KUALA LUMPUR, July 3 — Pakatan Harapan (PH) launched its Johor election manifesto today that pledged health insurance coverage with an RM100,000 annual limit for hospitalisation in private hospitals.
The Skim Kesihatan Johor targets 500,000 recipients living in the state, primarily the B40, M40 and eligible people with disabilities (OKU), for access to tertiary private health care.
“We know that some of them need services in private hospitals, but they get treated in congested government hospitals,” said Suhaizan Kaiat, who is running for PH in Larkin, during the launch of the election manifesto in Johor Bahru.
“So we want to give an opportunity to the B40 to access services in private hospitals, not just higher-income people. We will enroll them as participants in this insurance scheme and they will be covered for up to RM100,000 annually.”
PH has also pledged to revive the Kad Sihat Johor scheme for access to private clinics.
It’s not immediately clear if PH – should it win the Johor state polls – is planning to get an existing insurance and takaful operator (ITO) to underwrite the health insurance scheme and make payouts for claims, while the state government simply pays the premiums of 500,000 policyholders.
The Selangor state government’s Iltizam Selangor Sihat scheme – whose benefits are paid for by the state government – also has a hospitalisation benefit, but it’s far smaller at a maximum RM10,000.
Ironically, the Madani federal government is currently working on designing a Base MHIT product, also with an RM100,000 annual limit, but its proposal is far more complicated by trying to insert complex elements like a diagnosis-related groups (DRG) reimbursement system for providers.
Base MHIT’s standard-plus plan has an RM300,000 annual limit, but this comes with a whopping deductible of RM10,000 to RM15,000. A deductible is the initial amount the policyholder must pay before coverage begins.
Crucially, people who wish to purchase Base MHIT must pay for premiums themselves, with Bank Negara Malaysia governor Abdul Rasheed Ghaffour even suggesting that policyholders dip into their Employees Provident Fund (EPF) retirement savings.
Skim Kesihatan Johor, however, appears to be free.
If a Johor state government under PH chooses a single ITO to underwrite Skim Kesihatan Johor – as opposed to the federal government’s proposal to expand the Base MHIT offering to multiple participating ITOs, hence leading to a fragmented risk pool – the former will likely be able to negotiate for cheaper premiums and better benefits due to a guaranteed customer base of 500,000 policyholders.
