who often misdiagnosed illness and are well below the standards of Singapore trained doctors will be send back to their own countries when their contract expires and not taking up space for our own Singapore soon to graduate doctors.

    The practice of putting patients with potential heart conditions on powerful vaso dilators for months while awaiting their turn to have a heart scan or angiogram should be stopped as this practice has caused thousands to die or suffer a stroke while waiting. Thousands of Singaporeans die each year of a blockage in their arteries because they were not given a scan (non invasive) or an angiogram (invasive) to detect the blockage to clear it on the spot. Instead a normal ECG is done and they are told nothing is wrong with them and send home to die a sudden death from a heart attack.

    The ECG or a even a stress test or blood test will not detect a blockage, only a scan or angiogram will. The risk of dying from an angiogram is only 0.05 per cent when perform by inexperience doctors which is marginal compare to the thousands who could have been saved if the blockage can be cleared in time instead of being send home to wait months for their scan.

    If the government hospitals are so lacking and fully stretched they should consider sending patients with potential heart blockages to private hospitals or labs for scanning with the government paying the difference. This should continue until the government hospitals catches up with facilities and more doctors for such heart conditions.

    The only resources S'pore has is it's people and therefore we should spare no expense in the pursuit of health and education especially so when 70 per cent who die of heart attack are between the productive ages of 30 to 50 and seldom senior citizens.

    Hopefully the new health minister will not do further damage by following on the heels of minister Khaw to even further reduced the health budget. The opposition parties got it right when they proposed a budget of 10 billion instead of our miserly 3 billion at the expense of our citizen's well being.

    The old mantra of ministries milking its citizens as much as they can no longer is the right solution. In this modern age it is how efficient they perform for the good of its people and country that matters and not total wealth accumulation. Lets now judge how efficient our new health minister is by benchmarking if he can reduce the waiting time to no more than 2 hours and clear the backlog of heart cases.

    And what is the point of milking it citizens and creating billions more of reserves when a sizable portion of that is lost through overseas investment which could have been better utilized for better health system, education system and more support for growing local business and companies (which does not relocate to cheaper countries as the multi-nationals do) to create more jobs and a better transportation system.
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