Juicy July

Just when you thought it was safe to go back to your insignificant and quiet existence as a doctor after the magnificent launch of the Pioneer Generation Package, July saw the majestic herald of something even grander and awesome in healthcare.

No I am not talking about the Medishield Life. I am talking about Dr Susan Lim husband’s lawsuit against the lawyers of the Singapore Medical Council for alleged overcharging. The irony is so thick you can cut it with Darth Vader’s crimson lightsabre. Interestingly, the Senior Counsel who was involved in this case was judged to be not guilty of overcharging by a review committee of the Law Society because the law firm claimed he “was not involved in the preparation of the bills” (2 July, Business Times) . This hobbit wonders if we can apply the same standard to doctors. If the clinic manager bills a patient a million bucks for a liver transplant, the surgeon can be considered to be not guilty of overcharging as long as it can be shown he wasn’t involved in the preparation of the bills and the clinic manager did it on his/her own accord. I think I will set up a separation of operations and decision-making between my clinic’s billing department and the professional service department (Which incidentally is really a partition board separating me from my clinic manager who does the billing in my 20 year old HDB shophouse). Incidentally, my clinic manager also happens to be my wife and as any male doctor will tell you, once your wife is involved in the administrative matters and operations of the clinic, you really, truly have zero influence over how the clinic is run. You have less rights than the clinic residential lizard.

Will the Singapore Medical Council learn from the very wise review committee of the Law Society and accept such an arrangement as defense against accusations of overcharging?

Let’s move on to the other BIG news on the healthcare scene – the launch of the Medishield Life Scheme (MSL). This Hobbit actually welcomes many of the new features of the MSL scheme. For one, it won’t penalize me for living too long. I always wondered one day when the effects of The Ring wore out and I needed some serious medical care, what medical insurance will cover me? I mean, I am 165 and Medishield cover for me expired 85 years ago even though my only pre-existing disease is Taenia Goblinus in my hairy feet, which I contracted while fighting all those hideous goblins at Misty Mountains. Otherwise I am quite healthy.

My only complaint is that MSL’s payouts are pegged to B2 and C class bills, which are really quite little since the BS and C classes are already heavily subsidized.

With my newfound wealth from starring in a trilogy of movies, I really was hoping to stay in a better class bed when I get sick. There’s where the Integrated Plans (IPs) come in, I suppose. But these IPs are run by commercial insurers and you know how these commercial guys work. Once you claim for something, your premiums may either shoot up or you are then excluded from cover. These guys can be more commercially driven than those Lonely Mountain dwarves.

It’s the hot and humid season again and dengue is peaking and the threat of haze is looming. This hobbit doesn’t know which is worse, the dengue or the haze.

Anyway, let’s hope there is no mad rush for the N95 masks again. Just to recap how incredible/frightening the push for N95 use was – the relevant authorities stated briefly on their website last year –  “ The N95 mask is necessary for individuals who are susceptible to the impact of haze, including persons with chronic medical conditions especially lung or heart disease, elderly and pregnant women. These individuals should wear N95 masks if they plan to undertake prolonged outdoor activity when the air quality is poor”.

I am not making this up. This hobbit took a screenshot of this on 21 June 2013 and it is on record. Fortunately common sense prevailed and the advisory for N95 masks was changed to something that was more clinically sensible. If not, we may have had a lot of people dying from respiratory distress and heart failure from N95 masks than from the effects of haze itself. I am told by unreliable sources that the consummate professional who was purported to have approved this jaw-dropping advisory has gone back to the world of academia, where everything is academic.

Meanwhile, the World Cup has come and gone. There are a few things you can learn from this World Cup that is quite instructive:

• Flu is not an excuse for an MC. Seven of Germany’s players were supposed to have contacted flu before they played France in the quarter finals

• The guys at National Council for Problem Gambling need to get some counseling after being the butt of all those jokes

• Creating a vertebral fracture is a weapon of mass destruction

• Suarez’s incisors can be used as bone graft for Neymar’s fracture

• Growth hormone injections can really make a guy duller – just look at Lionel Messi’s facial expression when he received his Golden Ball award

Meanwhile, this Hobbit wants to put on record that he disagrees with the commonly held perception that our Ministry of Health is staffed by heartless bean counters who are so miserly that if they can help it, they will make doctors re-use drug pens and patients to bring their own toilet paper. This is totally untrue. Only patients that have been issued incontinent pads need to bring their own toilet paper.

Seriously, we should disabuse Singaporeans of the idea that MOH is miserly and heartless. Just over the last weekend, it was reported that the Auditor General’s Office had discovered that between Jan 2011 and Oct 2013, MOH had disbursed $64,000 to 99 people who had already died.  Maybe the dead need to pay for ERP charges on the highway to the after-life. Or maybe it’s an enhancement to the Medishield Life package – Medishield Life-after Super Integrated Plan. And we are not talking about seventh month hell notes here, dude. Legal tender Singapore dollars. This is to also underscore that we are truly an inclusive society and even the dead are not forgotten.

Well, that’s all for July, folks. See you in August when the Hobbit celebrates National Day. For now, if you see a short guy with hairy feet hanging around the Children’s section of public libraries reading books, you know who that is…….

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