KUALA LUMPUR, June 25 – Bandar Kuching MP Dr Kelvin Yii has proposed introducing social health insurance to cover workplace accidents and address the rising dialysis costs borne by the Social Security Organisation (Socso).
The DAP lawmaker pointed to a gap in social protection, noting that workers are not covered outside of working hours and that costs from accidents are increasingly high and alarming.
“The protection provided by the Ministry of Human Resources (Kesuma) through Socso only covers accidents occurring during working hours or activities classified as ‘work-related disasters’. Therefore, workers are not protected outside of working hours or the workplace,” Dr Yii said during a debate on the Employees Social Security (Amendment) Bill 2024.
In 2023, 63,199 cases of permanent disability (keilatan) and pensions for deceased contributors (penakat) were reported to Socso. Of these, 31,345 (50 per cent) were due to road or home accidents.
Meanwhile, out of 82,876 accidents reported to Socso in 2023, only 68,220 were accepted as work-related disasters, leaving 14,656 (18 per cent) unprotected.
In 2022, the Royal Malaysian Police (PDRM) reported 4,574 road accident deaths among adults aged 16 to 60 years. However, only 622 road deaths from commuting accidents were reported to Socso.
“These non-work-related cases could be helped with a comprehensive accident protection scheme equivalent to the current Socso scheme for working hours,” Dr Yii said. “In an ideal world, we want Socso or the government to provide comprehensive protection for all. But as responsible policymakers, we must ensure the sustainability of a ‘social insurance’ policy.”
The Malaysian National Healthcare Accounts Health Expenditure Report 2011-2021 stated that Malaysia’s total expenditure on health care has hit RM78.22 billion, or 5.1 per cent of GDP. Trauma-related costs for workers alone is estimated at about RM378 million.
Additionally, Prime Minister Anwar Ibrahim’s government allocates RM450 per month to disabled workers through the Elaun Pekerja Orang Kurang Upaya (EPOKU) scheme under the Department of Social Welfare (JKM), costing an estimated RM217.5 million annually. Combined, these costs for worker-related accidents could reach RM595.6 million.
This does not account for increasing costs due to health issues and non-communicable diseases (NCDs). Socso’s dialysis expenditure in 2023 was RM356.31 million, with an increasing trend each year.
“Therefore, we might need to consider alternative financing and models that do not overly burden contributors but provide comprehensive protection for them,” Dr Yii added.
Dr Yii said the global trend in social protection financing is shifting from tax-based to social insurance schemes, with emphasis on sustainable and self-financing mechanisms.
Germany and Japan have long-standing social insurance systems funded by employer and employee contributions, covering health care, pensions, and unemployment benefits. China and Indonesia have recently adopted similar models to ensure stable funding for social programmes.
According to the International Labour Organization (ILO), this shift reduces fiscal pressure on governments and promotes fairer distribution of social protection costs.
Dr Yii believes Malaysia should adopt best practices and the concept of “shared responsibility” to create a sustainable system for covering accident costs.
“If we extend protection from working hours to 24 hours with a small additional contribution of 0.75 per cent, a worker earning RM2,000 would contribute an extra RM15 per month (RM180 per year). This would provide significant benefits in case of any accident, including:
- Medical Benefits: unlimited medical-related costs according to the Fee Act.
- Temporary Disability Benefits: 50 per cent of average daily salary for sick leave (e.g., RM130 for four days based on average daily salary of RM65).
- Permanent Disability Benefits: long-term periodic payments to replace income loss until death (e.g., RM1,072.50 per month based on average daily salary of RM65 for 100% impairment from traumatic brain injury).
- Dependent Benefits: continued periodic payments to dependents.
- Permanent Attendance Allowance (ELS): additional RM500 per month for insured requiring special care.
- Funeral Benefits: a discount of RM3,000 upon insured’s death.
- Rehabilitation Benefits: unlimited rehabilitation costs covering physiotherapy, vocational therapy, implants, prosthetics, orthotics.
- Education Benefits: educational loans to insured’s children.
“So we see, there is indeed an additional contribution, but the protection provided is far greater and more beneficial to contributors in the event of any accident,” Dr Yii said.
“The world of employment has now changed; the work world no longer has boundaries where workers can be anywhere. With this, social protection must also be enhanced and improved for users and contributors.”
