DIFFERENT STROKES

BY ADI SATRIA

A veteran of the media industry, recognises that being part of the ageing population, the already inflationary cost of living should not burden the challenges posed by our people in meeting health challenges, and a better deal must be provided, not just to patients but to doctors and health care workers alike.

RECENT announcement on the increase in healthcare premiums by insurance companies for private healthcare hospitals has sent the public into open debates.

The bottom line was the affordability of those within the M40 group who may not be able to afford the premiums. This will result in this large group switching to public hospitals, which will contribute to the already stressful level of service and the pressure among doctors and other healthcare staff.

A recent personal experience can aptly illustrate the situation on the ground. My other half had an unfortunate fall at home, which fractured her left hip joint, and she was admitted to the Ampang Hospital.

As she was not in critical condition, she was placed in the“ Yellow Zone” of the emergency ward for two days as the regular wards were facing a shortage of beds. Minimum care was administered, which contributed to her already traumatic mental state.

Once in the regular ward, the relevant doctors efficiently administered the proper procedures to prepare her for the surgery on the following Tuesday, precisely seven days after her fall.

FULL RECOVERY

The head of the surgery reassured us of the procedures. At the same time, other medical officers, including a psychiatrist who diagnosed her state of mind, felt she was ready to undergo the operation.

As her blood pressure was satisfactory and her sugar level was good, the operation was successful. She was discharged three days later, but the wound took only one week to heal. Full recovery will take a few months before she will be able to walk correctly.

I arranged for a private physiotherapist to come over to the house to work on her legs and thigh muscles, and walking was the only way to achieve this. Now, compare her experience with that of a friend of mine, an 80-year-old foreign man who suffered the same fate but was treated in a private hospital in Subang Jaya.

His operation was almost immediately, and upon discharge, he went to a nursing home to recuperate. Although he had diabetes, he insisted on taking food that

was high in sugar, which resulted in his sugar spiking and his wounds worsening and becoming infected.

He was then sent back to the hospital for treatment, but after a few days, the infection became so bad that an operation was needed to replace the metal joint. The initial operation cost him an astounding RM50,000, and this new operation will cost him another RM30,000!

As he had run out of savings, we advised him to discharge himself and go to a government hospital in Shah Alam. As expected, it was also congested, and he was later transferred to the Klang Hospital. This whole process took 10 days of waiting.

However, the good news for him was that the cost of the operations was only around RM4,000, much more than what my wife paid for as she was a senior citizen. With the plans to increase healthcare insurance premiums, there are concerns that many M40 households will consider not taking any health insurance or stopping their contributions, which will then put heavier pressure on public hospitals.

Many in the M40 group prefer health insurance coverage for private health care as it is considered more convenient, though not necessarily better, compared to public hospitals.

In fact, based on my own experience, being treated at government hospitals was quite satisfactory. The healthcare professionals were excellent, and I really salute and empathise with them on the challenges they face in providing the best for the patients. The rise in medical insurance premiums is expected to be between 40 to 70 per cent.

HISTORIC PROFITS

The insurance providers blame it on the rising costs of medical care in private hospitals. However, a closer look at the facts in the financial reports of the major players in the private healthcare and insurance industries shows a different scenario. IHH Healthcare announced a nett profit of RM534 million for Q3, 2024 while KPJ Healthcare hit a historic RM1 billion quarterly revenue milestone in the same quarterly period.

Healthcare insurance provider Allianz Malaysia recorded a rise in revenue to RM1.37 billion and a nett profit of RM167 million just for Q2 2024. Prudential Assurance reported RM963.47 million for its

financial year ending 2023.

Don’ t these facts suggest a thriving private healthcare industry? One wonders why the public must contribute more unfairly to the success of these industry players. In response to all this, the government announced in mid-March 2025 several measures to address the rising cost of health insurance and tafakul premiums, including adjusting premium rates and introducing more affordable options.

Four key steps to ease the financial burden on policyholders are the distribution of premium adjustment rates, postponing premium increases, reactivating specific policies and offering alternative products. The government will also expedite the reform of the national health sector over these three years, from 2024 to 2026.

MEDICAL TOURISM

At the same time, Bank Negara Malaysia, together with the Health Ministry and Employees Provident Fund, will also take steps to develop essential health insurance and takaful products that emphasise a value-based healthcare approach.

We need to see how these steps play out. Malaysia is also a very attractive medical tourism destination in the region, and it has attracted over a million health tourists in 2023 alone. Revenue generated was RM2.25 billion, with a further RM9.6 billion in spillover benefits to other industries.

Therefore, the consideration here is to relook at the rates imposed on our population because healthcare should be seen as a fundamental human right and an essential service to citizens and not for maximisation of profits.

The government has already launched the Flagship Medical Tourism Hospital Program( FMTH), an integral part of the Medical Healthcare Travel Industry Blueprint 2021-2025.

It aspires to establish Malaysia as a premier medical tourism destination. This programme provides several features, including tax incentives to selected flagship hospitals, and it must also ensure that our own local population is not charged the same relatively high rates imposed on these foreign patients.

Charity, after all, should begin at home. – THE HEALTH