Navigating The Future of Healthcare Financing In Malaysia

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The Association of Private Hospitals of Malaysia has proposed the establishment of a regulatory body to oversee reimbursement processes carried out by private payors in the domain of private healthcare financing. APHM has raised concerns regarding the Ministry of Health’s (MOH) active exploration of a public-private partnership model for healthcare delivery, which involves outsourcing services and introducing private financing initiatives. Dr. Kuljit Singh, the president of APHM, expressed apprehension that these private payors might hinder access to appropriate healthcare coverage and treatment for patients in the pursuit of reducing healthcare costs. He emphasized the importance of maintaining ethical payment practices by payors while controlling healthcare costs. APHM is willing to collaborate with the government, payors, and private hospital members to address this issue and make healthcare costs sustainable for all parties involved.

One example of a public-private partnership is the Madani Medical Scheme (SPM), where the government allocated RM100 million for a nationwide pilot project to fully cover the treatment of acute conditions at private general practitioner (GP) clinics for low-income earners. However, medical professionals have complained about the reimbursement rates set by ProtectHealth Corporation Sdn Bhd, a company owned by the MOH, as they are below market rates for consultations, medications, tests, and basic procedures. Health Minister Dr. Zaliha Mustafa announced at the HMA conference that the reimbursable fees for panel GP clinics are currently under review.

The HMA conference also delved into discussions regarding strategies to address the shortage of nursing professionals, reimagining the roles of nurses, tackling the issue of brain drain, and emphasizing empowerment through task delegation and the utilization of automation.

In addition to exploring public-private partnerships, Dr. Kuljit highlighted the reform of healthcare services in Malaysia through the Health White Paper (HWP), which outlines healthcare reforms over 15 years. He mentioned that transitioning to the proposed healthcare system in the HWP would involve adopting revolutionary technologies like generative artificial intelligence, which has the potential to generate text, images, and other media using generative models, promising advancements in healthcare.

Dr. Kuljit also expressed satisfaction with the government’s collaboration with prominent Big Tech companies to develop the National Health Records system, which aims to transform how health information is handled and accessed. Furthermore, he mentioned collaborations with entities such as Bank Negara, EPF (Employees Provident Fund), KWAP (Retirement Fund, Incorporated), and Perkeso (Social Security Organisation) to address social healthcare financing issues, intending to enhance healthcare services and achieve seamless integration across sectors. Dr. Kuljit emphasized that the private healthcare sector is actively working to build a more efficient and comprehensive healthcare system that benefits everyone.

In his keynote address, Dr. Kuljit emphasized the importance of embracing change in healthcare as a catalyst for innovation. He acknowledged that healthcare stands at the intersection of technological change, patient care, and administrative advancements, and this recognition empowers healthcare providers to create a more efficient system. He emphasized that healthcare comes with a premium cost, driven by profit and technology expenses.