TL;DR – What we have is a system that is focussed on treating diseases, not caring for our health.
I recently had a conversation with a friend of mine, K. Both of us are going to reach the age when we will be automatically enrolled into ElderShield. Yes, yes, the big 4-0! The ElderShield is supposedly to help us in case we get disabled. The reason we’re supposed to pay those premiums is so that the future generations don’t have to pay for us. We’re told that healthcare costs will go up.
But why? Why would healthcare costs go up?
My friend, K, raised an interesting point:
K: You would think that with improving medical technology, prices should go down instead. After all, as technology improved, computers got cheaper. As technology improved, cars got cheaper. So why should medical costs go up as technology improve?
Me: I also don’t know. Maybe it’s because as technology improves, doctors have more tools to find more diseases to cure.
K: Maybe. But it also means that they can run more tests. Some of those tests are unnecessary.
I had dinner last week with a doctor friend. After dinner, she looked at the way I walked, and asked to examine my knees. She felt my knees, got me to extend my legs, listened to the sounds my knees made and told me that I’m most likely to have early osteoarthritis. But not serious. She told me I can go see a specialist to confirm if I wanted to. But she’s sure she’s right. I went to see a specialist, just in case. The specialist recommended that I do an MRI scan and this test that test don’t know what test. All added up will be quite expensive.
In the end, I decided to just trust my friend that I have early osteoarthritis. So I skipped the tests and got straight to the part of treatment, which turned out to be quite simple. Just strengthening exercises, have in-soles to properly support my foot, take some glucosamine pills. Much cheaper. So maybe healthcare costs are going up because doctors are getting us to spend a lot on a lot of unnecessary things.
Me: Ya! Probably right! And if you aren’t feeling well, you won’t be in the emotional state to bargain with the doctor. Whatever they say, you just do. Especially if you have insurance. Because everything covered by insurance already mah. So free. Better take.
K: Actually… Not free la. You’ve paid for it. You’ve paid for it through insurance and taxes. And if you claim more, then you wait lor. Your premium sure go up one. And that’s the problem with “free” healthcare. People don’t see the costs. They don’t feel the pinch directly. So they end up consuming more. Going for tests and treatments that aren’t necessary.
I think DPM Tharman said something in an interview he gave. I think he said that countries where government pays for everything tend to result in overuse and over-prescription because people don’t feel the pinch directly.
Me: So actually hor… It seems like doctors make money by treating diseases. If we are all healthy, then doctors won’t make money. Or won’t make that much money.
K: Precisely. That’s why “healthcare” is a misnomer. We don’t have healthcare. What we have is a system that is focussed on treating diseases, not caring for our health, not focussed on minimising our need to seek treatment.
To be fair, it’s not just a problem here in Singapore. It’s a problem everywhere. It’s not something that’s easy to solve. No one has quite gotten it figured out yet. That’s why, even though the idea of a war on diabetes sounds cringeworthy, it actually does make sense. If we can all do our best to be a bit healthier, change our lifestyle a little so we that we don’t fall chronically ill as we age, then we might have a chance of keeping healthcare costs affordable. After all, prevention is better than cure!
Me: That sounds about right. But not easy leh. I mean… take eating healthily for example. How to do so when there’s so much good food!
K: Ya… I know… I know… Sigh… Well… Let’s eat today. Diet tomorrow la.
My friend and I then proceeded to stuff our faces silly. But… I think I’ll control my diet. And… exercise more… hopefully.
Meanwhile, click here for what DPM Tharman said about healthcare insurance.