I read with great interest Dr Bryan Kek’s recent letter on CodeBlue, “Cheaper Care Is Not Necessarily Better Care”. His arguments are timely and necessary as Malaysia faces the twin challenges of affordability and sustainability in health care.
Dr Kek rightly points out that driving health care purely on “cheapness” can compromise safety, quality, and accountability. A superficial focus on cutting costs often ignores the hidden risks — fragmented care, poor continuity, over-reliance on price competition — all of which can ultimately burden patients with higher costs in the long run.
The reality is stark: Malaysia faces medical inflation of around 15 per cent annually, one of the highest in the region. This is unsustainable for both households and payers.
If we continue with a fee-for-service model that rewards volume over outcomes, the system will buckle under rising costs. What may appear “cheaper” today could end up being far more expensive tomorrow.
This is why we need to look beyond “cheap” versus “expensive,” and instead embrace value-based, hybrid, and reformed financing models:
- Hybrid Care Models: A digital-first, physical-when-necessary approach ensures patients receive timely consultations, triage, and preventive interventions at lower cost, while maintaining professional oversight. Doctors and pharmacists each play complementary roles—doctors in diagnosis and care planning, pharmacists in access and adherence—ensuring continuity without fragmenting responsibility.
- Financing Reform: Capitation and Value-Based Care: Moving towards capitation and value-based care rewards providers for keeping patients healthy, not for the number of visits or prescriptions. This aligns incentives: providers focus on outcomes, patients receive more preventive and coordinated care, and costs are better contained. This is especially crucial in managing chronic diseases, where continuity and adherence matter more than volume.
- Quality as the Non-Negotiable Anchor: Affordable care must never compromise on safety, efficacy, or evidence-based practice. Cutting corners whether through under-qualified advice, unnecessary fragmentation, or chasing the lowest-cost product will only result in more complications, higher downstream costs, and loss of public trust.
Dr Kek highlighted the risks of conflating affordability with quality, and I fully agree. But I would also add that the solution is not to preserve the status quo of fee-for-service medicine, which itself is unsustainable, but to reimagine models that make care accessible, accountable, and sustainable.
As Malaysia reforms its health ecosystem, we must not be distracted by the false promise of “cheap care”. Instead, we should pursue affordable, quality care anchored in value, continuity, and sustainability.
Only then can we bend the curve of medical inflation and build a health system that truly protects both lives and livelihoods.
Dr Raymond Choy is a digital health advocate.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
