Outsourcing of medical services
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"A radiology group in Bangalore, India, has promised it can study X-rays and send a diagnosis within 30 minutes, Health Minister Khaw Boon Wan said yesterday. And it can do it cheaper too.
Mr Khaw said he saw no reason why Singapore should not pass on routine radiology work to cheaper places and concentrate on high-end work instead."
(Straits Times 8 Sep: http://straitstimes.asia1.com.sg/sub/singapore/story/0,5562,339446,00.html?)
Is this the way forward? Outsourcing diagnostics can certainly be cheaper and achieve better turnaround time. However, whilst labs in Singapore are accreditated by international bodies (Singapore was blowing its trumpet just few days ago about acquiring College of American Pathologists accreditation), the same cannot be said of low-cost diagnostic centres in India.
The Minister's idea is for the X-rays (and probably other lab tests in future) of Singaporeans who want a cheap service to be outsourced to India. Paying and foreign patients who are willing to pay for higher quality will have their tests done in Singapore at a higher price. Subsidized patients with difficult conditions will continue to be handled locally at higher cost, but with time more of these can be outsourced as the quality of Indian labs rapidly improve.
From the experience of others who have gone down this route, one implication is that hospitals will not want to train younger radiologists who do the bulk of the simpler cases. In any case, the easy cases have all gone to India anyway, so hospitals will just hire qualified radiologists to handle the complex cases. Secondly, in time, India and China will have so many cases that they will train increasingly more radiologists whilst we will lose them, as increasingly complex cases can be outsourced. Eventually, all of diagnostics will be outsouced (it has happened in the US).
The writing is on the wall: if you are a young doctor considering specialisation, there is no future in diagnostic radiology unless you are prepared to accept a lower pay or work in India, where the cost of living is lower. This will eventually happen to other disciplines that can be easily outsourced, such as telepathology for diagnostic pathology services. -
Ministers and MPs can and should be outsourced as well. They can talk to constituents, debate and vote on bill and policy matters via phone or video conferencing, email etc. Singapore will be able to save HUGE amounts of money, and these outsourced ministers and MPs can come from various countries, since our current leaders are more expensive than anywhere on this planet anyway. We can have them on 2 or 4 year contracts, subject to renewal. We must remember that the biggest drain on Singapore's coffers is in fact the Singapore parliament, as well as all the non-performing GLCs kept afloat with public funds.
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The problem with outsoucing anything for that matter stems from becoming beholden to these companies.
If these companies decide to one day turn around and screw you big time, you're stuck without alternatives and end up having to pay exhorbitant sums to clean up the mess.
And until India's quality improves significantly, i won't place a single dollar on putting my trust in their medical industry. The risk is just too great.
And if our ministers are serious abt making our medical sector world class, they better start finding ways to Kaizen their work procedures and processes to cope with the rising volume.
In short, become better, faster and cheaper, otherwise forget abt their pipe dream. -
I think outsourcing is unavoidable but really hope they would pass the savings back to the patients.
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you wait long long..... you just pray hard those people dont misread your X ray and you ends up having to pay the price for it both in monetary as well as bodily....Originally posted by lotus999:I think outsourcing is unavoidable but really hope they would pass the savings back to the patients.
unless there is tight control.... soon... your personal medical history would be available to anyone on the internet for the price of a song....
just like the recent case of service help desk of another country asking for IC and passport number of singaporeans....
outsourcing also have its risk.. especially when you cross borders... remember.... singapore laws dont work beyond our shores....
with due respects to all the medical professionals around the world....i wonder how would our foreign medical customers think when we tell them we just sent their X-rays to some god forsaken third world nation to be read by someone because its cheap....
the best part would be indians coming to singapore for treatment... and finds their x-rays are being sent back india to be read over there!! so... why bother come to singapore in the first place!!??? -
Unfortunately, the savings are usually passed on to management in the form of bonuses!
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It will mean more people in S'pore going jobless.
Also pity those poly students who are taking this course- all their studies wasted.
Don't expect medical cost to go down with this saving. Every year it goes up- they will cite increase in manpower, medicine, new technology, maintenance etc -
The NFK saga has clearely proven that despite all the assumptions about leaderships and high medical costs said to be inevitably associated with kidney treatments, at the actual work level, problems and assumptions are not always as presented.
One salient point arising out of the NKF saga is assumption about elites might look good to their leaders but to the people such perceptions are mere falsehood or fallacies.
The so-called affordability of kidney treatments was found to be totally misplaced based on one-sided assumptions and claims only. Figures and facts showed that these claims were trumped up to create good-looking score sheets to suit the high-profile personality. Even lawsuits on defamations could look good to the leaders but could be the results of cover-ups of facts about lengths of reserves due to narrow-minded attitude on the part of CEO and non-disclosing of correct facts to people in the first instance.
