Monday, February 28, 2011

Dr Susan Lim and the $22M medical bill...

I'm sure many of you have read about the Dr. Susan Lim case which is now before the SMC. She is trying to prevent the SMC from convening an investigation into her billing [Link]. I'm not here to discuss Dr. Lim's case or her morals but how the desire for Singapore to be a medical hub for the rich has raised the cost of healthcare for ordinary Singaporeans who are now made to shoulder the increasing financial burden of our govt's aspiration to maximise the profits made in this sector while keeping its own expediture on healthcare down by passing the increased costs to ordinary Singaporeans.

While Dr. Lim's case was brought up, the newspapers went around to interview doctors on what they think of it. Some say she should bill no more than $5000 a day others say it is okay for her to bill the $450k a day if the patient is willing to pay this amount for her services. There is no concensus on what amount she should bill a patient. Some suggested it should be based on patient's ability and willingness to pay. If this is true, Singaporeans with a median household income of $4-5K have to compete with the richest in the region. Healthcare is starting to get treated like housing -the good size bungalows for the rich and rental flats for the poor, you get what you pay for and the more you pay the higher the availability and quality. Pure capitalism.

Sometime back, I needed an minor operation on my back. I went to the GP who suggested that I pay a few thousand for day surgey at a private hospital called Eastshore. He told me the doctor there was very experienced, highly available and I can get my surgery the next day after an initial inspection. I asked him if there is any risk if it is done by a doctor with no experience. He told me the risk was minimal (nearly zero but doctors cannot say zero). I decided to have it done at the public hospital. The waiting time was months but I was not in need of any immediate treatment so I was opted to wait. To cut a long story short during my surgery I was put on LA (local anesthesia) - they killed the pain on my back but I was fully awake during the surgery. While they operated on my I could hear all the interesting small talk between a specialist and two surgeons who were "cutting" me. The surgeons sounded like rookies taking instructions from the specialist. I was quite okay with that given my condition was not complex and the surgery was a simple one. Half way through, the head of department came around to check on the surgery team. When he left, one of the surgeons said he was very nervous when his "boss" came to look at what he was doing. I told him, "hey doctor, you forget I'm still awake, now your patient also very nervous".

The surgery did go well and I have recovered fully. I was lucky to have a small problem and the public hospital took good care of it. However, my experience that highlights what is going in our public hospitals. Many highly experienced senior doctors, surgeons and specialists have been drawn out of our public hospitals into the private sector where they can earn much more money doing less work. That leaves those who remain in the public hospitals to handle a bigger loads - we enter a vicious cycle because those remain have to be retained with higher pay. The govt has shown no desire to fix this as they simply pass on the increased cost to Singaporeans (means testing, higher insurance premiums etc). They continue to advertise Singapore as a medical hub for the rich in the region[Linkj] and the expansion of capacity in private hospital will further strain our limited resources.

There is only one other developed country that allowed free markets to dominate healthcare - USA. We are going along the same trajectory and will reach a stage when it becomes very difficult to fix just like in the US. You cannot ask surgeons that make $15M a year to trottle down to $5M. We have already seen insurance premiums moving up - old schemes such as basic medishield becoming inadequate and more and more people with inadequate coverage. The medical care financial strain is moved up from low income now to middle income families. We continue to be told that "healthcare is affordable" and we are on the right track. This is not true. There are many other ways to run a healthcare system and many of my readers who are Singaporeans or ex-Singaporeans now living in Australia, New Zealand, Canada, France and UK attest the workability of other systems that give the sick the better care and lower financial burdens. The PAP likes to scare us by saying that such system can only lead to higher tax - ideologically the PAP likes to keep income taxes low but that comes at a price of burdening those in need. In the 2011 budget the PAP govt cut taxes for the middle income, in essence, giving money to all those in this bracket including those who don't need the money. But why do this? The govt hurt the sick people in the same income category by implementing means testing....why take from those who need it most to give to everyone? This philosophy can only exacerbate the effects of the already large income gap among the populace and thin out what ever remains of any safety net for those who need it most.


Anonymous said...

The old man has a lot of faith in our elites. So much so, he meddles with our gene pool to extract people like dr lim.
So we have a lot of dr lim out there. he then promotes the doctors and the lawyers and the generals and the CEOs etc to the highest echelon of power. No wonder the ministers pay is so highfalutin as dr lim lol

well, since that's the philosophy of PAP gov , why should dr lim be faulted? lol

Anonymous said...

From bankers to doctors, what is our country coming to? Everyone just try to cheat money out of people, whether rich or poor.

Anonymous said...

Don't forget the other profession - the lawyers, hahaha!

Anonymous said...

big fish eats big fish and the whale wants to be the referee?
give me a break

ah kow said...

The issue of spiraling health costs does not bite the population at large because the majority of the people dont get sick at the same time. Only a minority are devastated by medical costs. And this minority normally shrug their shoulders and say to themselves - "what to do?". The majority dont care. Sporeans take notice only when their interests are affected.

