KUALA LUMPUR, Feb 10 — Bayan Baru MP Sim Tze Tzin has emerged as a vocal advocate for ordinary Malaysians, calling out rising medical costs and what he describes as unfair billing practices in private health care.
Sim, who launched a platform to collect complaints about health care costs, said patients and insurance policyholders are left defenceless in a market dominated by powerful corporations and associations, such as the Association of Private Hospitals Malaysia (APHM) and the Life Insurance Association of Malaysia (LIAM).
“The biggest takeaway is that a lot of people are in need. A lot of people are frustrated, a lot of people are being treated unfairly and they are not alone. The consumer, the people who bought insurance, the people who go to private hospitals, they are vulnerable.
“They have no association to speak up for them. They have no organised body to help them to negotiate better terms,” Sim told CodeBlue in an interview in Parliament last January 8.
Sim said his platform has received at least 296 complaints, revealing issues such as steep premium hikes that seem to disproportionately affect retirees and individuals with non-communicable diseases (NCDs) like cancer, wide price disparities between insured and uninsured patients, and excessive charges in private hospital bills.
He cited data from Bank Negara Malaysia (BNM) to illustrate significant pricing gaps. In over 33,815 dengue cases, patients with insurance guarantee letters were billed an average of RM5,000, compared to RM1,288 for self-paying patients — nearly four times more. Similarly, for 53,188 pneumonia cases, insured patients were charged RM7,000 on average, almost triple the RM2,654 paid by those paying out-of-pocket.
Sim highlighted that while Malaysia’s official inflation rate is 2.5 per cent, medical inflation has surged to 10 to 15 per cent, with insurance premiums rising by up to 185 per cent in some instances.
“The charges [in private hospitals] have increased by 50 per cent from my own experience. This is illogical, and the consumer is at the receiving end of this,” he said.
Sim shared his own experience with rising hospital costs when his wife delivered their three children in private facilities. The cost of delivery rose from RM2,000 for their first child to RM4,000 for their second and over RM6,000 for their third within just four years.
“That’s an annual increase of about 50 per cent.”
Private Hospitals Should Not Be Exclusive To The ‘Super Rich’
Sim calls for greater accessibility to private health care, especially for the middle 40 per cent (M40) group, arguing that these hospitals should not be exclusive to the ultra-wealthy.
“I believe that health care, be it private or general hospital, must cater to all Malaysians and private hospitals must be affordable to M40. They shouldn’t be exclusive institutions for the ‘super rich’ or ‘maha kaya’. I don’t believe it should be like that,” Sim said.
He criticised private hospitals for increasingly targeting the wealthiest segments of the population, such as the T10, T20, and medical tourists. “They (private hospitals) are going after this market and then pushing the M40 to the general hospitals because it is increasingly unaffordable,” Sim said.
“What I’m saying is that I feel strongly for Malaysians who go to hospitals because they are in need and have no choice. In an emergency, you go to the hospital, and there’s a moral hazard — you have absolutely no choice and leave the decisions to the hospital.
“I want a fair system. Like everyone in the world, health care is the most important thing in people’s lives, and we need fairness. Hospitals shouldn’t operate as pure profit-making companies. To be fair, they can make a profit, but it shouldn’t amount to excessive profiteering, to me.
“So I feel a moral duty as a member of Parliament to speak up because I think everyone has horror stories or experiences where they feel they have not been treated fairly,” Sim added.
Talk Of Social Health Insurance ‘Premature’, Politically Sensitive
In the ongoing effort to address the rising health care cost, experts have proposed the idea of social health insurance, a system that would offer broader financial coverage for health care services.
However, Sim was cautious about jumping to conclusions. “I don’t want to jump the gun on whether we need social universal health insurance, because that is a big topic, and I think it should be driven by the Ministry of Health (MOH) or the government,” he said.
Instead of rushing into a universal health insurance system, Sim called for a comprehensive reform involving all stakeholders, including the government, the MOH, Bank Negara, private hospitals, consumer groups, and Members of Parliament from both sides.
“At this point, if we quickly jump to the conclusion that we need a social universal health insurance, I think it is too premature because it has huge implications.
“One of the implications is, for example, additional cost to the rakyat. It’s an additional cost to our employers. It’s an additional cost to even our young people or retirees. So these things have to be factored in,” Sim said.
He said the current system of dual health care in Malaysia — universal health care through public hospitals and private health care through private hospitals — has worked for many years. But there is a market distortion now, with escalating health care and insurance costs.
“Let’s try to regulate first. If it fails, then we can discuss whether we want universal health insurance. That can come later.
“Universal health insurance has the implication of cost, and at this point, the rakyat is suffering. If we introduce universal health insurance, we can get a very strong opposition from political opponents, from various quarters, and it actually may not get the intended outcome, because like it or not, whoever in the government in future, they must deal with health care costs.
“Whether universal health insurance is the right way to go, let a bipartisan committee look into it. Build the consensus, find the best solutions, only then we go for that,” Sim said.