It is time for the leaders to stop all the fallacies about inevitably high medical costs to entitle CEOs or ministers to keep raising fees or charges.
Get the NKF fallacies out of the way and start managing Singapore based on facts and objectivity. Put in another entrepreneurial board and overhaul departments or ministries like being done for NKF, all the presumed high costs of medical services will be found to be unreal due to laziness of the mind or inadequacies of persons or chief executives in charge.
That is why all government medical computations put up by previous ministers should be reexamined and overhauled and revamped. How about removing the land cost elements and unnecessary recoveries of fixed or infrastructure costs already paid by ciitizens and not to allow ministers to double-charge them again. -
Land and infrastructure costs are indeed included in hospital charges and that's one reason why costs go up. The other major reason is escalating manpower costs to retain specialist medical staff who are leaving for the private sector in droves.Originally posted by robertteh:How about removing the land cost elements and unnecessary recoveries of fixed or infrastructure costs already paid by ciitizens and not to allow ministers to double-charge them again.
Agree with you about the fixed costs..although the reason why they are included might be due to some accounting rules (I plead ignorance of this issue)...such as cost recovery to compensate for the annual depreciation in property value?
As for manpower costs, Singaporeans have clearly indicated they want the best doctors and best treatment available. However, these come at a price and the price keeps going up. Our doctors have qualifications that western nations seek for their own doctors. If we do not offer competitive rates for them, how can we retain them? The migration of skilled labour is a global phenomenon. Top doctors from UK are moving to the US where the pay is better. At the same time, doctors from India, Pakistan and Southeast Asia are moving to UK to take their place. If our patients demand standards of medical service equivalent to the US, we may well have to pay US rates as well. In this respect, I agree with Khaw Boon Wan that he will have to moderate the expectations of Singaporeans if we do not want to pay more for healthcare.
Can you offer an alternative? -
The entire approach to control cost has to be an 'all encompassing' approach that does not limit the Government action on any particular sector alone.
'Land Cost' is only one aspect of the problem, and is the primary cost that is well within the control of the Government as it is responsible for determining the benchmarked price that land is parcelled out for sale to developers and government agencies.
This is the first cost factor that will affect all other costs in Singapore.
Singapore will need to take a hard look what price it is willing to pay for the entire value system that it has in viewing material and non-material things in Life both at the levels of the political leadership and private citizens.
This will set the philosophical tone and direction for the country - as much as it was a national goal to increase salary so as to advance the technological skill levels of the citizens, it will be necessary for a NEW and DIFFERENT NATIONAL IDEOLOGY to be taught to the citizens.
Singapore will need to review this revaluation with consideration given to the strength of the Singapore Dollar being used to control its Cost of Living and to maintain a high Standard of Living - with both aspects referring to Housing, Food, Transport, Education, Utilities, Judiciary, Political, Cultural and Social standards.
'Moneytheism' - or 'the worship and chase for money' - was already seen in the early 1980s as a threatening pitfall to Singapore's future by the first Foreign Minister - Mr S Rajaratnam.
It was unfortunate that his voice was no longer politically influential in his retirement days, when he was reputed to have been a forceful counter balance to the determined opinions of LKY. -
I see the start of job cutting in the medical servce
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Tell the freaking gov not to include the land cost, taxes, levies and should be giving cheaper electricity and water bills. That would help a lot.Originally posted by oxford mushroom:Land and infrastructure costs are indeed included in hospital charges and that's one reason why costs go up. The other major reason is escalating manpower costs to retain specialist medical staff who are leaving for the private sector in droves.
Agree with you about the fixed costs..although the reason why they are included might be due to some accounting rules (I plead ignorance of this issue)...such as cost recovery to compensate for the annual depreciation in property value?
As for manpower costs, Singaporeans have clearly indicated they want the best doctors and best treatment available. However, these come at a price and the price keeps going up. Our doctors have qualifications that western nations seek for their own doctors. If we do not offer competitive rates for them, how can we retain them? The migration of skilled labour is a global phenomenon. Top doctors from UK are moving to the US where the pay is better. At the same time, doctors from India, Pakistan and Southeast Asia are moving to UK to take their place. If our patients demand standards of medical service equivalent to the US, we may well have to pay US rates as well. In this respect, I agree with Khaw Boon Wan that he will have to moderate the expectations of Singaporeans if we do not want to pay more for healthcare.
Can you offer an alternative?
After all the land belongs to us singaporeans.