Getting organized and lobbying for a better life to promote the common good is foreign to the average Sporean. I get the impression that lower income Sporeans see themselves as either victims of bad luck and bad karma or beneficiaries of good karma. And that their political leaders are gods who administer the bad karma and the good karma. So if you get is part of your karma to get stuck with the bill.

Perhaps the well educated high income earners need to show solidarity with those who've resigned themselves to their fate and to advocate the cause of the lower income groups.

The Pariah said...

Based on 27 Feb Sunday Times write-up of the Dr Susan Lim fiasco, it would appear that she willingly "prostituted" herself for top fees.

Out of self-respect, the good doctor should have rejected the 24/7 standby service for anything that is outside of her medical specialty expertise. But she did not.

I doubt it was because Dr Susan Lim went out on a limb to "save a life" (ie, because the patient purportedly would heed only her words).

So with all the top surgical skills, it would appear that Dr Lim chose to be a maid to the sister of the Bruneian queen for mega bucks.

That's prostitution of the soul (and self-respect)!

Anonymous said...

Actually by paying millions in medical fees is no guarantee one will live longer or normal, especially if one has cancer. In Dr Susan Lim's case, the patient died soon after.

There are other cases too where the rich and powerful died in their 50s, also due to cancer.
And Apple's Steve Jobs don't look physically OK, according to reports.

So Lucky made the right decision to go to public hospital for treatment with a good outcome at lower cost.

Or is Lucky really lucky?

Anonymous said...

But if you are rich, you get a second chance like the the CK Tang boss. But the life savior aka seller, got a jail term. If this is not the case of rich exploitation, what is?

Anonymous said...

Good decision by Lucky.

Why pay for expensive medical bill when you are already paying $30m of MPs combined salaries. If a Brunei royalty can ill afford $22m, it beats the hell out of me why singaporeans will pay an on-goiing invoice to the leaders. Instead of curing ills, they create more sickness sending poor peasants to grave earlier.

Brunei Sultan's Suite said...

Just to add to Ah Kow's comment at 28/2/11 14:53:
The 24x7 service is probably not just on-call style. The last I know, the Brunei Sultan's suite at Mt E has an adjoining room with 2 beds for on-call doctors, so that the doctors are just a room away, round the clock.

Private practice said...

Usually in private practice, upon the patient's request, the consulting doctor will provide a reference range of his/her fees based on the complexity of the case and the expected duration of the patient's hospitalization. Patients can seek a second opinion or to compare rates if desired. Patients can even change consultant mid-way if they don't like the current consultant's service.

It is anyone's guess if Dr Lim had advise patient of the above.

Nevertheless, Lucky's point that the private consultants are gradually priced out of range for the average Singaporean still hold.

One tip for those who need an alternative to the public healthcare: Some private consultants, especially the old-timers (elderly consultants) who had made good money in their earlier years, may be charitable enough offer special rates. Ask a private hospital nurse from that medical specialty for suggestions (strictly off the record, of course!).

DanielXX said...

blardy brunei sultan, i just wait for the day their oil runs out and they'll be down on their knees.

what have they done for their people all these years? 20 years ago a brunei dollar was stronger than SGD, now nobody will accept it in exchange for SGD. take it from me that having resources is really a curse. the people at the top just cream off all of it.

DareToAct said...

Our government's mantra is GDP growth at all cost. Bankers making tons selling rubbish to retail and high net worth customers; doctors charging millions treating the rich and famous; building casinos to serve the whales; will all add to GDP growth. Mini bonds, high health care cost, Singaporeans gambling their coffin money away, are all necessary side effects. Chiong ah, not to forget to buy that 300 sq feet condo ... Before having to settle with 200 sq feet ones.

Anonymous said...


It is called....democracy

Anonymous said...

From $24.8m discounted to $3.25m, implied that she profited 21.5m!!

She rendered the service over 33 days which means her per day charge would work out to $751,000, or $93,939 an hour!!!

Wow...she must think she is god by now.

Anonymous said...

Recently a comment was that " meritocracy should be balanced with a sense of community"

How can there be "community" when it is being eroded by an implosion of people with nothing on their minds except making money as quickly as they can?

Additional workers, talents come here not to sink roots.. if they did, I suspect its pretty shallow.

Ahhh! the nobel concept of meritocracy.. so utopian.. so desirable..but merit it seems, is a concept more relevant to Buddhism
where 'community' will fit far better.

This is probably our pinnacle.

From here on its a slow decline.

Enjoy the view before it fades.

DevilAdvocate said...

She's obviously talented & has a skill set that's highly demanded. So she's entitled to charge what the market can afford. It is just and is not like she's stealing or harming anyone.

If we as a nation feel that success is an ugly or immoral value, then are we saying that we should not promote talents? So we will never discover or nurture a Bill Gates or Steve Jobs even if he's really brilliant. Is that what we want, and why we do not have creative enterprises by individuals? What do you want from your society?

Anonymous said...

