Whither Medical Care?

In this city, if you can afford to pay, you pay more for healthcare services; if you are poor, then the Singapore government provides a subsidy and you end up paying less at the hospital. This is a fair way of providing medical services in the public hospitals. That was what I believed was the original intent all along - you pay according to your ability to pay but you still receive the same level of care.

But it seemed to have changed over the years - the ones who can pay more are allowed to choose their doctor and logically they will select the renowned and experienced ones who can provide better care than say those who are relatively new and with fewer years of clinical experience. The poorer patients have no choice - they have to make do with whichever doctor is assigned to them.

And then, some hospitals started differentiating services one step further - patients without subsidy are being seen in newer and better facilities with nicer ambience while their lesser brethren are seen in the older clinics.

The hospitals do argue that everyone does get the same level of care - but can this be assured?

Should this be the way? Isn't it more ethical for everyone to be seen by the same group of doctors and in the same facility? That both group of patients be accorded the same level of privileges? That both groups be entitled to the same clinical and service experience?

Those patients who pay more do so as they can afford to pay - it does not carry an entitlement of privileges and differentiated services.