Unnecessary Hospital Admissions And Insurance Claims — Dr John Teo

By CodeBlue | 01 May 2020

Every day the MCO is on, the non-Covid-related long-term health consequences for many and, even potential deaths, from delayed treatment cannot be underestimated.

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Recently , there was a letter circulating, apparently written by a CEO of a health insurance agency.

It detailed the drop by 59 per cent of medical claims from hospital admissions during the movement Control Order (MCO) period.

This reduction translates to approximately RM500,000 savings per week or RM2.5 million per 5 weeks of the MCO for the agency. This was ascribed to unnecessary hospital admissions as critical illness or accidents will still require hospitalisation and treatment during the MCO.

There are many reasons why medical claims and hospital admissions in private hospitals are down. The simple answer is that there are less patients attending private clinics or hospitals.

During this MCO, across the board, general practitioners’ patient load nationwide are down by 50% or some even up to 80 to 90%. This will lead to less referrals to private hospitals for patients who need further specialist management.

Even in private hospitals, many specialists are seeing low patient load and some actually run their clinics or hospital sessions on part-time basis.

Many private doctors struggle to acquire adequate personal protection equipment or have difficulty in assessing patients adequately with the limited Covid-19 tests available.

Many bravely turned up for work to provide that critical services despite their own personal high-risk status in a pandemic where so much is still unknown.

Many elective surgeries, although necessary, are delayed. This is to prepare for the possibility of government patients needing to transfer to private facilities in case there is an overwhelming surge of Covid-19 patients in government hospitals.

This is the exact reason why the MCO was implemented — to flatten the curve and allow our hospital systems to cope.

Private hospitals, in preparing for a national effort, are doing their utmost best to ensure our system can cope by making available bed space and even ventilators.

Please note that elective surgery is, by no means, unnecessary surgery.

It just mean that we can delay it with careful monitoring of patients to avoid complications, but it doesn’t mean that the large cyst or the kidney stones the patient have will disappear by magic!

On the patients’ side, many do not go for checkups or have any consultation for the stomach pain or lump etc due to the MCO and the need to stay at home.

This delay may turn out to have severe consequences or even deaths as certain diseases or cancers may be detected at late stages, requiring massive operations or even rendering their illness incurable.

Many patients with chronic non-communicable disease that need hospitalisation delay visiting the hospitals, which may lead to irreversible health consequences.

Every day the MCO is on, the non-Covid-related long-term health consequences for many and, even potential deaths, from delayed treatment cannot be underestimated.

We have yet to count the costs of all the unintended non-Covid physical and mental health sequelae of the MCO, not to mention the economic devastation to society at large. In particular, the poor, the marginalised and the under-served communities are suffering and paying a high price and some, even with their lives.

It’s most ridiculous as written in the letter that if this trend continues for the remaining 40 weeks of 2020, an estimated potential savings of RM20 million can be achieved.

Clearly the MCO cannot continue for long as even the five to six weeks had exerted untold costs on every level of society that will take years to recover, if we ever recover fully.

It is also ridiculous to claim that under this artificially imposed lockdown of the whole country that the reduction in hospital admissions represents unnecessary hospitalisation.

On the other hand, it was also written that the residual admissions represents true necessary hospitalisation, such as illness or accidents, as they do not disappear with the MCO

If everyone is supposed to stay home and there are much less cars on the road, naturally accidents would occur less as well. A car that doesn’t move parked at home all day is unlikely to cause any accident by logic!

The insurance claims savings are definite and this is also seen in many parts of the world with similar movement control or lockdowns.

To further claim that these savings can be translated to more affordable premiums in the long-term, enabling the company to promote more affordable and competitive products and doing more business, doesn’t seems to be appropriate.

The needs and sufferings are immediate and urgent. Many of the public are in dire straits.

What the insurance agency and industry as a whole needs to do is to, without delay, transfer all these savings to aid in the pandemic response.

The millions of ringgit in industry savings should be donated to increasing Malaysia’s health care system Covid testing capacity, supply of personal protection equipment to all health care workers and community-based related efforts in food or financial aid to those who urgently are in need.

That would be the most beneficial contributions the industry can give back to all Malaysians that had supported them over decades.

Dr John Teo, Kota Kinabalu, Sabah.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
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