You may hv plateau. There is enough technical and strategic intelligence to usher in a new millennium.
people who do not know when to shift gear and cruise are heading towards the cliff.
And you hv talented ppl pushing you over the cliff.
Are you that stupid?

Anonymous said...

Anonymous said...
The old man has a lot of faith in our elites. So much so, he meddles with our gene pool to extract people like dr lim.
So we have a lot of dr lim out there. he then promotes the doctors and the lawyers and the generals and the CEOs etc to the highest echelon of power. No wonder the ministers pay is so highfalutin as dr lim lol

well, since that's the philosophy of PAP gov , why should dr lim be faulted? lol

28/2/11 12:17

Pot calling the kettle black huh?

Anonymous said...

Dear Mr Lucky

Many highly experienced senior doctors, surgeons and specialists have been drawn out of our public hospitals into the private sector where they can earn much more money doing less work.

Should experienced senior doctors be denied the opportunity to make good money? Do you know how many years of training they have to go through?!!!

That leaves those who remain in the public hospitals to handle a bigger loads

And does this tell not you where the problem is? SG is simply not training enough doctors!!!

And U are comparing a minor ailment with cancer?!!!
Did Dr Lim fleece any local?
Did locals with median income of $2.4k seek treatment with Dr Lim?

Mr Lucky. Focus. Bread and butter.

Anonymous said...

Btw, Mr Mah is raising development charges for property. If you really want to rant ...

Anonymous said...

Its a distraction timed to fit the situation.. takes the heat off while attention is drawn away from the main targets.

Its a court fight between elites.
Let them be.

She did not steal, did not kill and most importantly, did not falsify.
The client felt overcharged and complained. thats all.

Leave her and the king alone.. they can take care of themselves and cant be bothered with us anyway.

The REAL issues are closer to home and affects us directly. The overcharging is mere soap opera and gossip.. does no good for ordinary folks like us.

Anonymous said...

Hi Lucky,

Remember, PAP needs Net happiness. The majority must be happy to win the election.

Anonymous said...

They fix a low quota for medical students in University in the early days and said high number will result in high medical cost. Now, private clinic compete with public hospitals for the same pool of doctors and supporting staff. We have to pay for the high medical cost due to the past poor policy or poor vision.

Anonymous said...

Welcome to free market forces.

And welcome to the many people here (foreigners included) imposing on scare resources (especially land space) having upward cost pressure.

Anonymous said...

Nah, welcome to stupid people. For a morsel of bread, they trade off their rights.

i went to MT E said...

Just to share my experience. i has a boil that was full of pus somewhere in my body that was causing me considerable pain.

According to the public hospital. this is not life threathening and i have to wait for weeks at best. the problem is if i wait, i will have to enure one more week of excruciating pain before the boil will break and drain itself which is not advisable. It will not drain completely, might be infected and the same area might have another boil again.

I went to a private hospital, they refer me to their surgeon in mt E. the guy used to be HOD in SGH. The first question he asked me was if i had any insurance. i told him yes, i got a good one.

All was happy from than, full of smiles he inspected my wound and he arranged a day surgery on the same day i visited him! unbelievable! Same day! i went in morning 1030, i had my surgery 12pm. finished by 1pm, woke up from general anaesthesia by 1.30pm, had lunch in paragon at 2pm and my dad drove me back to rest and i was in bed by 4pm.

The bill? 6k! if i had went to the public hospital, they would have charge me 1k+ after subsidy and after medisave, i probably ended up paying only 500.

Anonymous said...

//The REAL issues are closer to home and affects us directly. The overcharging is mere soap opera and gossip.. does no good for ordinary folks like us.//

Well said. Let's focus on the bread and butter for us all.

Healthcare affects everyone of all ages.  We need PAP to come up with a comprehensive plan where they would undertake more for the old, sick & disadvantaged, making it accessible/affordable and generally our medicare sufficiency. Truly show us their compassion and to Singaporeans who can call this home.

Anonymous said...

PAP denied everyone "universal healthcare" & "CPF withdrawal" saying No Entitlement, No Opportunities. Yet ALL our sitting MPs & elite civil service get life-long 17 years of pension - in one lump sum, tax free!

Anonymous said...

If only our Health Minister Khaw Boon Wan can guide us on how to get a bypass at $8(eight), much of our worry will disappear.
He is a pious man 'pu sa xin chang' with the compassion of Buddha, surely he will guide us.
Right ? Minister Khaw.

Anonymous said...

Our whole PAP government is a Ponzi scheme.
I hope those who sold their souls along to swindle the poor peoples' money, should ask how they can go to sleep and not have nightmares. If they seriously think they are the custodians of us, they ought to really look hard enough and see if their ego is misplaced. What sort of govt take millions from its people, and refuse their well being other than just enriching themselves.

Anonymous said...

If he helps everyone to cheap health care, how can he command millions in salary?

Yes, they will help you, but not before they make slaves of you - grateful for crumbs as they feast in palaces.

