APHM Wants Regulatory Body Governing Private Health Financing

APHM says MOH is “aggressively” exploring a public-private partnership model, which entails introducing private financing. APHM wants a regulatory body to govern reimbursement by private payors, as attempts to reduce costs may affect health care coverage.

KUALA LUMPUR, Sept 6 — The Association of Private Hospitals of Malaysia (APHM) has called for the establishment of a regulatory body to govern reimbursement by private payors in private health care financing. 

APHM pointed out that the Ministry of Health (MOH) is “aggressively” exploring a public-private partnership model for health care delivery that involves outsourcing services and introducing private financing initiatives. 

“Our fear is in the pursuit of trying to bring health care cost down, these private payors may further hamper the right health care coverage and treatment delivery to the patient,” APHM president Dr Kuljit Singh said in his welcoming speech at the Hospital Management Asia (HMA) 2023: Embracing Change For More Efficient Healthcare conference here yesterday. 

“As much as controlling health care cost is important, but the ethics of reasonable payments by payors must be watched. 

“APHM is happy to work together with the government, payors and all our private hospital members to discuss this together to make the health care cost viable for all parties.”

The Madani Medical Scheme (SPM) is an example of public-private partnership, in which the government allocated just RM100 million for the nationwide pilot project to fully subsidise treatment for low-income earners for acute conditions at private general practitioner (GP) clinics. 

However, doctor groups have complained about reimbursement by ProtectHealth Corporation Sdn Bhd, a company fully owned by the MOH, at below market rates for consultation, medication, tests, and basic procedures. 

Health Minister Dr Zaliha Mustafa told a press conference at the HMA conference yesterday that the reimbursable fees for panel GP clinics are under review.

The HMA conference’s key discussions also included strategies to tackle the prevailing shortage of nursing professionals, reimagining the role nurses play, brain drain, and emphasising empowerment via the delegation of tasks and by harnessing the power of automation. 

In addition to the exploration of public-private partnership, Dr Kuljit touched upon the reform of health care services in Malaysia via the Health White Paper (HWP), a document proposing health care reforms over a 15-year period. 

He said that the transition from the current system of health care to the one in the HWP will be accomplished via the adoption of revolutionary technology such as generative artificial intelligence, which is capable of generating text, images and other media using generative models and “offers great potential for the future of health care”.

“I am glad that the government is now working with many prominent Big Tech companies to construct the National Health Records system. This effort seeks to transform how we handle and access health information,” Dr Kuljit said.

“In addition, I was informed that [the] Ministry of Health is actively collaborating with valued partners such as Bank Negara, EPF (Employees Provident Fund), KWAP (Retirement Fund, Incorporated), and Perkeso (Social Security Organisation) to address another critical issue,” he added, referring to social health care financing.

“Through this collaboration, we hope to improve our health care services and achieve smooth integration across sectors. We from the private health care sector are working together to build a more efficient and comprehensive health care system for the benefit of everybody. 

Dr Kuljit said in his keynote address that embracing change in health care is what drives innovation and that the acknowledgment of the position of health care at the crossroads of technological change, patient care, and administrative advancements is what empowers health care providers to create a more efficient system. 

“This benefits both providers and recipients of care. The payors must understand this too as health care comes with premium cost, and it’s not inflation caused mainly driven by profits alone, but technology cost more.”

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