Exhorbitant charges by Dr Susan Lim

[edutilos-]

and have you ever heard of a terminal patient being billed in the millions for just 7 months of treatment?

Just to highlight, sometimes when local photographers print coffee table books for weddings, they also mark up the price from source. Of course not to this extent, but it's being done. How much do you think a bowl of rice in your standard coffee shop costs to produce and cook? Now change that to an expensive restaurant. Rice is still rice, even it is cooked lovingly. Mark-ups are actually a part of daily life; when you want to drill down to the details of how things work in reality, I guess the issue here might be "unrealistic proportions" as you say.

http://www.fiercehealthcare.com/story/most-expensive-hospital-stays-cost-about-18-000-day/2010-10-18

The top 5 percent of hospital stays averaged about $18,000 in charges per day in U.S. hospitals in 2008, according to the AHRQ. Hospitals charges for the most expensive stays tended to be for patients who were getting treated for septicemia, or blood infection, hardening of the arteries and heart attacks.

The average cost for the most expensive patient stays was based on the top 5 percent of stays by cost, or about 2 million inpatient stays. The stays lasted just under three weeks (19 days). The hospitals charged on average $191,984 for those stays.

7 months, assuming in the hospital, taking top 5% of US hospitals, $18,000 x 30 x 7 = 3.78 million USD = ~5 million SGD.

Still a fair cry from 26 million SGD, that's for sure, but just in case you think that healthcare comes cheaply when you ask for the best, then perhaps this will serve to highlight the fact that that's not true.

 

[kei1309]

Just to highlight, sometimes when local photographers print coffee table books for weddings, they also mark up the price from source. Of course not to this extent, but it's being done. How much do you think a bowl of rice in your standard coffee shop costs to produce and cook? Now change that to an expensive restaurant. Rice is still rice, even it is cooked lovingly. Mark-ups are actually a part of daily life; when you want to drill down to the details of how things work in reality, I guess the issue here might be "unrealistic proportions" as you say.

http://www.fiercehealthcare.com/story/most-expensive-hospital-stays-cost-about-18-000-day/2010-10-18



7 months, assuming in the hospital, taking top 5% of US hospitals, $18,000 x 30 x 7 = 3.78 million USD = ~5 million SGD.

Still a fair cry from 26 million SGD, that's for sure, but just in case you think that healthcare comes cheaply when you ask for the best, then perhaps this will serve to highlight the fact that that's not true.

to a certain extent this is true. but in this case, it was found that she had engaged the services of her friends, who also helped to treat this patient.

these friends had either not billed her, or in certain cases, only billed her a few hundred. on her part, when she submitted the bills to the Bruneian Istana, she inflated the costs into the hundreds of thousands. no matter how cheap the medicine or treatment was, she grossly overcharged.

and of course it takes 2 hands to clap; the Istana was lax in checking these medical bills.

one more point to take note is that the american healthcare system in the USA is much more expensive than in singapore. what would cost you $5m over there could maybe only be a quarter of the costs here.

 

[edutilos-]

one more point to take note is that the american healthcare system in the USA is much more expensive than in singapore. what would cost you $5m over there could maybe only be a quarter of the costs here.

Not sure if you are disputing the comparison; fact is, the issue here is: whether it's possible to rack up healthcare costs running into the millions over 7 months. Even if you insist on taking this patient's case into account, said patient is from Brunei, receiving treatment in Singapore. I suppose it would not be too far-fetched to imagine the patient receiving treatment in America either.

Anyways, it's just to dispute the disbelief at healthcare costs. Cheers.

 

[kei1309]

Not sure if you are disputing the comparison; fact is, the issue here is: whether it's possible to rack up healthcare costs running into the millions over 7 months. Even if you insist on taking this patient's case into account, said patient is from Brunei, receiving treatment in Singapore. I suppose it would not be too far-fetched to imagine the patient receiving treatment in America either.

Anyways, it's just to dispute the disbelief at healthcare costs. Cheers.

yea.. i see where you're coming from.. i've seen my Grandma's hospital bills before she passed away. Mt Elizabeth... she was in the Critical Care Unit for a couple of weeks and the bills came up to over $50k if i'm not wrong.

 

[Teo]

oh boy, these days high medical bills will shocked the patient to death instead...

For those mid and low income citizens how to afford??...most of them will be thinking better to d** than to burden their children with the exorbit medical bills these days.

 

[ricohflex]

Was told that in USA, if you are very ill or injured and are sent to hospital; they will refuse to treat you until you have money or have medical insurance.

Maybe the day will come when some societies recognise this problem that the low income simply cannot get medical treatment because they cannot afford it; and pass a law permitting a legal injection to be made (with signed consent forms) whereby the patient dies painlessly quickly. There will be objections but mostly because some interested parties realise that very rich patients may also choose this - and thus cannot be milked of millions of dollars billed for medical treatment.

 

[ninelives]

Was told that in USA, if you are very ill or injured and are sent to hospital; they will refuse to treat you until you have money or have medical insurance.
.

i thought this only happen in China? USA? seriously? i thought they got all kinds of welfare?

