The top ten most claimed illnesses under medical insurance include pneumonia, influenza, and fever, says the Finance Ministry.
Deputy Minister Lim Hui Ying, responding to Sim Tze Tzin (PH-Bayan Baru) during the ministerial Q&A session in the Dewan Rakyat on Wednesday (Feb 26), noted that in some cases, treatment costs for patients using pay-and-claim insurance were lower than for those with guarantee letters.
She added that while the government has not considered a national health insurance scheme, it remains open to studying the possibility in the future.
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Deputy Minister Lim Hui Ying, responding to Sim Tze Tzin (PH-Bayan Baru) during the ministerial Q&A session in the Dewan Rakyat on Wednesday (Feb 26), noted that in some cases, treatment costs for patients using pay-and-claim insurance were lower than for those with guarantee letters.
She added that while the government has not considered a national health insurance scheme, it remains open to studying the possibility in the future.
Read more at https://tinyurl.com/3vddtwba
WATCH MORE: https://thestartv.com/c/news
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NewsTranscript
00:00Based on the initial data base of the Industry Insurance and Taqaful or ITO,
00:08among the types of diseases that recorded a high increase in demand
00:13without a specific decline for hospital treatment in 2023
00:19under the Insurance and Taqaful of medicine and health or MHIT, including pneumonia,
00:26problems related to the back bones,
00:29problems with the digestive system, heart disease,
00:32kidney and ligament injuries such as dislocation and inflammation,
00:38acute appendicitis, virus and influenza infections,
00:43other problems related to the respiratory system such as bronchitis
00:48and upper respiratory tract infections or with the permission of upper respiratory infection,
00:55ear, nose and jaw diseases or ENT, and finally, fever.
01:01Based on research on the bill of the private hospital request to the ITO,
01:06there are certain cases that show a higher cost of treatment
01:11for patients who use a letter guarantee
01:15compared to patients who pay first and then request,
01:19or pay and claim with permission.
01:22Given that the treatment charge is not clear,
01:26more detailed research needs to be carried out
01:30to better understand the issue of the difference in charge
01:34and the steps that can be taken.
01:37The government is critical of this issue,
01:39including the experiences of the people voiced
01:43during the public hearing session of the new PAC state budget.
01:50Therefore, the government, through the Ministry of Health of Malaysia,
01:53continues to work together with all stakeholders,
01:57including the Ministry of Finance, the private hospital and the ITO,
02:01are working together to find a long-term solution
02:06and will focus on overall health reform
02:10to deal with the issue of inflation of treatment costs and charge charges at private hospitals.
02:16This includes increasing the transparency of treatment costs
02:19as well as the comparison of regular treatment costs.
02:22This joint action plan was also put forward to the PSC yesterday.
02:28Thank you, Mr. Speaker.
02:32Thank you, Honourable Minister,
02:34for clarifying that there is a difference between pay and claim and also guarantee letter.
02:41That is because when people enter private hospitals,
02:45they are surprised because the first question is not what is going on with you,
02:50what happened to you,
02:51but the first question is, do you have an insurance?
02:55So this is the problem in Malaysia and I hope the government will reform.
03:00My additional question to the Honourable Minister,
03:03is that the Bank of Malaysia on 15 January
03:08has issued a notice to all ITOs
03:13and they have to comply.
03:15But now we see that the people have various confusions
03:19because the surroundings, is it retrospective or prospective?
03:24And there are various interpretations that are not correct,
03:30so the letters are still confusing the people.
03:34I ask the BNM to look into this problem.
03:38And also I would like to say to the Honourable Minister,
03:42about the claim rejection by insurance companies,
03:45it is increasing.
03:46There are half of the people who enter the hospital,
03:49in the past, for example, cancer treatment,
03:53in the past they could claim certain procedures,
03:57but now they have to reject.
03:59And also generic medicines,
04:01now the insurance companies have only issued a letter to private hospitals
04:07that they need to change from the originator to generic medicines.
04:14Actually, there are half of the medicines that are not even generic.
04:18So how do we solve this problem?
04:21And the insurance companies also ask the private hospitals
04:31to give a high rebate,
04:33between 25% to 30%.
04:35If they do not give a rebate,
04:38they will be fired from their hospital panels.
04:44So I ask the government to look into this dispute
04:48between private hospitals and insurance companies.
04:52Honourable Minister.
04:53There are a lot of questions.
04:54Honourable Minister, you can only answer one.
04:57If not.
05:00The regulations are clear.
05:02Our regulations are in the Regulations Book, Regulation No. 24.
05:06It's up to the Minister, but time is precious.
05:09Thank you, Honourable Speaker.
05:12Thank you to the honourable new members.
05:16We are aware of the importance of this issue
05:20and everyone is very concerned about this issue.
05:26First, the government should be aware
05:29that the current state of affairs is complicated
05:33and requires the cooperation of all parties,
05:36including the Ministry of Finance, Ministry of Health,
05:39private hospitals, ITO and medical practitioners.
05:43This issue cannot be solved just like that.
05:48We have taken many initiatives,
05:50including the improvement of the country's health sector
05:53which will be immediately implemented by the government
05:56and the Ministry of Health.
05:58For the past three years,
06:00including the implementation of the Transition to Ease of Life
06:03and the Adoption of Private Health Care in 1998,
06:07the improvement of cost efficiency
06:09by reducing the cost of compulsory medical treatment,
06:13the implementation of the Diagnostic Related Group model
06:17or DRG,
06:18to determine the overall cost of medical treatment
06:21by replacing the fee-for-service system
06:25and increasing the cost-based treatment.
06:27We will also expand the availability of health services
06:31such as KKM and hospital development without benefits.
06:35The government through the Bank of Malaysia
06:38will transform the structure of MHIT products
06:41through the development of basic products
06:43with more affordable features
06:45besides prioritizing health care based on value.
06:50Finally, I would like to thank the honoured guest.
06:55He is also a member of the PAC.
06:58So, if you have any questions,
07:00we can, like the honoured guest earlier,
07:03we can discuss
07:05and get more answers from the honoured guest.
07:09Please, because my additional question
07:11was not answered in time.
07:14So, Minister, please give me a written answer.
07:18Thank you, Minister.