KUALA LUMPUR, July 10 — The government’s proposal to expedite elective procedures in government hospitals with Rakan KKM, a paid service to be launched in selected facilities, has triggered public outrage.
Some likened the programme, which will be priced above cost, to an “express lane” in theme parks, as many Malaysians, including medical doctors, criticised the exacerbation of inequality within the public health service.
“By introducing a pay-to-access model within public hospitals, it risks creating a two-tier health care system where those who can afford to pay receive faster, more comfortable, and potentially better care, while others, particularly low-income and vulnerable groups, are left to wait longer,” Universiti Malaya Faculty of Medicine Postgraduate Society vice president Dr Aiman Alias told CodeBlue.
“This undermines the foundational principle of public health care: that access should be based on need, not ability to pay. Although the initiative is positioned as a revenue-generating tool that won’t affect regular services, the blurred line between premium and standard care may lead to the diversion of limited medical staff, equipment, and space toward paying patients, inadvertently compromising service quality for others.
“Additionally, it may erode public trust in the fairness of the health system if perception grows that money, not medical urgency, determines treatment priority.
“Without strict safeguards, independent oversight, and transparent reinvestment into underserved areas, the Rakan KKM model could exacerbate existing inequalities, moving Malaysia further away from the goal of universal, equitable health care access.”
In a video on TikTok, which has been viewed over 130,000 times, former Puchong MIC division chief Awtar Singh told Dzulkefly Ahmad to resign as health minister.
“Whoever wants a heart operation and has money can go in through the back door. The doctor will operate first on those who can pay, while those without money must wait and will be the first to die,” said Awtar, who was sacked from his party last year.
“This is the Ministry of Health’s (MOH) system. Why do you want to create such a system? This isn’t fair to Malaysians. All Malaysians pay tax.”
Awtar referenced a Bernama news report with the headline: “Rakan KKM bukan penswastaan tapi usaha percepat rawatan kes elektif” (Translation: Rakan KKM isn’t privatisation, but an effort to expedite elective cases).
In disputing the “privatisation” label for Rakan KKM, Dzulkefly told a press conference Monday that patients could pay for “faster” access to elective procedures offered by Rakan KKM in public hospitals, instead of waiting six to seven months in the regular queue. Emergency cases, however, will still be managed equally without discriminating against patients based on their ability to pay.
A doctor pointed out that “elective” cases include heart bypass and transplant surgeries, saying: “Imagine if we can cut the list for organ transplant just because people can afford to pay. We can beat the black market already.”
Dr Muhammad Rahim from Ibnu Sina’s Medical Charity Organisation of Malaysia (Papisma) described the government’s terms for Rakan KKM, like “premium-economy wards”, “personalised care”, and “faster access”, as euphemisms for queue-jumping.
“In my training days, surgeons opened an abdomen because the patient needed it; now they will open it because the accountant nodded. Apparently, need has been reclassified as a subset of affordability,” Dr Muhammad wrote on Facebook.
He predicted that resources, including equipment, ward beds, and even anaesthetists, will eventually be diverted to the “revenue stream” of paying customers, causing the original queue to lengthen. This will increase even more aggressive marketing of Rakan KKM.
“After all, nothing sells a ‘fast lane’ like a traffic jam you yourself designed. But cheer up. The ministry assures us this is not privatisation. Merely public-private ‘cooperation.’ Indeed. And a wolf in scrubs is merely a collaborative canine.”
Another doctor posted on X that the waiting time for elective procedures in public hospitals may increase to 10 to 12 months after the launch of Rakan KKM, “since same number of staff now have to prioritise KKM ‘friends/ cronies/ orang kaya’ instead of regular netizens/ citizens.”
Contract doctors’ group Hartal Doktor Kontrak wrote on Facebook that the entire health care team must be fairly compensated under Rakan KKM, in response to a doctor saying that surgeries don’t just involve doctors, but also nurses, central sterile supply department (CSSD) staff, attendants, radiographers, blood bank, and janitors, among others.
A few Malaysians described Rakan KKM as “dystopian”, even likening it to a plot from the British anthology TV series Black Mirror. Another labelled Rakan KKM a “caste system” in the public health service.
Some equated faster service under Rakan KKM to the “pay-to-win” game design model, where players can gain a significant advantage over others by spending real money on in-game items, features, or currency, essentially “buying” their way to success.
“Government is literally doing a pay-to-win with our health. Now if you have money, you can get treatment before poor people, further backlogging the system and creating division and inequality,” one person posted on X.
Another person wrote on X that despite the government’s best intentions, Rakan KKM and its predecessor, the Full-Paying Patient (FPP) scheme, risked forming a two-tier health care system that provides better services for those who can pay, but longer waits for those who can’t.
“Overseas, similar dual track systems have widened health care inequality. In the UK, NHS partnerships with private firms often led to cherry-picking of profitable patients and underfunded core services. Malaysia cannot afford this slippery slope.”
The MOH plans to launch Rakan KKM in the third quarter of this year at Cyberjaya Hospital, Putrajaya Hospital, Sultan Idris Shah Serdang Hospital, and the National Cancer Institute (IKN) – offering specialist services for elective cases – even though the public health care sector faces massive specialist shortages across every specialty.
Based on MOH data, the public service only has 44 per cent of specialist doctors needed this year, short of nearly 11,000 specialists. Most specialties in the public sector don’t even have half of the number of specialists needed.
Azrul Azimi, a media officer in the MOH, claimed that public queues won’t be affected by Rakan KKM, as the programme will run after hours and utilise “unused capacity” in underused operating theatres and wards.
“Specialists are resigning for better pay in private, and people are complaining left and right. Rakan KKM offers structured incentives within MOH, helping retain them, reduce burnout, and ease the pressure,” he posted on X.
While claiming that Rakan KKM will reduce specialist doctors’ workloads, Azrul said in the same breath that the programme will run during evening slots and weekends.
Similarly, Dzulkefly’s special functions officer Ahmad Fadhli Umar Aminolhuda, who is an Amanah Youth exco member, claimed on X that the public queue might even be shorter because Rakan KKM, a paid service, will make use of health care workers’ “unused time”, like their off days and the “middle of the night”, while compensating them for it.
Doctors’ and nurses’ groups previously opposed a 45-hour work week in a new shift system under the Sistem Saraan Perkhidmatan Awam (SSPA), with the College of Emergency Physicians saying that “extensive” working hours of 45 hours a week increase the risk of medical errors. Now, health care workers are expected to work extra hours in Rakan KKM, albeit with more pay, on top of their standard 45-hour work week.
