• Senior Minister of State Koh Poh Koon said the committee would roll out changes for "quality, safe, cost-effective and affordable care" 
• It came amid a continuing tussle between the medical fraternity and insurers over the management of Integrated Shield Plans
• Dr Koh said discussions so far have been constructive as the parties sought ways to ensure continued access to good-quality, cost-effective healthcare

SINGAPORE — Minister for Health Gan Kim Yong will set up a committee to look into the management of Integrated Shield insurance plans (IPs) — including doctor panels — amid a continuing tussle between the medical fraternity and insurers. 

Dr Koh Poh Koon, Senior Minister of State for Health, said in a Facebook post on Saturday (April 3) that he met representatives from the Singapore Medical Association (SMA), the Life Insurance Association Singapore (LIA) and the Academy of Medicine Singapore on Wednesday to discuss improvements to the way IP panels are set up and administered. 

He said that all parties agreed to formalise an existing temporary committee into a committee appointed by Mr Gan. 

“The committee will take the work forward, and work in the public’s and patients’ interest to deliberate and implement changes for quality, safe, cost-effective and affordable care for all,” said Dr Koh. The Ministry of Health (MOH) will release more details about the committee and its proposed recommendations later.

Dr Koh said that the discussions so far were constructive and the parties sought ways to work together to ensure patients continue to have access to good-quality and cost-effective care. 

“These include expanding insurers’ panel of doctors with clear and transparent criteria, as well as improving the claims pre-authorisation process for treatment, particularly by doctors who were not on panels."  

The groups also discussed several ideas on improving the transparency of doctors’ fees and outcomes, and insurers’ performance as positive developments for greater public awareness. 

Better processes to deal with unfair behaviour were also on the agenda, Dr Koh said.

Responding to Dr Koh’s post, LIA said it looked forward to the collaboration among all parties with the formalisation of the committee.

“Open and constructive dialogue is essential in addressing IP-related issues and refining how Health Insurance Task Force recommendations are implemented.” 

The task force, comprising industry and government representatives, convened in 2016 to address escalating claim costs for IPs.

For the past few weeks, SMA and LIA have locked horns over the mechanics of IP schemes. 

Such insurance plans comprise two parts: A MediShield Life component managed by the Central Provident Fund Board, and the other provided by private insurers.

On March 25, SMA issued a position statement decrying that insurers had formed “highly exclusive” medical panels that excluded many private specialists and had disrespected fee benchmarks. 

The association representing doctors here also complained that insurance premiums had increasingly been used for non-healthcare cost items, such as insurers' management expenses and commissions for insurance agents. 

In its response, LIA, which represents insurers, said that there were cases of “over-treatment” by medical providers. It also called out SMA for using misleading analysis on insurers’ costs and claim costs.

On Friday, LIA issued a fuller response to SMA, noting that insurers have been increasing the size of their panel doctors and approving claims with surgeon fees spanning the full range of MOH's benchmarks.

It also said that the number of private specialists on IP panels has grown and now ranges from 250 to 400.

There were about 150 to 290 private specialists on these panels in March 2019, and about 200 to 350 in March last year.