Anyone in power, who is a capitalist, will do the same to you.

ForFreedom said...

Where is wikileaks? We need to save Julian Assange !

Anonymous said...

Vote your life away - regardless of party.

Anonymous said...

yes, anyone who pester you to vote is an idiot. you listen to these people, you are a greater

Anonymous said...

They are either asking you to chop off your head or pull out your heart.

Choose or vote! HA

Anonymous said...

On executive diversity
"Berkshire's CEOs come in many forms. Some have MBAs; others never finished college. Some use budgets and are by-the-book types; others operate by the seat of their pants. Our team resembles a baseball squad composed of all-stars having vastly different batting styles. Changes in our line-up are seldom required."

On executive motivation
"Many of our CEOs are independently wealthy and work only because they love what they do. They are volunteers, not mercenaries. Because no one can offer them a job they would enjoy more, they can't be lured away."

Our leaders should learn from Warren what talent and morals are.

Anonymous said...

Use yor blain use your blain. How to be wealthy without being mercenaries?

First slaughter the goondus then make the goondus worship at your feet by being a volunteer la

Anonymous said...

Now her lawyers and cronies are going to wriggle out of the situation even though it is a clear cut case of chopping carrot head.

Anonymous said...

Ask around, there are many SIngaporeans who choose not to see a doctor because it's too expensive. They are silently suffering in their flats and go to work each day.

My own father doesn't want to see the doctor and max out my medisave. The government is super secure while the citizens are super insecure.

Anonymous said...

Everyone goes through tragedy, however, I experience mine at a younger age. I lost my father when I was in my mid-twenties after a heart by-pass surgery. Later, people told me that he was too old for the surgery and should have just fetch him home to rest and let him live a few more months without going through all those pains of having tubes stuck into him. Our family really regretted. However, at that time the heart surgeon at SGH suggested the surgery and says it is the only means of survival. although the surgery were fully paid by me and my brother's Medisave, I still suspect the hospital were just trying to earn some money.

Anonymous said...

Dear Mr Lucky Tan,

I have been following and reading your blogs since day one.

I am deeply impressed by your analytical mind and your approach in the various issues or problems confronting our little republic.

I sincerely urge you to present yourself to Singaporeans for them to elect you to serve them in the new parliament.

If you do come out, I volunteer to be one of your volunteer workers.

Your sincere reader

Anonymous said...

You turn healthcare into a MARKET PLACE, the people will topple you.

Anonymous said...

It is all a vicious cycle. Everyone inflate their ego skyhigh and expects to be rewarded handsomely for work done. Work which can be done by more people if certain professions/fields are opened up to more participants (includes politics). We have seen the folly of capping no. of lawyers and doctors, let's hope we see improvement politically.

Anonymous said...

Change the people in the media. They are fucking idiots.

Anonymous said...

He certainly cannot be lured away...

He enjoys his work soooo mmmmuch.

Anyway, there is no other place that will take him..

By the way, to be a volunteer or a philanthropist, one must have

1) Killed
2) Stole
3) Lied
4) any other immoral deed.

Otherwise, how would one know what is helpful or hurtful?

For every light, there is darkness.
For every darkness, there is light.

Anonymous said...

The Govt has to set it right.. a good guide-line on the cost of such procedure. If the Govt lets market dictates, the doctor would ofcourse, wants the highest price possible. They want to live a good life and send their kids to overseas University.
Pretty soon good healthcare will be out of the reach of middle-income earners. Soon the middle-income earners will join the lowest half of society and compete for the basics. People of Singapore!(especially the middle-income) it is really time to show your displeasure before it is too late.

Anonymous said...

5 doctors are coming out in SUPPORT of her. More like, coming out to save their own $kin?

aaahhh....the good old money politics at work.

Trust our fatten elites you say?please

She is unfortunate to have been single out by foreign dignitaries.

If you catch one like her, there are certainly more of the likes out there since it is common practice.

Will the gov have the guts to open up the can of worms?

Or will they be sealed by money politics?

Foreign dignitaries are watching....uncomfortably.

Anonymous said...

the bill a whole of 6 month and not a day. i think everyone mislead by SMC. if the bill is 450k a day how much is total of 6 month?

DareToAct said...

Anyone know if she is one of the top professionals whose renumeration our ministers' pay based on? I tell you, we got our ministers cheap.

Anonymous said...

Latest : $40m in 4 yrs!
$10m per year
$833k per mth
$27k per day
$3462 per hr
$57 per min

So if Susan Lim came across a $50 note on a street, it wouldn't be worth her time to stop & pick it up.

Anonymous said...

When you get a yes-man like khaw who can lie thru their teeth to run the most cost-sensitive ministry, you end up with one horror story after another, all covered up in lies.

Claiming that his heart surgery costed only $8 when the truth was because his ministry took care of almost the whole bill and the rest was paid by all the fawning insurance companies is just outright pack of lies (and even then, some friends in civil service still didn't quite understand why he managed to only pay $8).

