I WOULD like to share my experience on one aspect of what led to higher medical costs at Singapore General Hospital (SGH) on Dec 10.

I visited a senior consultant at G Clinic to get the results of my laboratory tests done earlier. The senior consultant told me my test results showed no abnormality. The response was very polite and reassuring and took less than three minutes. However, the charge for three minutes - professional fees plus GST - added up to $61.14.

For this same investigation, I had visited the senior consultant on Nov 28 and was charged $61.14, followed by a lab test on Nov30 for which I was charged $1,713.11 and for a review of the results on Dec 10 - $61.14. The entire process cost a total of $1,835.39 without any subsidy. I presume the first two charges are justifiable, but not the third with a three-minute review of the results.

The hospital's charging system, which is no fault of the doctor's, has been structured in such a way that some charges added at certain stages are not justifiable - for example, at the lab results review stage I have mentioned earlier.

The review should be considered part of the investigation and should not mean a fresh charge unless further follow-up is required where the findings are of concern.

I am sure my encounter with such a built-in escalating cost structure is not the only such example.

While the means test is in hot discussion, I urge the Ministry of Health to audit the billing structure and reduce costs that are added unnecessarily.

Medical care cannot be cheap if we want the best, but to allow medical costs to escalate in such a way is unjustifiable.

Tay Kok Cheng

This letter was first published in The Straits Times on Feb 6, 2008.