Doctors in Black: Rising cost of private healthcare

At the time of writing, a group of doctors dressed in black are gathered in front of the PMO to protest a new law mandating to display the price list at private healthcare facilities. This is part of the deal for Ministry of Health to review charges by private clinics. 

As reported in The Star here, doctors "were seen holding placards that read “We will not be silenced”, “Healthcare workers are undervalued”, and “Unfair fees and policies keep current and future doctors away”".

The Price Control and Anti-Profiteering (Price Marking for Drugs) order under the 2011 Act has been gazetted and signed by Domestic Trade and Cost of Living Minister Datuk Armizan Mohd Ali to take effect on May 1st.

Malaysian Medical Asociation (MMA) is naturally opposed to the regulation to display and is of the view it will not bring down the price of healthcare. 

Without a convincing explanation, they forecast it could lead to closing down of medical practices and further strain on the healthcare system. The private medical practitioners are upset it is no more "business as usual" and had to abide by commercial rule.  

Nevertheless, there is a grace period before the new rule is fully enforced and that should allow clinics to scramble do so. 

Consumer interest 

As for consumers, they welcomed the rule as it gives them "more power to make purchasing decisions based on clear price information, in line with the principle of consumer rights." In other words, doctors cannot charge at their whim and fancy, thus will have to compete. 

By right, there should be a separation of role between physician and pharmacist. 

Physicians should be focus on diagnosing and prescribing medications, while pharmacists specialize in dispensing, counseling, and monitoring medication use. It serves as a safety net, identifying potential errors in prescribing, checking for drug interactions, and providing patients with personalized medication information. 

In Malaysia, the separation of prescribing and dispensing is an ongoing discussion and debate, with various stakeholders expressing different viewpoints on its potential benefits and challenges. 

Medical insurance

There was a big public uproar at the end of 2024 over the increase in premium for medical insurance. 

Medical inflation tend to be higher than headline inflation, however for the past few years since the Covid 19 pandemic, the increase in medical inflation was obviously on the rise (refer the chart).

"Currently, over 90% of every premium dollar goes towards paying claims, with little control over these costs. The ratio of claims hit 101% to 111% in 2018-2023, excluding pandemic years."

According to Finance Minister II Datuk Seri Amir Hamzah Azizan, the continuous rise in medical inflation led to an increase in the claims rate for medical and health insurance and takaful (MHIT). 

There have been interim measures taken by BNM to address the problem. 

Private Hospital 

Since then, a debate has been on-going on private hospital charges. Datuk Dr Mah Hang Soon, MCA Deputy President calls for hospital supplies and services (HSS) charges to be regulated with the introduction of policies and immediate action taken to curb profiteering and protect patients across the country. 

According to Senior Insurance Consultant Chan Wei Fay, bulk of the charges often comprised miscellaneous hospital supplies and services. Drug prices merely made up to a third of the bills issued by private hospitals.

Any measures undertaken will affect private clinics too. 

All along and still happening, private hospitals can get away with Ebernezer Scrooge charges. Yet the last review of consultation charges for private clinic was 30 years ago!   

Feedback from private clinic doctors (among which happen to be this blogger's regular breakfast kaki) pointed the blame for the rising cost of private healthcare to the mushrooming private hospital and the posh car driving doctors.  

Association Private Hospitals Malaysia president Datuk Dr Kuljit Singh denied private hospitals are overcharging “except for a few isolated cases”.

“We can prove this if necessary. The government can carry out a scrutiny to ascertain if there are discrepancies in our charges,” he said in an interview prior to PAC’s announcement of the public hearing in February.

In a recent interview, he claimed they have “no control over costs related to medication, medical equipment and emerging technologies like electronic medical records and artificial intelligence. This is made worse by the unfavourable currency exchange rates. 

"As a result, we have to absorb these costs, which are ultimately passed on to the patient in the final bill.”