 

[Alan Chan]

oh boy, these days high medical bills will shocked the patient to death instead...

For those mid and low income citizens how to afford??...most of them will be thinking better to d** than to burden their children with the exorbit medical bills these days.

first off i'm not selling any insurance coz i'm not an agent. thats why everyone should get the cheapest yet most important hospitalization insurance (those guaranteed renewal type, NOT general type) that covers most of the bills. agents will always try to sell you life or endowment policy first coz it give them the fattest commission but its actually not the most urgent product to buy.

 

[9V-Orion Images]

Was told that in USA, if you are very ill or injured and are sent to hospital; they will refuse to treat you until you have money or have medical insurance.

Maybe the day will come when some societies recognise this problem that the low income simply cannot get medical treatment because they cannot afford it; and pass a law permitting a legal injection to be made (with signed consent forms) whereby the patient dies painlessly quickly. There will be objections but mostly because some interested parties realise that very rich patients may also choose this - and thus cannot be milked of millions of dollars billed for medical treatment.

Sicko directed and produced by Michael Moore is one of his better "documentaries". :bsmilie:

 

[plsoong]

logically, if one has heart problem, one would consult a cardiologist. however, in dr lim's case, she is a 'renowned' surgeon who was supposedly chosen by an advanced breast cancer patient. (of course, the patient/('istana' will pay) is super rich, so the choice is hers to make.) so, in our limited mind, one cannot fathom why not a female 'renowned' oncologist be helming the team treating her?

like that must as well i chup in and KPKB also how come the REAL people slogging our asses off in the labs doing 24/7 until kee siao are not helming the team and also paid more than the docs?

ultimately oncology is still in its RESEARCH INFANCY, so y aren't RESEARCHERS paid more ? rather, even scientists armed with PhDs and a couple of years or work experience, making ground breaking research (so that the medical dudes can test and use to treat patients) the income is still meagre and less than an exponentially increasing pay of a basic MBBS after the same years of working.

sigh........welcome to the world of murky, dirty MEDICAL politics....

 

[dreaming]

Had the patient survived, the story will be different

the rich royal family thought she can revive the patient, so willing to fork out initially. when the patient pass away, they realised no amount of $ can save a person's life.

do you paying extra for a experience specialist, the confidence level will be higher? higher percentage of healing?

 

[ricohflex]

i thought this only happen in China? USA? seriously? i thought they got all kinds of welfare?

http://www.bizmology.com/2008/04/29/us-hospitals-no-insurance-no-45000-check-no-service/

http://www.mindfully.org/Health/2008/Demand-Cash-Hospitals28apr08.htm

Don't know reality about USA.
But Canada.... a friend of a friend had migrated to Canada for many years. Met him when he returned to Sing few years ago. He returned to get treatment for heart bypass. Arteries clogged. Why did he not seek treatment in Canada, since he chose to migrate there? Ah...there are somethings we do not know. Not everything is wonderful in other countries and the grass is not always greener elsewhere. Most likely if he had waited to be treated in Canada, he would be dead by now.

 

[Yappy]

Money not enough!

 

[La Fontaine]

like that must as well i chup in and KPKB also how come the REAL people slogging our asses off in the labs doing 24/7 until kee siao are not helming the team and also paid more than the docs?

ultimately oncology is still in its RESEARCH INFANCY, so y aren't RESEARCHERS paid more ? rather, even scientists armed with PhDs and a couple of years or work experience, making ground breaking research (so that the medical dudes can test and use to treat patients) the income is still meagre and less than an exponentially increasing pay of a basic MBBS after the same years of working.

sigh........welcome to the world of murky, dirty MEDICAL politics....

Each one chooses his or her job or profession according to his ability, liking or opportunity.

Some docs in Govt hospital are working long hours and getting mediocre pay.

GP in neighbourhood clinics working long hours and charges 35bucks for consultation and medicine all in. After paying for rent, his assistants and utilities and other cost, I doubt there is much money for him.

Sometimes, we tend to envy those property agents who collects easily 2% of a $1M property - is it really easy money? Everyone would wanna to be in that position. Is it really a bed of roses? Compare that with the contractor who takes 3years to build that condo, working with sweat and blood and not certain if he can even break-even.

Stock broker who makes lots of money. Well, not everyone can do that.

 

[cks2k2]

i thought this only happen in China? USA? seriously? i thought they got all kinds of welfare?

In the US, no medical insurance = no doctor/hospital to treat you.
Because of all the trivial lawsuits doctors there are scared of practicing!

The social security system there is practically broken and there is no universal healthcare for its own citizens unlike say SG.

 

[mattlock]

the press is obviously out to vilefy her.
Please read into the details of the whole situation.
Brunei complained about the price. They did not pursue it much further than that at first, and susan lim had provided a very generous discount.
SOME people within the industry itself convinced the brunei side they should push the matter further.
What for?

Read how much time the doctor had to put aside for the client too and the outrageous demands made on susan lim.
She makes alot of money, that's great for her. She's also very reknown, she pioneered the liver transplant in Singapore.