Only this country can afford to run surpluses year after year and giving back so little to the low and mid-income. Raising GST *(which affects the lower income most) and cutting corporate taxes to the level of Ireland can only mean one thing - more redistribution of wealth from poor to the elites. Even before that, Singapore's Gini coefficient (which measures income inequality) is higher than Egypts's. Well, we will see in the coming elections whether opposition will raise any of these issues, if they are worth just 1 cent, I will walk the thousand miles to eat their chilli crab (provided its not pap price).

Anonymous said...

whao..she must be the most productive person in Singapore!

Wonder how that translate to
- how many peasant lives she has saved?
- how many breakthrough surgeries she has done?
- how many stem cells discoveries she has made?
- how many brainy talents she's mentored?

If she has to perform a $8 surgery, then she would have to make 1250 surgeries per day to make $10k per month. No wonder she's moved up the value chain,shifting loyalty to treating royalties lah.

spirit of Dr Chan Ah Kow said...

perhaps Dr Susan Lim is doing a service to Spore's reputation as a medical hub. Her medical bill of $22M tends to suggest Spore is the place with the best medical expertise...somewhat similar to our PAP politicians who bill us tax-payers in millions for their remuneration. (can actually call it out-of-this-world)

isn't it a coincidence, despite the $Millions spent, Dr Susan Lim's patient ended up biting the dust while we tax-payers are likely to go down the same path ?

Anonymous said...

"In today’s Singapore, all these Hundred Schools of Thoughts can form their political parties and stand for election. Mandate is given to them by the citizens to implement their manifestoes. Voters should appreciate their rights to vote and vote wisely. Political parties are given chances to approach people (like the rulers in pre-Qin era) freely in a democratic county. In Hundred Schools of Thoughts era, no scholars or philosophers were detained or killed even they offended the rulers (e.g. Mengzi, Zhuangzi etc) until Qin united China. These people were respected by the rulers perhaps because they formed no threat to their governments. The voting must reflect the wishes of the citizens, deep from their hearts." - unquote

It is called freedom to let the "intellectual" to fuck the people's mind with "substance". No wonder the world is one fucking hell hole.

" However, Mohism went into decline so suddenly after Qin dynasty. " - unquote

You see, if there were substance, it would not have declined.

Your kind of "substance" is best peddled in the back lane of Geyland. There, democracy works best.

Anonymous said...

"Let a thousand flowers bloom" was Mao's attempt to trap many of those who put forward views that were unwelcome to his regimes. We know these intellectuals were eventually executed.

In modern day SGP, it means they are prosecuted!

Anonymous said...

Have you considered both are wrong?

Anonymous said...

You mean PAP & the Intellectuals?

Of course, possible. Even the majority of people can also be so wrong.

But it should not stop us from having a robust, open and vibrant discussion as freedom of expression & will are inherent to a human's soul and growth.

Anonymous said...

You are talking about out of wedlock and I am talking about eternal bliss.

If you are not ready for eternal bliss, by all means, go out and seduce.

Anonymous said...

Or be seduced.

Anonymous said...

It's time to get out of Sinkapore.

Anonymous said...

Yes ! It's high time to get out of Sin.

Sin is never good and i am not talking about morality, i am talking about survival and living.

Anonymous said...

Surely you don't mean 'original sin' crap that has been fed to idolators?
We are known as SIN because we are a garden city you know.

Anonymous said...

these people should be taxed very very high because they benefitted the most from this lousy system created by the papayas.

Anonymous said...

meritocracy to the papayas means exploiting your own kind at all costs. it is creating a generation of beastlike mammals.

Anonymous said...

What will happen if your salaries are pegged to top surgeons like her? Food for thought.

Anonymous said...

Willing buyer, willing seller. Free market. Only problem was that the government was left out and didn't get a share.

Anonymous said...

Hmm "i went to MT E said..."'s experience is EXACTLY what we had when my wife went to see a specialist at a private hospital... she kept asking if we were insured... we realised that she based on our reply to make decision to admit my my wife; after we told her that we were insured... doctors, just like car workshops causing inflated car insurance premium, are largely responsible for our high medical/insurance costs!

Some readers may feel that well it's a free market, and she's a top surgeon (like our MOE minister), she's entitled to capitalize on her patient's conditions and charge obscene fees (the fact that she repeatedly offered discounts/waivers... she must have felt that it was an obscene unjustifiable fees!). But she's a doctor! Where's her ethics and moral for such profession?

Medical fees must be regulated and our government should stop telling us it's best to let the market decide... perhaps the ministers are happy to peg their incomes to all these so called top professionals!

A nurse said...

To "i went to MT E" at 28/2/11 22:50:

"i had my surgery 12pm. finished by 1pm, woke up from general anaesthesia by 1.30pm, had lunch in paragon at 2pm"

Just to point out a possible mis-perception. You probably had local anaesthesia (LA) plus some sedatives, not GA. LA plus sedatives can still knock a person out, depending on the doses and the person's tolerance. If you had GA, you will probably not be able to lunch at 2pm without throwing up your food instantly.

