MOH engaging Great Eastern to better understand suspension of Mount Elizabeth pre-authorisation
GE's rationale was that high costs from the two named hospitals were the reason for this decision. PHOTO: ST FILE
SINGAPORE – The Ministry of Health (MOH) is engaging insurance group Great Eastern (GE) to better understand the impact of its decision to suspend pre-authorisation certificates for the Mount Elizabeth hospitals.
In its reply to queries from the media, MOH said Integrated Shield Plans (IPs) insurers 'would have to ensure that policyholders continue to be able to access the full benefits of their policies in accordance with the terms and conditions for claims, as stated in their policy contracts'.
GE, in a message to its panel doctors earlier this week, said it has temporarily stopped issuing pre-authorisation certificates from June 17 for policyholders admitted to Mount Elizabeth and Mount Elizabeth Novena hospitals.
Its rationale was that high costs from the two named hospitals, compared with other private hospitals, were the reason for this decision.
Pre-authorisation confirms that the insurer has approved the medical treatment, including the costs, before the treatment begins.
GE told its panel doctors the decision was not a reflection of their clinical quality, but the insurer was 'prioritising facilities that deliver the same high-quality care with greater cost transparency and cost-effectiveness'.
The decision took both the hospitals and GE policyholders by surprise.
In its e-mail to the media, MOH said the ability to afford major medical expenses is understandably a concern for Singaporeans and that all Singaporeans are covered by MediShield Life, which is sized to provide coverage for large subsidised bills.
'Singaporeans may opt to purchase IPs or additional coverage. As these are commercial products, while MOH regulates the key parameters of IPs for financial sustainability, individual insurers' changes to administrative processes such as pre-authorisation framework and partnerships with private providers are based on their commercial and actuarial considerations.'
The Straits Times has reached out to both GE and IHH Healthcare , which owns the Mount Elizabeth hospitals.
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Now that the problem has been spelt out and made the headlines, perhaps MOH should engage not just GE, but also all the IP insurers as well as private hospitals in a discussion on their charges. IHH would then have the opportunity to either show that the charges at the two hospitals are not excessive, or justify why they are. If it can't do this, it may have to rein in the charges. Escalating healthcare cost is a major concern, and the current brouhaha opens the way to possibly nipping some of the push factors in the bud. Salma Khalik has been covering health issues for over 20 years. Source: The Straits Times © SPH Media Limited. Permission required for reproduction. Print
