LETTERS: Private health insurance may not be the best option. Private health premiums are often risk-rated; thus, people with pre-existing conditions and higher risks, like the elderly, face higher, often unaffordable premiums or are denied coverage.
Furthermore, fee-for-service reimbursement encourages unnecessary investigations and overtreatment. Such investigations escalate costs and thus raise premiums, further burdening the consumer.
Yet, in the face of an overburdened public healthcare system, consumers are often forced to access private healthcare. Without some form of insurance, they are forced to pay out of their own pocket, such as through their savings or borrowings.
These are the worst forms of financing healthcare, as they could cause personal and family financial catastrophe.
But out-of-pocket expenses (OOP) have been increasing. In 2020, Malaysians spent RM22.6 billion on healthcare for OOP expenses. In 2021, this had increased to RM26.6 billion, which can cause severe hardship for individuals and families.
Compared with OOPs, private health insurance is a better choice. Yet in 2021, only 7.1 per cent of healthcare financing was from private insurance companies. The Health Ministry constituted 49.3 per cent, while out-of-pocket expenses were 31.5 per cent of total healthcare financing.
According to the National Health and Morbidity Survey 2019, 78 per cent of Malaysians lacked private health insurance, with 43 per cent citing affordability as the primary obstacle.
Despite the limited percentage of consumers having private health insurance, there have been some serious complaints and issues. This included misselling of insurance products, limited coverage for medical care, suboptimal reimbursement policies and claim disputes.
To address them, the Federation of Malaysian Consumers Associations (Fomca) supports establishing a regulatory body to oversee health insurance payouts. Its primary function would be to govern the practice of reimbursements by private payers that are fair and just to consumers.
The payment structure should be transparent and ethical, not left to the whims and fancies of the payers. The regulatory agency should mediate grievances between the consumer, the service provider and the insurance company.
Concerning healthcare, Fomca's first choice will always be the public healthcare system to ensure that healthcare is accessible to all Malaysians. A well-regulated private healthcare system will ensure justice and fairness to those who purchase private medical insurance.
Private health insurance is certainly a better mode of financing compared with OOP.
Dr PAUL SELVA RAJ
Deputy president, Federation of Malaysian Consumers Associations
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times