I am writing this because I don't want potential patients to read this comment on Lucky's popular blog and go away thinking that they can eat immediately after waking up from G.A. From my experience, there are those impatient in-patients (pun intended) who insist on eating upon rousing from general anaesthesia, despite being advised otherwise of the reasons for waiting and their expected recovery. Then they complain of not being able to retain their (non-hospital) food. Such people are a source of nurses' jokes.

kelly said...

Nice post touching on what Singaporeans can afford for a surgery.

Not all surgeries are necessary...almost 1 third are un-needed! My brother had his tonsils removed cos his doctor said it would reduce symptoms of flu or cold. He was brother never had a fever after that, but he still had flu and cold from time to time.

NEVER rely on conventional medicine alone, because waiting time in emergency room can kill! And there are hospital-acquired infections as well (some due to staff's neglect) which they don't always report. I think Singapore Medical Council is doing the right thing - stepping up their guards on shoddy and unacceptable medical practices!


Anonymous said...

There are just too many unjust practices and exploitation out in the market place. Representative democracy won't be able to address all these grievances of the people. One man cannot speak for thousands. This is the Internet age. The thousands can be heard.

Anonymous said...

"Not all surgeries are necessary..."
Anon 2/3/11 03:11

But if a doctor recommends it, would you say no? Or how many would bother to go to another doctor for a 2nd opinion, or yet another for a 3rd opinion, etc, etc?

Hospital-acquired infections due to staff's neglect? One has to accept as having very slim chance. And count oneself as very unlucky if it happens. Because most likely damage had been done even if there is recourse.

Frankly what choice do you have except to trust and pray? Or try your best to stay healthy?

Ah Hai! said...

Nice one, Lucky! Actually, I dont think Dr Lim overcharged at all.

Just look at our fat cat PAP MPs, they do nothing, wayang all the time, give stupid answers or sleep during Parliament debates, couldnt catch an escaped terrorist, double up as soothsayers when there's a flood, blame us Sinkies for everything, draw a ridiculously high salary, act blur or dumb, lose our S & C money during the Lehman crisis, lose our CPF investing in some foreign banks, tell us HDB is affordable but it's only so if an average guy makes S$1m a year & sue the pants off everyone that even dares to question their lousy policies!!

So you, Dr Lim isnt expensive, at least she could help & save a life, whereas our beloved leaders just know how to suck us dry like an old & ugly hooker along Geylang Lor 8! This coming election, pls do the right thing!

Anonymous said...

Looks like we need to rely on technology to address all these complains. Even politicking will soon be technologically managed. HAHA
Welcome to the...Matrix.HAHA

Anonymous said...

it is not too far fetched. we are already looking at complex figures/data and crunching numbers to decide on a course of action.
what can your humble computer not do?LOL
the good thing?
CHEAPER,better and faster. LOL
get rid of all these over paid and over hype EGOS LOL

Anonymous said...

Yah yah yah, the life blood of the market place will be controlled by the ALMIGHTY. WAWAWAHAHAHA

Anonymous said...

Will the days of MASSAGING numbers by humans be numbered? Or how about the slimy manipulative glib tongue politician lawyer be arrested?


Anonymous said...

I say... All these greedy pigs will be fucked big time

Anonymous said...

Save me a trip every 5 years to listen to snakes

Anonymous said...

Nobody argues with numbers. Maybe we should call it... SIN City instead of SIM City.

Anonymous said...

Dictators will be threatened by the wind of change.Political parties will dissolve. The wise shall rise to the call of duty.
Will there be peace on earth good will towards men?
Show me the nearest Casino. I am placing my bet.
But who knows, the odds are indeed against me. I may lose :)

Anonymous said...

Gates are binary. It is either opened or closed.

Vote wiselee.

Anonymous said...

"Singapore is permanently plugged into the free world of practising democracies where virtually all member countries accept that disruption is the price to be paid for adopting a political system which, despite its flaws, is arguably the best that society has so far devised."

"And it is precisely the freedom to be disruptive that will ensure the continuance of that most fundamental of democratic premises—that the system of checks and balances belongs to the people, and to the people alone."

You listen to that kind of intellectual masturbation, you die.

Anonymous said...

$$$what can your humble computer not do?LOL$$$

guess which genius demarcate the land for the elite winner? said...

Dear Mr Lucky Tan,

The team and I from Channel NewsAsia would like to invite you as a guest for our upcoming episode of

Do contact me at if you are interested.

Thank you so much.

Blogtv team

Anonymous said...

Dear lucky

dont succumb to her bait, this kristie neo from blogtv is just a pap mole/isd agent in disguise!

its obvious that they wanna unveil who u are and shut down ur blog before elections!

Anonymous said...

I think Lucky will be thrown into jail as soon as he shows up.

Anonymous said...

pap very good in creating a system that gets the wrong people to be doctors, lawyers, leaders.

