FPMPAM says subjecting referrals, investigations, and medication choices or even quantities to TPA approval is "intrusion" into clinical decision-making, "not benefit management". Managed care supposedly "achieves" lower costs by restricting care.
TPAs and insurance companies must revise GP consultation rates to reflect modern primary care. The fees set by some TPAs or insurers remain at levels set over 20 years ago. Stronger primary care saves insurers money, but only if it's properly supported.
With the right mindset, both GPs and specialists in private practice can do their best to be meaningful partners of the Madani government in ensuring the health and welfare of the rakyat.
At a Penang town hall organised by PMPS and FPMPAM, GPs demand that their consultation fees be raised to RM40-RM125, pointing out that the majority of their cases are from TPAs. FPMPAM wants TPAs to be prohibited from paying doctors the statutory minimum.
Despite a GP consultation fee ceiling increase to RM80, MMA expresses deep disappointment with the government retaining the RM10 floor rate, saying this low floor risks undercutting by TPAs who have been paying doctors below RM35. MMA wants RM50 minimum.
MMA tells Naccol not to overstep into the regulation of health care, saying that its role is to address cost of living concerns, not medical practice. MMA urges the health minister and MOH to safeguard the integrity and autonomy of the medical profession.
Amid stagnant GP consultation fees, 6% SST is imposed on private health care for foreigners. MMA says compliance cost exceeds SST collected. Foreign patients visiting GP clinics are mostly low-wage workers in 3D jobs. "This isn't reform; it's regression."
MPCAM calls for GP consultation fees to be raised to RM50-RM80 from the current RM10-RM35. The doctors' group says patient bills at GP clinics will stay the same even if consultation fees are increased to minimum RM55, as clinics will cut medicine charges.