THIRTY years ago, there were only a handful of private healthcare facilities in Malaysia. Those who needed to be admitted to a hospital would be admitted to General Hospital. Long queues, shoddy wards, overworked doctors and nurses were the norm.

Today, thanks to improving socio-economic factors and the increasing number of private hospitals, we have many options.

The main contributors to this success story are the insurance companies and increasing number of health professionals.

Insurance companies provide affordable medical insurance to the public and up to 80 per cent of private hospital bills are paid by them.

Health professionals are happy to work in these facilities as remuneration and quality of life are better. Businessmen make a handsome profit building and running these hospitals.

But will the future be as rosy?

As the cost of drugs, medical equipment, wages and rental rise exponentially, there will come a time when medical insurance will be affordable only to the elite.

How much longer can insurance companies provide these affordable packages to the public? Do these companies make money or is it a service provided to complement life-insurance sales? The biggest losers will be the consumer.

Consequently, government-run hospitals will be overwhelmed by patients, which will cause a massive strain on the economy. The quality of service in government health facilities will fall and our status as a provider of first-class medical service in the region will falter.

There are four parties involved that have to be educated so that this mammoth healthcare responsibility doesn’t befall our public healthcare system.

The first are insurance agents. Cards are sold by unscrupulous agents with no explanation. The most important fact that must be explained to the consumer is that there is a limit to the amount claimable.

For example, if you have a RM10,000 limit coverage and you are billed RM9,000 for one admission, there will only be RM1,000 for future use.

The second is a few private hospitals with unscrupulous practice. As the volume of doctors and specialists increase, the number of private hospitals will also increase.

Contrary to popular belief, not all private hospitals are making a profit. This leads to admitting patients for the most trivial of symptoms for monetary sake. The administrators close an eye as long as profit is shown.

For a simple viral fever that needs basic treatment, one can be admitted for days and expensive drugs are administered to inflate the bill. Profit on drugs can be as much as 50 per cent.

In other instances, symptoms are faked and, sometimes, insurance agents, doctors and patients work in tandem to get the client an unwarranted medical check-up. Ethics, which are supposed to be embedded in doctors, have been replaced by ringgit and sen.

The third are the patients. As the premium is being paid monthly for them, it seems justified to get some benefit in return.

In layman’s term, it is the “kiasu” attitude. A faked chest pain will entitle one to all the investigations needed short of an open-heart surgery. Most insurance companies don’t reimburse outpatient treatment. Overworked, frustrated employees get themselves admitted for minor complaints to have a break or a short holiday.

The result is working days are lost and companies have to fork out more for the following year’s premium. Sometimes, admissions are falsified and patients can get admitted, go back to their homes and return the following day. Justified cases are rejected in these hospitals as there are no beds for admission.

The fourth is the body that approves the opening of medical schools and recognising foreign medical schools. Years ago, to be a doctor, you had to excel in education.

The bottom line is we need quality doctors, not quantity. Who are the losers? The people. Insurance premiums will skyrocket and, eventually, they will be unaffordable.

There are two ways to salvage this situation. First, there should be a NCB (no claim bonus) similar to motor insurance.

Second, a small percentage of the hospital bill, except for accidents, must be borne by patients.

Source: New Straits Times