While 2024 was the Year of the Payer, this year has seen a stunning reversal with policies in favour of medical doctors across the public and private sectors in Malaysia.
CodeBlue identified three major policy decisions in 2025: a 40 per cent increase in the on-call allowance (ETAP) rate for medical officers, the Ministry of Health’s (MOH) defence of the medical profession in private health insurance, and deferral of drug price display enforcement to 2026 amid court challenges.
Although the medical fraternity may still be dissatisfied with the pace of change, these policies represent a major shift that was not easy to make.
40% ETAP Hike, First Increase Since 2012
Under Budget 2026, the government allocated a 40 per cent hike in the ETAP rate for medical and dental officers in public service, including specialists, marking the first increase in 13 years since 2012.
The new ETAP rate for weekend active calls for medical officers (MOs) was increased by RM80 from RM220 to RM300 per shift, while specialist doctors will get an RM100 raise from RM250 to RM350 per shift.
The new RM300 weekend on-call allowance rate for MOs is equivalent to RM12.50 per hour for a 24-hour shift, up from the much maligned RM9.16 hourly rate.
The 40 per cent ETAP rate hike is estimated to cost the government an additional RM120 million a year. In total, the government will now spend about RM407 million annually on on-call allowances for doctors and dentists in the public health care system.
Considering that the MOH’s Human Resource Division (BSM) initially proposed limiting the ETAP increase to the now-axed Waktu Bekerja Berlainan (WBB) pilot project to reduce financial implications to some RM20 million, a 40 per cent hike costing RM120 million is a win.
The huge raise was likely decided by the Cabinet due to immense political pressure, especially after Dewan Rakyat Speaker Johari Abdul compared the work and remuneration of doctors to politicians.
Of course, increasing ETAP by just RM3 to RM13 per hour for a 24-hour on-call shift won’t be enough to retain doctors in public service – or even in the country. So the Madani government should not rest on its laurels, but continue to address the doctor brain drain – not dismiss it as “brain circulation”.
MOH Puts Its Foot Down On ITOs, TPAs
Doctors’ complaints against private health insurance and third-party administrators (TPAs) or managed care organisations (MCOs) have persisted in Malaysia for years, with little action from the MOH.
But newly appointed Health director-general Dr Mahathar Abd Wahab has shown assertive leadership in just a few months, after he was catapulted to MOH’s top medical position last May from his previous position as head of Kuala Lumpur Hospital’s emergency department.
In October, the Health DG issued a stern warning to insurers and takaful operators (ITOs) and TPAs against interfering with doctors’ clinical decisions that he said could violate the Private Healthcare Facilities and Services Act 1998 (Act 586).
Then the medical practice division directed ITOs and MCOs/TPAs to halt their practice of using old MOH letters as a blanket rule to justify claims denials, saying its opinions are limited and specific to the individual case referred.
The MOH has also mandated MCOs/TPAs to submit information to it by January 31, 2026, for the establishment of a new national MCO/TPA registry.
Medical practitioners may still face perceived payers’ interference with their clinical decision-making. Amid a lack of regulation over health insurance practices, payers continue to exert authority over providers in private health care.
But the unprecedented move by MOH’s top doctors to defend their colleagues restores some balance of power in the face-off between the medical profession and the insurance/TPA industry that’s seemingly backed by Bank Negara Malaysia and the Ministry of Finance.
Deferral Of Drug Price Display Enforcement To 2026
Despite widespread opposition from general practitioners (GPs), the MOH’s Pharmaceutical Services Programme (PSP) continued to push its drug price display mandate, with Domestic Trade and Cost of Living Minister Armizan Mohd Ali gazetting an order that took effect last May 1.
Doctors fought back with an historic protest in Putrajaya on May 6, as more than 700 practitioners demonstrated against the Domestic Trade and Cost of Living Ministry’s (KPDN) jurisdiction over the mandatory display of medicine prices in private GP clinics.
Seven medical and dental associations, and an individual GP, filed suit against the price display mandate. Last October, the High Court here granted leave to their judicial review application; the Attorney-General’s Chambers did not oppose the application.
Previously, in an August affidavit filed by Health Minister Dzulkefly Ahmad in court, the MOH decided to defer enforcement of the price transparency policy to January 1, 2026.
It’s unclear if price display enforcement will continue to be suspended beyond January 1, pending a court hearing and disposal of the lawsuit by doctors’ groups.
Although the policy originated from the MOH, the price display mandate and enforcement fall under KPDN’s jurisdiction, as the order was gazetted under the Price Control and Anti-Profiteering Act 2011 (Act 723).
Doctors across the public and private sectors may feel like they’re under siege. But developments in recent months have slowed the decline of the medical profession’s power and prestige, as practitioners reminded payers and Putrajaya that saving lives supersedes everything else.
Only doctors can do what they do.
