The Ministry of Health (MOH) should scrap the ruling of drug prices display for medical clinics. This ruling intends for medical clinics to display the cost of each pharmaceutical item being prescribed or sold, so that patients have a choice to purchase medications from the clinic or from an alternative retail outlet.
The intention to reduce the cost of private health care provided by the medical practitioner using this very absurd ruling is unacceptable and extremely damaging for any business or practice, probably unheard of anywhere in the world.
Let us look at the situation objectively. Is there a complaint that medications provided by medical clinics are expensive or exorbitant and way above the acceptable cost of care?
Can we apply this weird principle to control any form of business, e.g. “what is the cost of taugeh, noodles, sambal, cucumber, chicken pieces, and ikan bilis in your stall?” or “what are the itemised costs of a vehicle, e.g. Proton 50?”
It is understandable for the Ministry of Domestic Trade and Cost of Living (KPDN) to monitor the cost of sugar, eggs, chicken, cooking oil, and flour, as these are basic items that the poorer segment of society depends on for survival.
One may now say that health care is an essential service and needs some form of control. Under the Private Healthcare Facilities and Services Act 1998 (Act 586), doctors’ fees have been controlled and capped – unfairly – for both the family or general practitioner and specialist for already 20 years 12 years respectively.
The “poor” family practitioner is a dying breed, especially the solo practitioner, who can barely survive these days with a tragic fee capped at RM 30, far below the hairstylist, the masseuse, spa operator and other services, including plumbers and electricians.
Introducing the drug display ruling will put a “nail on the coffin” on this service, as many will rather close shop than to be trapped under yet another ruling, not to forget the other dilemma of e-invoicing.
To sum up, the whole concept and implementation of drug price displays is totally unacceptable for any practice or business. The MOH should scrap and withdraw this ruling.
If the Ministry truly feels obligated to the public, one way can be that the Ministry itself displays all the drug costs on its website for any patient or customer to check.
We believe that the health minister has good intentions and is pragmatic and determined to solve basic issues in health care. It must be a team of advisers behind the scenes that has brought about this ridiculous ruling. We certainly hope it is not our fellow colleagues from pharmacies.
It is totally unnecessary to force yet another rule on family practitioners.
Separation between medical practice and consultation from drug or medication dispensing has been a long-term goal. We have seen the growth of both retail and larger pharmacies all over the country; most of them are doing well. There is therefore no need for the pharmacies’ industry to take a portion of the “rice bowl” away from the private medical practitioner.
The whole private medical clinic industry, especially family practitioners, will collapse with this ruling, leaving only the big players.
One must take into consideration that the fees for consultation are unacceptably low and have not moved up with inflation over the decades at all. In the sixties, I recall that parents had to pay between RM10 and RM15 for a consultation with medication, the latter if there was an injection.
At that time, RM15 could purchase a pair of spectacles, a pair of long trousers, or a long-sleeved shirt. It was also the cost of dental care and extraction then.
Fast forward to this day – we find all those items mentioned are now well over 10 times and more, while the poor doctor has little choice but to accept a token increase to RM30.
An example to consider is the consultation fee to see a specialist, currently capped at RM235, while it would easily be £500 (RM2,880) to £1,000 (RM5,759) for a consultation in the United Kingdom or the equivalent in the United States. Down south in Singapore, a consultation is SG$250 (RM832) upwards.
We hope that the MOH will cancel or suspend the drug pricing display ruling. If it is the intention for the Ministry to separate medical practice from the dispensing of medications, then the entire Act 586 must be reviewed to allow a significant regular increase in the cost of consultation for doctors – to make it comparable with all other professions per hour, and even match the plumber, electrician, and masseuse.
If appeal after appeal continues to fall on deaf ears, the medical profession in the private sector will have no choice but to take either legal action or resort to other measures.
Dr Sng Kim Hock is writing in his personal capacity, although he is currently adviser to the Association of Specialists in Private Medical Practice (ASPMP).
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