What she wants to charge for her markup is her problem. If the brunei princess didn't die I doubt that they would be complaining about her services.

 

[mattlock]

I hope you read the comments by the very doctors who supplied their services. They did not complain about her "markup", and did not feel it was a markup. Also the treatment was not just in Singapore, if you read the details she had to basically set up a mobile hospital in brunei for an extended period.

to a certain extent this is true. but in this case, it was found that she had engaged the services of her friends, who also helped to treat this patient.

these friends had either not billed her, or in certain cases, only billed her a few hundred. on her part, when she submitted the bills to the Bruneian Istana, she inflated the costs into the hundreds of thousands. no matter how cheap the medicine or treatment was, she grossly overcharged.

and of course it takes 2 hands to clap; the Istana was lax in checking these medical bills.

one more point to take note is that the american healthcare system in the USA is much more expensive than in singapore. what would cost you $5m over there could maybe only be a quarter of the costs here.

 

[kei1309]

I hope you read the comments by the very doctors who supplied their services. They did not complain about her "markup", and did not feel it was a markup. Also the treatment was not just in Singapore, if you read the details she had to basically set up a mobile hospital in brunei for an extended period.

if you've read carefully, i've not vilified her in any way, nor have i said that she's anything bad. i made neutral comments in that post based on facts presented.

the way you've presented it makes it sound like i've placed her in a negative light. are you accusing me of that? by the way, if you've read the other articles, you might have seen a few hundred becoming a few hundred thousand.

her friends might support her, but they're HER FRIENDS. anyone can say that it's because they're her friends, they support her. but looking at it from a completely neutral point of view, have you heard of Friends with Benefits? It might not be as simple as a little support :dunno:

no doubt, she might have enemies within the medical care community that were jealous of her success as well.

if you say that i'm biased, i can tell you that i can write a few essays on this case, with all the facts known, and present the case from all different angles.

so do not target me, Mr Mattlock, when others have had their own views.

 

[plsoong]

Each one chooses his or her job or profession according to his ability, liking or opportunity.

Some docs in Govt hospital are working long hours and getting mediocre pay.

GP in neighbourhood clinics working long hours and charges 35bucks for consultation and medicine all in. After paying for rent, his assistants and utilities and other cost, I doubt there is much money for him.

Sometimes, we tend to envy those property agents who collects easily 2% of a $1M property - is it really easy money? Everyone would wanna to be in that position. Is it really a bed of roses? Compare that with the contractor who takes 3years to build that condo, working with sweat and blood and not certain if he can even break-even.

Stock broker who makes lots of money. Well, not everyone can do that.

well, just fyi, a GP in neighbourhood clinic working long hours and charging cheap (in average) still earns more than a PhD qualified scientist (in average)....that despite going broke for(ever) to study to the top of the league...just to earn lesser.

Each discipline have their own pros and cons....no doubts about that...but RESPECT is in due course. We respect the stress that a stock broker has as well as the immense risk.... thats y he/she CAN be paid well.....

now back to the comparisons.....do scientists get as well respected and deserve their meagre pay? u think the drugs that is dished out by the doctors come from their own hard work? how long is long hours? i doubt any GPs have to burn the midnight oil and even overnight in their clinics DAILY just to come out with a plausible solution to their patients? and at the end of getting some breakthrough, only to be another statistical number of scientist, with the same sh*tty pay.

and don't even start me on risks of GPs vs scientists......there are things that the general public do not know enough.

 

[ricohflex]

Usually doctors asked to treat any family member of any royal family (Japan-Thailand-Cambodia-Brunei-Malaysia-Monaco-England-Sweden-etc) will treat it a a lucky break of a lifetime. The patient is rich and powerful, can grant many privileges and honours to the doctors that they like. Even in USA, where there is no royal family, but there is a President. The doctor who performed life saving surgery and removed the assassin's bullet from Ronald Reagan, had a meteoric rise in his career after that.
So even after this very public case, doctors will still hope to get royal family members as their patients.
Usually with royal family, the doctor is told to do the medical treatment first and talk how much money later. Surely the royal family can pay.
The lesson from this case, is if you are the doctor, even with royal family, please talk money upfront first and say how much and get agreement in writing (preferably through lawyers). Then cure. To prevent accusations and complaints being made at high level against you, better talk money first. After all royalty is involved so it is taken seriously even though the complaint is done in the form of an official of that country asking for a discount on behalf of his royal family (but note he did not ask the doctor but instead ask our state official). So although it is made to look as though only a discount is asked, it appears to have the same effect of a state-to-state-complaint.

It also depends on who it is. Some kings (e.g. Thai King) are so loved by their subjects and held in such deep reverence that the idea of sending him a bill (even if it is not grossly inflated) for medical treatment is probably unthinkable if he is treated in his own country by a doctor who is his subject.

By the way, Robert Mugabe (who is not well loved by his citizens) in coming to Singapore for eye medical treatment. Wow - all the way from Africa. Our eye doctors must be good.