Stop private hospitals from overcharging patients

Photo: Tribune News Service

PARLIAMENT’S Public Accounts Committee (PAC) should be commended for bringing to light the fact that private healthcare providers have been imposing unnecessary charges for basic items in patients’ hospital bills – a practice that has reportedly been taking place for many years.

Items such as alcohol swabs, clinical waste disposal, and pillowcases, which should reasonably be included under room and nursing service charges, are instead being billed separately. Although these may appear to be minor charges individually, they collectively impose a significant financial burden on patients and medical insurance policyholders.

The relevant ministries must take immediate steps to strengthen oversight of private hospitals and insurance providers. This includes addressing the practice of insurers having “closed pools”, which has contributed to sharp increases in insurance premiums and placed an unfair burden on long-standing policyholders.

To put an end to these practices, I propose the following measures:

> Establish a joint regulatory body: The Health Ministry and Domestic Trade and Cost of Living Ministry should establish a joint regulatory body to oversee the billing practices of private hospitals.

This body should ensure that patients are not charged separately for essential items that ought to be included as a part of standard hospital services.

In addition, the Health Ministry should publish a comprehensive list of basic consumables and services that cannot be billed separately. Such transparency will empower patients to identify and challenge inappropriate charges.

> Launch a public complaints portal: The Public Complaints Bureau under the Prime Mini-ster’s Department should establish a dedicated online portal for patients to report instances of overcharging.

A centralised reporting mechanism will enable the authorities to gather evidence directly from the public, identify recurring offenders, and take swift enforcement action against hospitals that engage in unfair billing practices.

> Strengthen regulatory oversight of insurance premiums: Bank Negara Malaysia should require insurers to provide actuarial justification before implementing substantial premium increases.

Insurance companies must demonstrate that any repricing is based on objective factors such as medical inflation, claims experience, reserve requirements, and other measurable financial indicators, rather than arbitrary commercial decisions.

> Ensure fairer insurance pricing: While insurance premiums naturally increase with age, insurers should be encouraged to adopt gradual annual adjustments instead of imposing sudden and excessive hikes.

Annual caps or premium- smoothing mechanisms would help prevent policyholders, particularly senior citizens, from facing unaffordable increases after the age of 60 or 70.

> Strengthen claims management: Insurance companies must enhance their claims management processes by reducing fraudulent and unnecessary claims. They should also work closely with private hospitals to ensure that treatments and procedures are medically necessary and appropriately priced.

Better claims management will help contain overall healthcare costs and moderate future premium increases.

The government, regulators, and the insurance industry all have an important role to play in ensuring that patients receive fair treatment and are not subjected to unreasonable charges. While the cost of individual items may appear insignificant, the cumulative amount collected through such practices over many years could be substantial.

Patients should not be expected to bear unnecessary costs for basic consumables that are integral to routine hospital care. Stronger regulation, greater transparency, and more robust enforcement are therefore essential to restore public confidence in the private healthcare system.

The relevant authorities must act without delay to end these practices, protect consumers from unfair billing, and ensure that every ringgit paid by patients and policyholders reflects genuine and necessary healthcare services.

DATUK Ir LAWRENCE LOW

MCA vice-president

MCA Economic & SMEs Affairs Committee chairman