I read with keen interest the recent CodeBlue article “Bleak Future For Malaysia’s Health Assurance Industry”, written by Dr Mohamed Rafick Khan.
The concerns raised are valid and timely. Malaysia’s health assurance ecosystem is undoubtedly under pressure, but the root cause goes deeper than funding gaps or premium increases alone.
At its core, the challenge lies in misaligned incentives across the health care ecosystem.
Health care systems struggle when each stakeholder is optimised in isolation. When providers are incentivised by volume rather than outcomes, insurers are left managing uncontrolled utilisation, doctors face tension between clinical judgement and financial constraints, and patients ultimately bear the consequences through higher premiums or reduced access.
In such a system, sustainability becomes elusive regardless of how much capital is injected.
Cost containment should not be misunderstood as denying care like what most believe in. Instead, it should be reframed as designing smarter care pathways that ensure patients receive the right care, at the right time, in the right setting and at the right cost.
Preventive care, early intervention, and appropriate utilisation are far more sustainable than repeatedly financing avoidable complications downstream. Without structural alignment, attempts at reform will continue to feel punitive to one group or another.
A sustainable health assurance model requires incentives to move in the same direction. Providers must be supported and rewarded for quality, outcomes, and appropriate care rather than sheer throughput.
Payers need the data, transparency, and tools to guide care decisions upstream instead of reacting to claims after the fact. Patients should be empowered with clarity on care options and costs so that access remains affordable and trust in the system is preserved. Regulators, in turn, play a critical role in setting the guardrails that promote accountability, transparency, and long-term viability.
Health care reform should not descend into a debate over which stakeholder is at fault. The real opportunity lies in aligning capital, clinical practice, policy, and technology around shared goals of access, affordability, and accountability.
When incentives are aligned, innovation can truly serve patients rather than distort behaviour.
If Malaysia can move the conversation away from defending silos and toward aligning incentives, there remains a credible path forward for a resilient and sustainable health assurance industry.
Constructive dialogue, such as that fostered by CodeBlue, is an important step in that direction.
Dr Raymond Choy is founder and CEO of Heydoc Health, as well as secretary of the Association of Digital Health Malaysia.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
