The Government's attempt to control the rise in health-care spending by asking doctors to use cheaper drugs and treatments where possible reflects a dilemma that is faced by societies across the world. New technologies that have revolutionised medicine and brought cures for diseases that just a few decades ago were considered incurable have also turned the setting of health-care priorities into a nightmare. Is it better to spend a large amount of money on an expensive new treatment to save the life of one patient or would that money be better spent treating a larger number of less seriously ill people? With finite health budgets, this is the kind of choice that health administrators have to confront with increasingly regularity.
Health and Welfare Secretary Dr Yeoh Eng-kiong's announcement that doctors will be told not to prescribe expensive treatments and procedures when cheaper ones will do is an understandable response to the need to maintain strict controls on health-care costs. It has led to equally understandable concerns that doctors will be forced to compromise on the quality of treatment in order to cut costs.
The guidelines that Dr Yeoh has described need not lead to a fall in standards. In fact, much of what he has said reflects common sense. Before sending a patient for an endoscopy, or a similar diagnostic procedure, any good doctor should carry out a preliminary check to warrant that such a test is required. Similarly, if cheap but effective treatments are at hand, doctors should be encouraged to use them in preference to more expensive ones. It is important though to reassure patients they will not be denied expensive treatment if they require it.
The public, however, is unlikely to take kindly to an attempt to place restrictions on the kinds of treatment available to them. But it is a harsh fact that in a largely tax-funded health system, there is a limit to how fast health budgets can grow. This is especially so when there is a general reluctance to increase the level of taxation.
If people want unrestricted access to the most modern drugs and medical technologies, they will have to be prepared to pay for them through insurance schemes or mandatory savings plans. If not, they will have to be content with the restrictions of the tax-funded system. In health care, as in most other things, nothing comes free.
