MMA urges for further refinement of health insurance initiative


PUTRAJAYA: Several aspects of the Base Medical and Health Insurance/Takaful (MHIT) plan must be carefully calibrated to ensure the initiative achieves its intended outcome, says the Malaysian Medical Association (MMA).

MMA president Datuk Dr Thirunavukarasu Rajoo said this was essential to ensure there are no barriers towards timely care, especially for older persons and those with chronic conditions.

General practitioners, he said, must also be supported with appropriate access to diagnostics, referral pathways and operational support to implement existing clinical guidelines effectively and safely within an expanded scope of care.

"Premium structures and policy terms should remain transparent and predictable to maintain public confidence, and safeguards must be in place to ensure that healthcare costs are not inadvertently shifted back onto patients," he said in a statement on Monday (Jan 26).

While the MMA supports the National Diagnosis-Related Group (DRG) system under MHIT as a step toward improving cost control and efficiency, he strongly reiterated that doctors' professional fees are already regulated and must remain outside the DRG scope.

"The DRG should apply solely to unregulated hospital facility charges to enhance transparency, fairness and uphold the integrity of medical professionalism," he said.

MMA, he said, also welcomes the government's push for healthcare digitisation under the MHIT, noting how it is key towards improving efficiency.

He said the involvement of general practitioners in the outpatient management of selected conditions such as dengue fever, pneumonia, bronchitis and influenza is a positive step forward.

"This represents an important step towards strengthening primary care, which is central to a resilient and cost-effective health system.

"When primary care is effectively utilised, patients benefit from earlier intervention, continuity of care and better health outcomes," he said.

Dr Thirunavukarasu said public engagement is also vital when it comes to reforms.

"Continued dialogue with healthcare professionals and the public will help ensure policies reflect clinical realities and patient needs, especially ahead of the proof-of-concept phase this year.

"We remain committed to supporting reforms that are clinically sound, equitable and sustainable," he said.

The Base MHIT plan is expected to be rolled out in 2026, with full market rollout in early 2027. It is intended to standardise baseline coverage across insurers and takaful operators, improving portability and price transparency.

 

 

 

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