KUALA LUMPUR, Feb 11 — Bayan Baru MP Sim Tze Tzin has called for fairer pricing practices in private hospitals, criticising excessive profiteering and highlighting complaints about inflated charges for basic medical items and drugs.
Sim, who has created a platform for complaints about health care costs, shared examples of patients being billed repeatedly for routine checks using blood pressure (BP) monitors and pulse oximeters, with charges far exceeding their retail value.
“Some of the unreasonable pricing, for example, digital BP monitoring – some people complained to me about being charged RM54.70. A pulse oximeter, to check your pulse, costs RM10 or RM20 at a pharmacy? But some patients were charged RM58. If they are tested three times, they will be charged RM58 three times in one day.
“I think this is not fair,” Sim told CodeBlue in an interview in Parliament last January 8.
The PKR lawmaker added that drug prices in private hospitals are often double or even triple the rates at pharmacies.
“People complained to me about Legalon capsules. At the pharmacy, they cost RM132, but in the hospital, it’s RM234. Duphalac is RM22 at the pharmacy, but RM40 in the hospital. Oral mouth gel is RM65 or RM66 at the pharmacy, but RM105 in the hospital. It’s all double.”
Sim called for transparency and fairness in medical billing, saying: “It cannot be 90 items (in the medical bill) and every item is double, double, double. I think it’s not right.
“I don’t blame them (private hospitals) because they need to cover other costs, like nurses’ wages and other expenses, but I think it has to be fair.
“If you want to charge for certain things, you have to be transparent – for example, say the room charge is to cover capex. I think stakeholders must come together and really look at what constitutes a fair and sustainable price,” Sim added.
Excessive Profiteering Must End, Sim Calls For Regulation
Sim acknowledged that private hospitals, pharmaceutical companies, and insurers need to make a profit to survive and drive innovation. However, he said “excessive profiteering” must be addressed to protect the most vulnerable.
“I know private hospitals need to make money. I know pharmaceutical companies need to make a profit, and I know insurers must make a profit for them to survive. Profit actually drives innovation. Private hospitals, for example, if they make a profit, they can bring in the latest technology to Malaysia and help treat the most difficult cancer or improve treatment for diabetic patients. So I’m not against profit,” Sim explained.
“But I am against excessive profiteering. I believe we must fight for the poorest people. That’s where the Member of Parliament, or people in politics, we are given the mandate, we are voted in to speak up for them.”
Sim said that while the issue of profiteering is complex, regulation is necessary to ensure fairness. He pointed out that 30 per cent of private hospital charges are for doctors’ fees and drugs, while 70 per cent are unregulated.
“I have received complaints that people are being charged RM20 for a pair of gloves. One box of gloves costs only RM40. If the doctor accidentally tears the glove, the patient is charged RM40 twice,” Sim said.
“This is where I believe regulation is needed. It’s very difficult to scrutinise these bills, especially when you receive a bill with 90 itemised charges. Most people just accept them and pay,” he said, adding, “I always joke with people. You go into the hospital, you already ‘pengsan’, and then you come out and faint again when you see the bills.”
Sim proposed that stakeholders, including the Ministry of Health (MOH), private hospitals, and consumer groups, work together to develop a regulatory system that is both acceptable and transparent. He pointed out that there is currently no authority to oversee the unregulated charges in private hospitals.
“This is the ‘Wild Wild West.’ Seventy per cent of the charges are unregulated, and there’s no enforcement. The Ministry of Domestic Trade (KPDN) or the Malaysia Competition Commission (MyCC) cannot intervene because there is no ‘punca kuasa’,” Sim said.
As a Member of Parliament, Sim is now pushing for stronger oversight of private hospitals. “We are not strangulating you; we are regulating you to make sure it is a sustainable industry for the long term. That’s what we are articulating.”
When asked if MyCC should intervene to break up large private hospital groups or address potential mergers and acquisitions to make prices more competitive, Sim believes it is premature. He noted that various groups are still competing in the market, and there is no indication of a monopoly at this stage.
“I think what we are advocating for is regulation of charges and price transparency. Many doctors and the Ministry of Health are advocating for DRG (diagnosis-related groups) to make pricing more competitive.
“I believe we should try those measures first. I don’t see a monopoly in this case. Breaking up companies is the business side of things, and there is no super monopoly that warrants the government to come in (and intervene).
“For example, in the US and Europe, companies like Microsoft and Google are being broken up because they are dominant players. But I think in our case, there’s no such kind of monopoly there,” Sim said.
Excessive Admissions And Unnecessary Medical Tests In Private Hospitals
In addition to exorbitant charges, Sim also mentioned receiving complaints about unnecessary admissions and diagnostics in private hospitals, while downplaying claims that private hospitals are at full capacity.
“Whether private hospitals are at full capacity or not, we don’t know. Actually, I think it can be run more efficiently. Sometimes we get complaints about over-admission or unnecessary admissions,” Sim said. “We also receive complaints about unnecessary investigations, screenings, and diagnostics.”
In September last year, CodeBlue reported a patient disputing Pantai Hospital Kuala Lumpur’s RM611 charge for an antibiotic-resistant bacteria screening prior to his admission.
While Pantai maintains that MRSA screening is part of its policy to prevent transmission, the patient argues that hospitals should only charge for essential treatments and non-essential charges should require patient consent.
“I want to warn the private hospitals and I want to warn the insurance companies. If the excessive way of the American style of health care system, only the rich can have health care and the poor is left out. This is a formula for disaster,” Sim said.
“Look at what happened in America – someone assassinated a big insurance company CEO, and he became an instant hero because there’s an injustice there,” he added, referring to the murder of UnitedHealthcare CEO Brian Thompson in New York last December. The suspected killer, Luigi Mangione, had pleaded not guilty to state charges.
“We don’t want that to happen here. This is an injustice to the rakyat, and I’m going to fight back. I’m not going to let that happen.”
Sim urged Malaysians to stand with him and the government in this critical moment as the future of sustainable health care is at a crossroads.
“If we don’t do something now, things will continue to deteriorate. It will create a society where only the rich can afford health care, and the poor will wait in long lines at government hospitals, and that’s a formula for disaster. Support us.”
