I THANK Dr Tang Kok Foo for exposing the mercenary practices of doctors and hospitals ("Reasons for soaring private health-care costs"; Thursday).

As he rightly pointed out, doctors' bills contribute most to the rising cost of private health care.

Private hospitals are no less culpable. They charge high rents for clinics, operating theatres and laboratories, which encourages doctors to carry out unnecessary tests to generate income.

The fee-for-service model offers unbundled services that are paid for separately, encouraging specialists to offer more treatments because payment is dependent on the quantity of care given.

In short, private hospitals, faced with high financial targets set by the management, work hand in glove with doctors to encourage over-utilisation of services.

Some hospitals use terms such as "ward fees", "nursing fees" and "miscellaneous fees" for the same service rendered. That is why patients must insist on a detailed bill upon discharge, and scrutinise it carefully.

The mark-up on inpatient medication, blood tests and everyday items such as tissue paper and diapers can be as much as 200 per cent.

When queried about items in the bill, cashiers can give excuses that the layman is in no position to verify.