GEORGE TOWN: Malaysians struggling with soaring medical insurance premiums could see relief from next year as the government rolls out reforms aimed at controlling private healthcare costs and medical inflation, says Bayan Baru MP Sim Tze Tzin (PH-Bayan Baru).
Sim, who has been championing the issue, said the reforms followed concerns raised over rising medical insurance premiums and private hospital charges.
He said several measures had been introduced in 2025, including a Public Accounts Committee (PAC) investigation which resulted in a comprehensive report.
"The Government also established reforms for private healthcare and healthcare financing.
"It set up a joint committee involving the Health Ministry, Bank Negara and Finance Ministry," he said on Tuesday (Oct 6).
Sim said the committee had announced five key strategies involving 12 initiatives to reform the private healthcare and medical insurance sectors.
"The Government has announced a basic medical insurance scheme for Malaysians who can afford medical insurance.
"Those who currently feel burdened by medical insurance premiums are now covered under a pilot programme, and next year the Government will expand the scheme to all Malaysians in the first quarter," he said.
On private hospital charges, Sim said the government had introduced Diagnosis Related Groups (DRG), which would benchmark the cost of medical procedures.
"Previously, when conducting a medical procedure, hospitals would calculate every item used, including gloves, and charge patients accordingly.
"Under the new system, it will be a lump-sum payment, and hospitals will have to work within that amount.
"If the procedures are more or less the same, the costs should also be similar. There is no way to overcharge.
"That is how DRG will help control costs," he said.
Sim said the third key measure was the implementation of electronic medical records (EMR), which would allow medical information to be accessed across healthcare facilities.
"EMR is important because we do not have to do an X-ray at one place, then go to another hospital and do it again, and then go to a government hospital and do it again," he said.
"You do it once and it is already in the system, so all places can refer to the same X-ray.
"It saves costs and avoids overlapping," he said.
Sim said the three measures were among the 12 initiatives under the government's reform of the private healthcare and insurance sectors.
"I think next year, when these are rolled out, they will have a good impact on the sharp increase in insurance premiums and private hospital costs," he said.
However, Sim said the reforms would take time to implement, particularly DRG, which was a complex system.
"This takes time because we know we cannot simply overhaul healthcare that involve lives," he said.
