A bitter pill to swallow

TWO years after his retirement at the age of 60, father of two, Peter Hoe decided to stop paying for his medical insurance and instead rely on public healthcare.

The escalating cost of medical insurance, where he was paying more than RM10,000 a year, was the major factor in his decision.

“I signed up for a hospitalisation and surgery package more than 10 years ago at my previous place of employment.

“But the premiums for my medical card kept going up every two years or so.

“As a retiree, I decided that although the coverage was important, it was a cost that I could save by going to a government hospital.”

Hoe, 65, is part of a growing number of retirees, largely from the middle-income category, who are moving away from private healthcare and now utilising public healthcare services and facilities.

Malaysia offers virtually free healthcare services to its citizens and our facilities are acknowledged to be among the best in the region.

On paper, there is no issue with any Malaysian citizen making use of these facilities.

However, usage of public healthcare has ostensibly been the domain of the B40 or less privileged community in this country.

But skyrocketing private hospital fees and medical insurance premiums have seen more well-off Malaysians utilising government hospital services and this is starting to put a strain on our public healthcare.

“I had an enlarged prostate a few months ago but I was forced to wait more than two months before I was given an appointment for surgery to rectify the issue,” Hoe said, adding that a two to three months waiting period for procedures is common at government hospitals.

In Parliament this week, the Health Minister said a total of RM23.25bil has been spent on buying medicine from 2015 to 2023 for public hospitals and clinics, adding that over the past eight years, medication-related expenses have increased by 30%.

These government hospitals and clinics are now experiencing staff shortage and seeing long waiting times for patients to consult doctors.

The doctors themselves complain about long working hours and many have become disillusioned with the system.

Ironically, some of our best and brightest doctors have moved to the private healthcare sphere, both here and overseas, drawn by higher salaries, better perks and shorter consulting hours.

According to a 2023 report from Bank Negara Malaysia (BNM), Malaysia recorded medical inflation at 12.6%, significantly higher than the global average of 5.6%.

This prohibitive cost of private medical service is putting a burden on public healthcare because the middle class can no longer afford to pay.

It is a chicken and egg situation because medical insurers have upped their premiums as a result of increased healthcare fees, further burdening the consumer.

It is an open secret that hospitals will charge different fees based on whether a patient has medical insurance.

I witnessed this firsthand at a reputable private hospital when I went to the payment counter after my father-in-law was discharged from surgery.

The fee quoted was significantly higher for medical insurance compared to what I paid using my credit card. And when I queried the staff on this discrepancy, I was told that this is normal practice.

I was flabbergasted! To me, this is a fraudulent way for private hospitals to make their money. Insurance companies make huge profits. But can you blame them for increasing their premiums when they keep forking out more for claims?

The system stinks and the authorities cannot turn a blind eye any longer as we, the consumers, are the ones who are suffering.

We suffer because we pay both exorbitant fees for private healthcare as well as medical insurance. And we suffer because of the backlog and deteriorating services at public healthcare facilities.

The recently tabled Budget 2025 did provide a modicum of relief for the middle class –expanded tax reliefs for medical treatments (up to RM10,000), mental health, and elderly care.

But this is a drop in the ocean when you consider that health insurance grew at an average of 9.5% a year and according to BNM, is affecting 4.5 million policies.

I fully agree that Bayan Baru MP Sim Tze Tzin’s recent criticism of BNM for allowing insurers to adjust premiums under existing agreements is justified.

“If price hikes for goods are penalised under the Price Control and Anti-Profiteering Act, why are hospital charges and insurance premiums left unchecked?” he asked.

He also highlighted the financial burden faced by Malaysians due to unchecked private hospital charges, citing examples such as a RM19,000 bill for a routine procedure and soaring maternity costs, adding that while medical procedures are regulated under the Fees Act, other hospital charges remain uncontrolled.

But Sim’s belated warning that escalating costs could push middle-income groups to rely on public hospitals, further straining an already overburdened system and affecting access for low-income patients, is too little too late.

It is a farce because the M40 have already made the transition to public healthcare.

Sim and other parliamentarians should be taking aim at private healthcare.

The Malaysian public is not buying it when private hospitals and the insurance industry claim that the costs for their businesses are unsustainable because both these sectors continue to rake in increased profits.

And it is the height of irony when both these industries play the blame game for the rising cost of healthcare.