KUALA LUMPUR: Overservicing in the private healthcare system is driving up costs and complicating insurance dynamics.
Former Federation of Private Medical Practitioners' Associations Malaysia (FPMPAM) president Dr Steven Chow said that overservicing in Malaysian hospitals is prevalent, being one of the few countries where accessing general practitioners (GP) and obtaining medication is relatively easy.
This accessibility often leads to long queues for consultations and treatments.
"Overservicing requires patients to see a general practitioner before accessing specialists, which in turn affects insurance dynamics.
"When insurance comes in, they cherry pick. They are not going to insure someone who is 65 or someone who's got a bad family history of diabetes.
"All these cherry picking will occur and it will actually come in even when there's DRG (diagnosis-related groups) in private hospitals," Dr Steven said on the New Straits Times' podcast Beyond the Headlines.
While Dr Steven acknowledged the government's initial efforts through the Parliamentary Select Committee on Health and its six recommendations to address rising insurance premiums, he said it was important to involve more stakeholders, particularly the public.
"I think a national survey must be done, how can we move forward like this?" he added.
He argued that taxpayers, who ultimately bear the costs, deserve a voice in these discussions, whilst questioning why only doctors' opinions are heard.
He added that the public has the right to express their views on using either the current and old but modified system.
Emphasising the fundamental doctor-patient relationship, Dr Steven described it as "a social contract" that is now under threat from commercial interests.
"Imposing a commercial version into this contract is going to create a lot of difficulties both for the patient as well as for the doctors," he added.
He highlighted alarming trends where patients face barriers to treatment.
"We have seen situations where exclusion causes made it impossible for patients even to seek treatment.
"Even a guarantee letter takes so long that they just give up," said Dr Steven.
He said that complaints from payers, doctors, and private hospitals indicate systemic flaws within the healthcare system.
"Before we talk about just addressing it with a payment mechanism, I think a total relook at the system is required," said Dr Steven.
Reflecting on past initiatives, Dr Steven called for a return to expert consultation in order to reassess the system and provide informed recommendations to the government.