KUALA LUMPUR, July 9 — The Ministry of Finance (MOF) has pushed the responsibility for regulating charges by private hospitals to the Ministry of Health (MOH), amid high medical inflation.
At the Dewan Rakyat special chambers last July 1, on the subject of rising health insurance premiums, Kota Melaka MP Khoo Poay Tiong cited an anecdotal account about a private hospital that charged his uncle, who had health insurance, RM6,000 for an eye laser procedure.
Prior to the procedure, doctors at the hospital reportedly told Khoo’s uncle — before he said he had a medical card — that the eye laser procedure would cost less than RM3,000, half of the eventual bill.
“If we pay with our own money as an individual, the price is far cheaper. But if we have a medical card, private hospitals will charge the maximum fees,” said Khoo at the Dewan Rakyat special chambers session on the issue of a rise in medical insurance premiums.
“So in this issue, we see that it can actually be less than RM3,000. But if we have a medical card, they will charge the maximum. There are even reports of people saying that when they’re sick and they go to private hospitals, when they sit in a wheelchair in the emergency department, the bill they get after they’re discharged includes fees for sitting in that wheelchair. Even for that, they charge RM50.”
The DAP lawmaker stressed that the problem did not lie with doctors, believing the charges by specialist doctors to be “reasonable”.
“If you don’t have a medical card and you say that you need to pay yourself, usually the doctors will reduce their professional fees. But the problem is with private hospitals. Private hospitals’ annual financial reports all show no losses; they all make huge profits.”
Deputy Finance Minister Lim Hui Ying said in response that regulating private hospital charges required further discussions with the Ministry of Health (MOH) and private hospitals.
“I will pass this to the Health Ministry.”
Citing AON’s 2024 Global Medical Trend Rates Report, Lim said Malaysia’s medical inflation rate increased to 10 per cent in 2022 and 12.6 per cent in 2023, far exceeding the global 5 per cent average in 2022 and 5.6 per cent in 2023.
“So it’s a fact that the rise of medical costs in Malaysia is higher than the global average. Once again, we need to discuss this with the Health Ministry.”
The 13th Schedule of the Private Healthcare Facilities and Services (Private Hospitals and Other Private Healthcare Facilities) Regulations 2006 – under the Private Healthcare Facilities and Services Act (PHFSA) 1988 – only regulates the professional fees of registered medical and dental practitioners practising in private hospitals, such as consultation and performance of procedures.
The 13th Schedule was amended via an order by the health minister more than a decade ago in 2013 to increase the professional fees of doctors and dentists practising in private hospitals by 14.4 per cent, based on the consumer price index (CPI) of health care from 2002 to 2010.
“The other components of the hospital charges – such as fees for accommodation, laboratory investigations, nursing care, use of equipment and operation room, drugs used – are not regulated due to the varying costs in operating and maintaining a private hospital at different areas of the country,” then-Health Minister Dr S. Subramaniam said in a statement in March 2014.
“The country’s health care is more affordable than its counterpart in the region and with the overall safety, political stability, hospitality, and attractive packages reinforce to make Malaysia a medical hub in the region.”
Bank Negara Malaysia (BNM) has mandated insurers/ takaful operators (ITOs) to provide at least one medical and health insurance and takaful (MHIT) product with a co-payment feature by September 1.
Co-payments – which are out-of-pocket payments paid by the insured patient at the time of a claim – were set by the central bank at a minimum 5 per cent of claimable expenses, while ITOs are allowed to determine the cap.
BNM said in a statement last Saturday that ITOs can continue to offer MHIT products without a co-payment feature to new consumers, even as it promoted co-payment health insurance to help curb medical inflation by “controlling the over-consumption of health services.”
BNM’s February 29 policy document states that ITOs will no longer be allowed to design new MHIT products without a co-payment feature. The Galen Centre for Health and Social Policy expects this to take effect beginning next year and for co-payment plans to eventually replace existing products.
The health think tank warned BNM that its new co-payment regulatory decision could expose households to financial catastrophe and cause the cancellation of health insurance policies, leading to higher patient loads on the public health service instead.
