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Straits Times
29-06-2025
- Health
- Straits Times
Forum: Sustaining affordable healthcare is a shared responsibility
We refer to the Forum letter 'Insurers' restriction of patient choice undermines trust in system' (June 19) and wish to provide context on pre-authorisation and panel doctors. To ensure a sustainable healthcare ecosystem, all parties need to play a part in making quality healthcare affordable and accessible. Insurers and patients are payers of healthcare services. Healthcare providers who recommend treatments and charges must do so responsibly to manage healthcare inflation. The year-on-year increase in medical costs is untenable, and Integrated Shield Plan (IP) insurers will continue to be proactive in introducing measures to ensure patients continue to receive quality care while balancing the collective needs of policyholders to keep premiums affordable. Ultimately, policyholders bear the brunt when medical and claims costs escalate. This is why IP insurers regularly review claims data and update their practices, measures and controls to ensure a sustainable healthcare system. Pre-authorisation and panel doctors were among measures recommended by the multilateral Health Insurance Task Force in 2016 to address escalating healthcare costs. Pre-authorisation is a service – not a contractual clause – that gives policyholders assurance that their treatment will be covered when deemed fair and medically necessary. Not all IP insurers offer this service, and, where it is limited to selected hospitals, it is often due to cost or implementational considerations. The absence of pre-authorisation does not restrict a policyholder's choice of healthcare provider. Besides pre-authorisation, policyholders may apply for an electronic letter of guarantee as a waiver of deposit, reducing the need for upfront payment. Panel doctors provide quality treatment at pre-agreed rates, and policyholders may enjoy additional benefits such as lower co-payments. The introduction of panel doctors has reduced instances of over-treatment and over-charging, helping to ensure a more sustainable healthcare system for all. Despite rising premiums, the total IP portfolio continues to operate at single-digit gross margin and sometimes at a loss. The insurance industry is committed to policyholders' interests and to communicate any changes to benefits and coverage. We urge all parties – including doctors, hospitals, government agencies and patients – to work collaboratively in managing healthcare costs to ensure continued access to quality healthcare in Singapore. Chan Wai Kit Executive Director Life Insurance Association, Singapore More on this Topic Forum: What readers are saying Join ST's Telegram channel and get the latest breaking news delivered to you.
Straits Times
23-04-2025
- Business
- Straits Times
Forum: Financial advisers must adhere to high ethical standards and industry regulations
Forum: Financial advisers must adhere to high ethical standards and industry regulations We thank Dr Tan Yia Swam for her letter 'Insurance agents asking doctors to change codes to ensure claims go through' (April 17) and refer to the Ministry of Health's reply 'MOH will review MediShield Life coverage for prophylactic mastectomy' ( April 22). We would like to provide more context regarding Integrated Shield Plans (IPs), preventive treatments and ethical guidelines for financial adviser representatives. IPs offer coverage for hospitalisation, surgery and selected outpatient treatments on top of MediShield Life coverage. As IPs are today designed to cover medically necessary treatments, treatments and procedures that are preventive in nature are not claimable. IP insurers are constantly seeking ways to balance the scope of coverage with premium affordability and sustainability for policyholders. Benefits and coverages are reviewed from time to time, taking into consideration advancements in clinical practice and medical science. We note that the Ministry of Health is undertaking a review of the matter. IP insurers will review the scope of IP coverage accordingly. Financial adviser representatives play a key role in providing advice to their clients on insurance products, including IPs, and must adhere to high ethical standards and industry regulations. If consumers or healthcare practitioners encounter potential misconduct, including being pressured to misrepresent medical codes for claims, they should provide the details to the relevant insurers for further investigation and action. We recognise the complexity of the situation and good intentions of all parties involved. The life insurance industry is committed to working closely with all relevant stakeholders to best address the needs of policyholders equitably. Chan Wai Kit Executive Director Life Insurance Association, Singapore More on this Topic Forum: What readers are saying Join ST's Telegram channel and get the latest breaking news delivered to you.
