Life has been surreal. The accompanying photograph in this article was taken on 26 January 2020. It was the second day of the Lunar New Year, and an emergency meeting had been called to discuss the detection of COVID-19 cases in Singapore and the supportive measures to be rolled out.
Family and friends
Just like that, 23 months have gone by. My youngest child grew from a toddler to a small boy. My eldest, from a big boy to a pre-teen. I crossed the big 4-0 quietly, without the big celebration I would have wanted. It has been more than two years since my move to private practice and I am entering my second year as President of the SMA. The river of life and time is flowing fast, and I have seemingly been swept along...
This period has been eventful. I have kept a list of all the stressful events that have happened, and will probably need to see a therapist someday, when I can find the time to. In the meantime, sporadic meetings with friends will have to suffice!
If nothing else, physical isolation has taught me one thing: no man is an island. No woman either, for that matter. Family and friends have sustained me through this period. Staying strong for our loved ones – whether it is our spouse, parents or kids (or furkids!). Talking to friends, listening to each other's woes, sharing in their grief and triumphs. Friends who share on their Facebook pages or who privately updated me on their personal illnesses, deaths in the families and relationship problems. Friends who share funny stories, insights or memes that make me LOL (laugh out loud) in the middle of work. These little connections mean so much to me.
My healthcare family must include the SMA Council – while some members have come and gone, we have all somewhat kept in touch over the past 16 years! The newer extended family would include the Multilateral Healthcare Insurance Committee (MHIC) as well. Just like any family, there are cliques, some disagreements, and so many different personalities in the mix. Imagine a large family, with in-laws, cousins twice removed, relatives in their second marriages, etc. It is complex – people may have their differences, but one thing we all have in common is the desire to put patients first.
Advocacy and self-governance
It was after much discussion and deliberation within the SMA Council that we published the Position Statement on "Troubled Integrated Shield Plans" on 25 March 2021.1 This required courage and unity. Council members shared their concerns and fears of repercussion, yet many put forth the need and indications to take a stand – for doctors and for patients.
This Position Statement triggered its own small tidal wave of change which resulted in the appointment of the MHIC2 with representatives from the Academy of Medicine, Singapore, Consumers Association of Singapore, Fee Benchmarks Advisory Committee, Life Insurance Association, private hospitals and SMA, of course.
Since its inception on 27 April 2021, the MHIC has been having much needed discussions on issues affecting the entire healthcare ecosystem – issues impacting healthcare cost, patient autonomy and professional practices.
Meetings were held monthly, mostly via Zoom – it is no easy feat to coordinate the schedules for over 20 busy people, and additional sub-committee meetings were held almost on a weekly basis. I thank Deputy Secretary (Policy) Ms Ngiam Siew Ying for her leadership in chairing a diverse group and getting strongly opinionated leaders of the profession to come to the table to wade through pain points, agree on important targets and come to an equitable proposal.
Some important decisions have been made, with a key one being the formation of a Clinical Claims Resolution Process, announced on 9 November.3
I am glad that SMA has had a hand in bringing about these changes. I have always held that SMA can make a difference when we lobby appropriately, for the right cause. While platforms like Facebook, WhatsApp and Change.org seem to be convenient vehicles to raise a ruckus and gain a following, might does not make right. I urge readers to look through previous issues of SMA News to better understand the complexity of healthcare financing, and resist asking for a simple one-dimensional solution.
With the Ministry of Health-led announcement of a fairer system for patients, the SMA is following through the momentum by taking a big, practical step to help support the much-needed transformation in the healthcare ecosystem.
Health Connective: a real-life solution
Health Connective is a collaborative effort of three technology partners in the healthcare space – Smarter Health, Assurance Technology and Health Catalyst – to provide a unified platform to improve the efficiency and effectiveness of the interactions between the key stakeholders in the healthcare ecosystem. SMA supports this initiative.
One oft-heard complaint by doctors and insurers is that "There is too much paperwork!", followed by "This increases time and costs!" and "There's no transparency!" Having a single platform for all users – patient, doctor, hospital and insurer – to communicate effectively will greatly reduce this element.
In this issue, we will outline some of our aspirations for Health Connective (see page 14). You have a part to play as well. It was Barack Obama who said, "Change will not come if we wait for some other person or some other time. We are the ones we've been waiting for. We are the change that we seek."
I hope you will join me and be part of that change.