Anonymous said...

Hi Lucky, my father when for a prostatectomy due to cancer of the prostate in Hospital Besar Kuala Lumpur. They did it using the latest key-hole surgery. The bill came to about less than RM100!!!.
Its hard to belief but sometimes i fell really lucky to be a Malaysian.

electronic medical records said...

Oh' that bill was so high, how come it became high as that. Anyway, According to research, The right electronic medical records software system can save a physician practice time and money, while also improving patient outcomes.That's the reason why many wants to have their own electronic medical records software system. Thanks for sharing.


Anonymous said...

The Government of Singapore should step in and control the health cost. If this Dr Susan is allowed to charge sky high price for her consultation, other doctors will follow soon. It's a shame there is doctor who cares more about digging money from a dying cancer lady.

Tang Li said...

The charges a exceedingly high.

However, I think we need to look at several points, which have already been raised in court:

a - The money does not go to her personal pocket but to maintain a business including equipment and staff.

b - The sums we're looking at were for a 7-month period. Question why Dr Lim had to wait for 7 months to send out the invoices - most normal businesses bill as soon as they can - that is unless the Brunieans were showing they had no intention to pay.

c - For 2007, Dr Lim actually lost money.

d - Dr Lim is a private practice doctor dependent on the willingness of her customers to pay. What businesses is it of the government to decide if she is "overcharging" ? Surely that's between her and the patients that were more than willing to pay for the last 7 years.

Jumari said...

Amazing blog - has drawn a lot of anonymous faceless and gutless humans with slandering words, and let me join you in this. Listen to my contribution:did anyone pick up that the second disciplinary committee formed under the auspices of Dr Tan Ser Kiat, spurned lover and public servant, pronounced from his high office in Sept 2010 that:
the new regulation 42 as amended by SMC to target Dr Lim and deny her justice, would immediately apply to Dr Lim and instructed his legal assessor to inform Dr Lim of his decision, which was minuted and in the court documents. This was further reinforced by the AGC in front of Justice Pillai who challenged AGC " are you serious about this ?" He further said that this would be a breach of Natural Justice". What happened on March 28 in the High Court was a complete about turn, (a twist & shout) by AGC, who, in accepting their unlawful treatment of Dr Lim, said that the amended regulation 42 was suddenly no longer applicable. To which i now say " are you kidding ???" On hindsight, this amended regulation 42 which was enforced by the spurned lover and his office upon a damselle in distress was unlawful and will have to eat humble pie, as the court has directed so. If there is any accountability and integrity in the office of the Singapore Medical Council, there should be an apology and action taken against those who tried to bulldoze unlawful regulations to target a citizen.Rather than being carried as Headlines, this was buried under fine print !!! But it will surface....hehehehee

Betty said...

Your reference to prostitute reminds me of the blockbuster "deep Throat". Did anyone know that the spurned lover Professor Tan Ser Kiat, in his capacity as SMC Chairman, rammed down HER throat, an amended regulation 42 designed to target Dr Lim. If not for her application for Judicial Review, and the fairness of the High Court, Dr Lim, like the rest of us Singaporeans, would have fallen to our knees, at the mercy of public officers who abuse their powers and lose touch of reality. Go watch the movie

Anonymous said...

Susan Lim's Mentor:
Sir Roy Calne
Professor of Surgery at Cambridge University, 1965-98

"The abuse of power will destroy the only world we know, be gentle."

Sir Roy Calne is a true pioneer in the highly specialized medical field of organ transplantation. As a medical graduate from Guys Hospital , Sir Calne taught anatomy at Oxford University (1957-1958) and started research on organ transplantation in 1959 at the Royal College of Surgeons of England . From 1961 to 1965, Sir Calne was Lecturer in Surgery at St Marys and Westminister hospitals and Professor of Surgery at University of Cambridge wih special interest in organ transplantation. Throughout his career, Sir Calne has made a series of remarkable breakthroughs in the medical field of transplantation: he started the first European Liver Transplant programme in 1968 and performed the first pancreas transplant and the first intestinal transplant in the UK in 1979 and 1992 respectively. For his astounding efforts and achievements, Sir Calne was made Harkness Fellow at Harvard Medical School (1960-1961), Elected Fellow of the Royal Society (1974), Knight Bachelo r(1986) and President of the International Transplantation Society (1992-1994).

Anonymous said...

I am a medical doctor from the USA. Although IMO it is a nice dream to bill a single patient 450k per day, it is shameful to do so in reality.

As a sought after surgeon I am sure she can earn quite decent living by charging normal fees, or even a bit above normal.

If an orthopedic surgeon(a highly paid specialist) does 5 hip replacements/day and earns 25,000 dollars, is that not adequate???

450,000 is almost 20 X that of the above orthopedic example.

In actuality she apparently cannot cure cancer but even if she could, it would be way more noble to either give it away to help humanity, or license it through a drug company, that way she could earn money but also help many many people by doing so.

