AS the 13th Malaysia Plan (13MP) was announced in this most recent Parliament sitting, many Members of Parliament voiced concerns over the rising cost of living, particularly in relation to healthcare.
These concerns were not mere rhetoric; they reflect real anxieties faced by real members of the public, and genuinely echo the voices and concerns of patients.
While the Health Ministry has outlined several plans to address concerns that are underway, such as the development of medical and health insurance/takaful policies and other structural reforms, many doctors are hearing this recurring feedback from our patients: “When will these plans actually change how much I pay at my next doctor’s visit or for my next procedure?”
This is a fair question. Sustain-able and meaningful healthcare reform takes time, and implementation across the system, from policy to practice, is a complex process.
I understand that the ministry is currently continuing its work in data collection for a Diagnosis-Related Group (DRG)-based hospital payment system.
Both insurers and private hospitals are also actively contributing to these efforts through the Joint Ministerial Committee for Private Healthcare Cost, which is engaged in collaborative studies on medical cost structures and recommendations for more transparent pricing.
For the everyday patient however, the wait for policy-level change can feel long and uncertain.
While systemic reforms unfold, there are practical steps patients can take to regain a certain degree of control over their healthcare finances.
Minimising the unexpected
I often advise patients not to wait for illness to strike, and instead to start reviewing their current health insurance or takaful plans now. Not all policies are created equal, and many insurance policy subscribers don’t fully understand what their coverage includes until they need it.
It is important to understand what conditions and treatments are covered by the policy, if there are any co-payments or caps, if additional riders are needed for specialist care or chronic conditions, if the plan includes outpatient care, diagnostics, or rehabilitation, and so on.
Reviewing and updating your policy can make a significant difference in minimising unexpected out-of-pocket expenses and managing stress in unexpected situations. If the coverage is not the best fit for your current health conditions, speak to a financial advisor to see what makes the best financial and medical sense for your unique situation.
It is also essential for patients to understand what their insurance policy covers and to stay informed about updates or changes. Private hospitals must do the same to ensure alignment and avoid misunderstandings during the claims process.
For example, the Life Insurance Association of Malaysia and the General Insurance Association of Malaysia recently issued a reminder to private hospitals and doctors that a guarantee letter (GL) does not equate blanket coverage – ie, it does not necessarily mean that all costs will be covered. Insured patients are strongly encouraged to review their policy details carefully and consult with their insurance agents to fully understand the scope and limitations of their coverage.
Bear in mind that many employers offer healthcare benefits that go unused simply due to lack of awareness. These might include annual check-ups, dental coverage, mental health services, or even subsidies for private medical treatment. I strongly encourage Malaysians to take advantage of these regular checkups.
The 13MP places a strong emphasis on preventive and primary healthcare. This is a strategic move that benefits both Malaysians as individuals and the nation as a whole in the long run. By focusing on early intervention and disease prevention, we can significantly reduce overall healthcare costs, while helping Malaysians live longer, healthier lives.
For patients paying out-of-pocket, private hospitals often offer structured payment plans or instalment options. Some even have joint plans with third-party payment facilitators or offer credit facilities for larger procedures.
Patients are encouraged to speak to the billing department about these options. In addition, most private hospitals provide financial counselling services to help patients estimate treatment costs, navigate insurance claims, and understand alternative payment options.
As part of the government’s efforts to empower patients in managing their healthcare, the Medicine Price Display Order came into effect on May 1.
While this initiative aims to promote transparency, many private hospital operators believe that displaying medicine prices alone is insufficient to truly educate patients about the overall cost of care, particularly in inpatient settings.
Medication represents just one component of a hospital bill. In a real-world scenario, patients are more concerned with understanding the full range of potential charges in their bill, including consultation fees, laboratory tests, and other associated costs. Without this broader context, price transparency efforts may fall short of their intended impact.
In light of this, the Association of Private Hospitals had a recent engagement with Health Minister Datuk Seri Dr Dzulkefly Ahmad to advocate for the inclusion of financial counselling as a more comprehensive and effective tool to empower patients manage their healthcare financing. During the meeting, the minister expressed his support for financial counselling services, recognising their value in helping patients better understand their medical bills and explore available payment options.
Medical financial counselling
Financial counselling is not a new concept. Many private hospitals have long been offering complimentary financial counselling services, which are available to all patients to improve healthcare cost literacy and supporting informed decisions.
In addition, patients can speak to their doctor who would be able to provide an estimated cost range for any treatment or procedure. While it may not be possible to quote an exact figure since unexpected developments during a procedure can lead to additional charges, a cost range would provide patients with a reasonable idea of what to expect and enables patients and their families to plan their finances more effectively, avoid surprises, and make informed decisions aligned with their budget.
In many cases, alternative diagnostic approaches or phased treatment plans can be tailored to suit both medical and financial needs, and doctors would be able to assist patients to find the right balance.
The reality is, as the cost of living increases, the cost of healthcare increases in tandem. Never-theless, for many Malaysians, healthcare is a non-negotiable priority, and many are willing to spend on it because good health is invaluable.
Recognising this, private hospitals have and will continue to play a supportive role to the public healthcare system by contributing to key areas highlighted in the 13MP, including in the areas of education, supporting government-led public health programmes, and alignment with national healthcare goals.
To date, many proactive steps have been taken by private hospitals, and initiatives to support the nation’s healthcare agenda will only be enhanced moving forward. The Association of Private Hospitals Malaysia recently proposed to both the Public Accounts Committee and the government initiatives to enhance billing transparency.
The association has also expressed willingness to collaborate on industry and government reviewing for billing restructuring used by insurers and private healthcare providers, which has been welcomed by the government.
Malaysia is fortunate to have a dual healthcare system where public institutions provide accessible care for all, while private facilities drive medical innovation, and offer advanced treatments and global competitiveness.
This complementary balance not only reduces the need for Malaysians to seek treatment abroad but also strengthens our position as a hub for medical tourism, contributing to national economic growth.
While industry stakeholders and the government collaborate to moderate rising medical costs, my hope is that patients do not feel powerless in their day-to-day healthcare experiences during this ongoing process.
By proactively understanding the insurance options available, engaging openly with healthcare providers, and utilising available financial counselling services, patients can take meaningful control of their healthcare finances. This empowerment is crucial, not only for peace of mind but also to ensure that the healthcare system can serve Malaysians effectively and sustainably in the future.
Ultimately, your health is your most valuable asset. Taking charge of your healthcare financing is not just about managing costs but more importantly, about securing your wellbeing and that of your loved ones for years to come.
Datuk Dr Kuljit Singh is president of the Association of Private Hospitals Malaysia and an independent director of the Malaysia Healthcare Travel Council Board. The views expressed here are solely the writer’s own.
