KUALA LUMPUR, Sept 25 — A middle class couple living in Kuala Lumpur expects the Ministry of Health’s (MOH) private wings to have the same standards as conventional private hospitals.
Sheryn Kok Lai Ping and Leong Chiew Why are the perfect target market for the new RakanKKM programme that seeks investments from government-linked investment corporations (GLICs) in a special-purpose vehicle to fund the expansion of private wings in government hospitals.
The middle-aged married couple are willing to spend, in MOH’s private wings, RM20,000 or up to 80 per cent of the rates charged in private hospitals. But they have high expectations for the RakanKKM service that must be met before parting with their money.
“Faster diagnostics, quicker test results, and access to the latest drugs should not be compromised – it should be the same standard as private hospitals,” Kok told CodeBlue in an interview.
Kok also expects short wait times for treatment in MOH hospitals’ private wings, pointing out that delays may worsen illness or endanger patients.
While Kok welcomed the MOH’s proposal to place patients from certain tax brackets in the “affordable” private wing, the 55-year-old woman urged the ministry to clarify the fees that will be charged in the new private wings in its hospitals and “how much patients need to compromise.”
“When I look at the picture posted of a first-class ward in Selayang Hospital, it really brings me back to the dodgy government hospital feel,” Kok said.
She added that the private wings in MOH should operate regular hours like any hospital. Currently, the full-paying patient (FPP) service available in 10 MOH hospitals only operates after-hours or weekends based on the specialist’s availability, as these specialist doctors also work in the public health service.
“It will be a challenge for the MOH to draft out a system to ensure FPP patients get treatment like they are in any private hospital. Should the MOH actually invest in new equipment and teams specially to cater for the FPP?” said Kok.
“If private hospitals can make so much money, I believe MOH private wing can do the same by charging 20 per cent cheaper, and yet still be able to finance any new set-up. It cannot be positioned utilising ‘spare’ capacities for FPP.
Kok and her husband, Leong, said they had not previously heard of FPP, even though the service was launched nearly two decades ago in 2007.
Kok stressed that the RakanKKM programme must be well-coordinated.
“Patients do not want to go to a hospital and be treated as secondary patients based on spare capacities when available or by doctors who are tired as that’s their overtime.”
“MOH should set a percentage (e.g., 20 per cent of capacity) for FPP, using the income generated to subsidise the B40. This creates a win-win situation where FPP patients know they are not just standby patients but receive full attention from specialists. The entire hospital staff is also rewarded handsomely.”
Health Minister Dzulkefly Ahmad told the recent World Cancer Congress (WCC) 2024 in Geneva, Switzerland, that the expansion of private wings in government hospitals under RakanKKM is aimed at raising revenue for the MOH and reducing the attrition of specialist doctors, describing it as health financing reform.
He did not specify if RakanKKM would hire outside staff – including specialists, medical officers, nurses, pharmacists, and other support staff – or utilise existing health care professionals in the understaffed public health service.
The health minister had also claimed an “excess” capacity of medical equipment like MRI and CT scanners in MOH that could be used in the private wings.
Both Kok and Leong said they didn’t mind paying for treatment in government health care facilities. For more than six decades, the MOH has provided universal health care to all citizens irrespective of their socioeconomic status, charging only RM1 outpatient and RM5 specialist fees to see a doctor.
“We don’t mind paying. If we’re paying RM30,000 for treatment at a private hospital, the actual cost is probably only RM20,000 at a government hospital. We’d happily pay that. It doesn’t need to be as expensive as high-end private hospitals,” the couple told CodeBlue.
“But the problem with government hospitals is that they only charge RM5, and then we have to wait in line for who knows how long.”
Kok added: “MOH needs to enforce that only the B40 (bottom 40 per cent) enjoy free health care; all others pay.”
Rejected By Insurance For Undergoing Regular Health Screenings
The couple was recently hit when Leong, 58, was hospitalised last month for gallstones and underwent surgery at a private hospital in Petaling Jaya, Selangor, to remove his gallbladder – his first hospital stay ever – with a total bill nearing RM35,000, which he paid out of pocket using his credit card.
Leong, a semi-retired businessman who markets automotive rubber parts, said his medical insurance application a few years ago was denied, despite his overall good health.
The 58-year-old man has always taken a proactive approach to his health, regularly exercising and getting annual health screenings, with scopes and heart scans every five years. His most recent check-up revealed a 25 per cent heart blockage, which his doctor deemed insignificant for his age. He also has a thalassemia trait and slightly elevated sugar levels.
“I did a heart scan five years ago, and it showed a 25 per cent blockage, which the doctor said was nothing to worry about. The doctor told me, ‘A 25 per cent blockage at 54 years old (at that time) is normal.’
“When the insurance company reviewed the test report as part of my application for medical insurance, they rejected me, suspecting I had heart disease.
“I do check-ups every year not because I’m sick, but for prevention and early detection,” Leong said. “Yet they saw the 25 per cent blockage and assumed I must have heart disease.”
Leong had previously been covered by general insurance with limited benefits for 20 years through his company. When the company scaled down its operations, he considered getting personal medical insurance.
Leong joked that next time he might need to sell his assets to cover such expenses: “Sell house, sell car, sell organs.”
Savings Crucial For Medical Emergencies
His wife, Kok, believes saving is essential for building emergency funds in case Leong faces another medical episode.
“That’s why I said it’s good for him to save money because, honestly, at his age, his yearly premium would probably be around RM8,000. If he stays healthy for 10 years, with interest, he could save about RM100,000,” Kok said.
However, the concern is the risk of serious diseases like cancer or stroke that may require expensive long-term care.
“Cancer treatment costs a lot. For heart issues, with early detection, you can get a bypass or other procedures that are not going to cost an arm and a leg, so it’s manageable.
“But if it’s a major illness that requires significant expenses…of course, if he does medical check-ups every year, hopefully, it can be caught early. He also doesn’t drink, which reduces his risk. We have to do our part to minimise the risk,” Kok said.
According to the National Health and Morbidity Survey (NHMS) 2019, only 22.4 per cent, or 6.39 million Malaysians, are covered by personal health insurance. About 43 per cent, mostly those aged 70-74, said they couldn’t afford it, while 36 per cent felt they didn’t need it.
The survey also revealed that 0.8 per cent, or an estimated 199,444 people, were declined insurance coverage by companies.
Only 16.5 per cent of the population used personal health insurance to pay for health care. The majority – 81.2 per cent – paid out of pocket, relying on themselves, family, or household members.
Self, family, or household payments were most common among those aged 50 to 54 (83.9 per cent) as well as for unpaid workers or homemakers (86.2 per cent).
Rising Premiums Force Rethink Of Health Insurance
While personal medical or health insurance is helpful for covering large medical expenses or sudden major illnesses, many are becoming more sceptical about whether they can afford the rising premiums in the long term.
Kok, who obtained personal health insurance a few years ago, is reconsidering whether to continue paying premiums, as they are expected to rise again next year.
“I signed up for medical insurance about three or four years ago, but now I’m questioning whether I should continue with another potential 30 per cent increase next year,” said Kok, whose policy is an older one without a copay option.
“My friend told me not to terminate my current plan. If I switch to a new copay plan, they’ll ask for a medical check-up, and then this or that will be excluded. It’s not fair.
“So, what do we do? We’re stuck with paying high premiums.”
Two senior citizens in their mid-60s recently complained about a steep hike of their medical insurance premiums of up to a whopping 275 per cent and 72 per cent.