945.00 to drain pleural fluid is not unreasonable, but to "doctor" the bill to what 78,000 is absurd, and so blatantly and astonishingly absurd that such an intelligent person would do it and not think it would raise red flags of fraud.
Blinded and perverted by greed. Now we have a "blind and perverted surgeon" that in reality may not be all that smart.

IMO and many years of experience, I believe the vast majority of doctors would not do such a thing, but those that will, sadly damage all of our collective images.

Anonymous said...

PS from USA medical doctor.

I would accept a scenario to bill for 450K/day if the patient (very wealthy) and the doctor, and a third party either transparent charitable organization or medical center needed funds for a worthy cause that would do things to help people.

Pariah Logic said...

Dr Susan Lim is widely known in Asia and Singapore for being the first surgeon to have performed a successful liver transplant in 1990. Dr Susan Lim is also widely known as the "Spirit of the Century", an Award conferred upon her by the Singapore public in a national contest held to identify the role model for the 21st century. Dr Susan Lim is in active general surgery practice at the two premier hospitals in Singapore (Mount Elizabeth and Gleneagles Hospitals) with practices in breast surgery, abdominal and gastrointestinal surgery, liver, gallbladder and pancreatic surgery, advanced laparoscopic surgery, transplantation, colon and rectal diseases and cancer, and robotic surgery.

Dr Susan Lim should not be blamed for such media hype. Dr Susan Lim is of course, within the target sights of naysayers and negative press, but can we know the real story behind Dr Susan Lim and the Brunei royal family. Sensationalism aside, we have more problems to deal with then this fiasco of Dr Susan Lim. After all Dr Susan Lim lies right under the radar of the ministers who, under no other circumstances, far outweigh this subject of Dr Susan Lim .

Pariah Logic said...

Dr Susan Lim has gone on to further pioneer in the field of general surgery. Also, Dr Susan Lim has introduced, under her very auspices of Dr Susan Lim, two new surgical technologies for Singapore, the mammotome minimally invasive breast biopsy and most recently, the Da Vinci robotic general surgery program for Singapore. Dr Susan Lim continues to be actively involved in research, training and education and delivers lectures/presentations to both the medical profession and public in specialised aspects of surgery. With such achievements, can we slander the good Dr Susan Lim so readily?

Pariah Logic said...

LAWYERS for Dr Susan Lim fiercely dispute claims that Dr Susan Lim offered to waive her $24.8 million billings in exchange for Brunei's Ministry of Health to instigate a halt in disciplinary proceedings against Dr Susan Lim.

Lee Eng Beng, senior counsel for the surgeon, countered the Dr Susan Lim portrayal drawn by Singapore Medical Council's (SMC) lawyer, Alvin Yeo in Singapore's High Court on Monday with regards to Dr Susan Lim

"There is no evidence to say the discount is based on a guilty conscience," said Lee.

Yeo had suggested that Dr Susan Lim offered substantial discounts, eventually waiving Dr Susan Lim fees altogether, out of fear the SMC would take action against Dr Susan Lim for overcharging a Bruneian patient after the Brunei ministry wrote to Singapore's Health Ministry complaining about the unusually high bills. Dr Susan Lim 's patient, Pengiran Anak Hjh Damit, passed away in August 2007.
Read also:

The $20 million medical bill controversy

The first discount was made on August 1, 2007 after Dr Susan Lim spoke with third-party officials engaged by Brunei requesting a reduction of fees. Dr Susan Lim said even though Dr Susan Lim justified her original bills, Dr Susan Lim voluntarily reduced them to $12.1 million, which she regarded as "fair and appropriate" for services rendered, given her long-standing relationship with the patient's family.

Gemeni said...

Dr Susan Lim said she was only aware that disciplinary action was being taken against her after Dr Susan Lim received a letter from the SMC's complaint committee on December 18, which was one month after Dr Susan Lim offered to waive her fees.

Regarding the "Letter of Good Standing", she requested from Brunei's health ministry in January 2009, the surgeon claimed that during her meting with Brunei's Health Minister, Dr Susan Lim asked for the letter so that there was documentary evidence the ministry was satisfied with Dr Susan Lim's professional standards and treatment of the patient.

Dr Susan Lim maintains that during this meeting, the minister asked if there was any room to discuss a lower final amount but the surgeon told him Dr Susan Lim had not come to negotiate a settlement of the amount, but to make sure the ministry understood the nature of the services provided, the billing process and the quality of the treatment.

"Her position has always been clear: she is entitled to the $12.1 million for payment for the services rendered to the patient in 2007," said Lee.

Anonymous said...

Lucky Tan, u gotta see this:

Nimfa Collins said...

There are two types of general medical billing: physician's billing and facilities billing. Facilities may encompass hospitals, clinics, nursing home, etc. Physician billing is separated by the fact that it's billed on what's known as a HCFA-1500 form almost exclusively. Facilities will often use both the HCFA-1500 and the UB-04 for billing, depending on who, for whom, and what they're billing.

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