High health cost in Singapore has led to many bad consequenc

fymk SG

I am surprised that you can claim to be a nurse when you cannot even understand that the AMD is about respecting patient autonomy and nothing to do with heakth economics. Or perhaps the long words are too difficult for you.

There is a price for modern medicine and not everyone can afford it. What is best treatment for the breast cancer patient in Medan may be considered inadequate in New York, but it's the best available given the Indonesian's circumstances. What kind of treatment the Singaporean gets must depend on what she can afford. The government should provide the level of treatment for the poor that society is prepared to pay or able to afford.

I am surprised that you claim to be from Oxford.

If it was not about quality of life, they would not be using the statements in the brochure:

" We tend to take many things in life for granted, including life itself.
Often we wait till serious illnesses or accidents strike before we start to think about life and death issues. To die naturally, in peace and with dignity is what many would want in their final moments. While medical advancement may help prolong life artificially, it cannot stop the dying process. Making early choices about our medical care in the event that we have a terminal illness and are unable to make our wishes known will spare our loved ones the difficult decisions that have to be made on our behalf."

AMD is also about giving the patient autonomy . I am not disagreeing with it. Primary reason is quality of life. It will save the doctors from making the decision to prolong the patient's life through unnecessary advanced medical interventions because of secondary factors i.e. angry emotional relatives who will have to foot the bill later.

In an economic rationalistic perspective, unnecessary and inappropriate treatments will tie up limited medical resources when someone with a chance of recovery should have got it . AMD has an indirect link with economics .

You are talking about people tieing up the system for curative treatment and I point out that no one can play God and say that a patient will only survive for 3 months - sh*t happens, so does miracles. Denying a patient life saving treatment in their own country when it is available is unfair ,unless it is their own fault like alcoholics wanting a liver transplant while they are chugging tons of ethanol.

I believe in a system where affordable and reasonable standards of healthcare should be made available for someone who is not a terminal stage patient and have a high probability of surviving the treatment with a reasonable quality of life . If the doctor says that there is a 30% chance, it is still a chance and should be provided to the patient especially when the treatment is readily available in Singapore, albeit the cost. Once we start denying curative treatment to those we deem not worthy or cannot afford the cost , it will be a slippery slope . What's next? Deny treatment to the physically or intellectually disabled because they don't contribute to society economically compared to someone who is not disabled?

If the patient have the money , they can fly out to New York for the latest spanking new medical breakthrough of a treatment on their own money.

Ahm97sic SG

Terminal illnesses and high medical cost - left to die ? Morally incorrect but moneywise correct ? Left to die at home or at hospital ? Cheaper to die at home or more expensive to die at hospital ?

Expensive drugs or treatments for terminal illnesses to prolong lives ? Expensive to hospital and the taxpayers but not so to patients' family members ?

In fact, it is more important to ask the patients themselves. How do the patients feel physically and mentally ? To them, it is not a matter of living three more months or three months less. It is how they feel physically and mentally living from day to day. Is the intricating pain, great discomfort bearable ? Is there any way to help to alleviate their physically suffering from day to day that is more important to them. Is there any help to ease them on the path of dying to death ? Is there any help extended to them to live out their remaining days ?

(Currently, the doctors and nurses are there to care for the patients when they are in the hospital BUT when the patients are discharged, they are left in the home without the appropriate help. Many families do not have the knowledge and experience to care for the patients. Yes, there are organisations that will help and these organisations are only a drop in an ocean).

Ahm97sic SG

Hi everyone, to share the information for those who need to see a specialist.

Based on my experience, when you are sick and need to see a specialist, you can

(1) see a polyclinic doctor to get a referral letter to see the specialist in a government hospital so that you can receive sudsized medical treatment. You still need to pay cash for outpatient visits and diagnostic tests. You can only use medi-save only if you are being hospitalised BUT BE PREPARED TO WAIT FOR UP TO SEVEN MONTHS BEFORE YOU GET TO SEE THE SPECIALIST.

(2) see a GP to get a referral letter or see a polyclinic doctor to get a referral letter which states the name of a specific specialist BUT you will have to see the specialist as a private patient. You can see the specialist within a week, usually at the next clinical session of the specialist. The oupatient consultation fee will cost between $60 to $150 per visit BUT the blood and diagnostic tests can easily cost $100 to $1500 (eg MRI scans) per visit. The medication cost can easily cost a few hundred dollars to more than a thousand dollars if the medication is non-standard drugs.

(3) go to a private hospital to see a specialist in private practice but the cost will be even much higher than seeing a specialist in a government hospital as a private patient.

(4) go to the AE department and if you are being admitted, you will get to see the specialist during your hospitalisation.

(5) see a polyclinic doctor when your conditions have deteriorated until emergency and the polyclinic doctor can write a referral letter to get you direct admission into the hospital.

(6) call the specialist clinic and the appointment centre daily to check whether any patient has called to cancel his or her appointment and if you are very lucky, the staff will call you and you can rush down immediately to see the specialist.

Thank you for your kind attention.

Regards,

ahm97sic

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