Some co-pay policyholders may have to pay even more as there is no cap on the hospitalisation amount. The situation gets worse since, starting next year, insurance and takaful operators will not be permitted to offer new non-co-payment products, according to the Medical and Health Insurance/Takaful Business Policy document.
HEALTHCARE insurance and takaful policyholders are expected to pay more for treatment of covered illnesses on top of their monthly premiums but this does not seem to reflect the “whole-of-nation” approach.
For the much talked about approach to work, society, including the economy and public institutions, must collaborate closely to resolve problems.
It seems the burden is being placed squarely on the shoulders of policy holders without seeking a more sustainable or effective option to keep healthcare costs down.
A co-payment option will be offered by insurance and takaful operators from September onwards. The minimum deductible is RM500 or 5% of the total medical bill for the policy year, with no cap on the bill amount.
Insurance and takaful premiums will be lower for those who choose co-payment option. This option is to encourage more responsible usage of healthcare services, reduce false claims and minimise the use of the suite of treatments or medications that policyholders with no co-payment option may not need but are covered for, which is referred to as “buffet table syndrome.”
According to the Medical and Health Insurance/Takaful Business policy document published by Bank Negara Malaysia on Feb 29, co-payments will not apply to emergency treatment, including for accidents, outpatient treatment for follow-up treatment arising from critical illnesses such as for cancer or kidney dialysis and, treatment sought at a government healthcare facility.
An excerpt from CodeBlue, a popular healthcare news portal, went viral on social media platforms late last week. It became the subject of concerned inquiries by policyholders to their insurance or takaful agents, but there appears to have been no other communication on the matter.
Policyholders are rightly worried because, even though this is an option, the government has not made any media statements. This makes it look like the measure is quietly being pushed through at a time when the cost of living and healthcare costs continue to rise.
The majority of middle-income earners, who have healthcare insurance, are asked to pay out-of-pocket even when they diligently pay their monthly premiums. The biggest question among policyholders is: “What about private hospitals? Why aren’t they holding down costs? ”
The issue of who is doing what is also never-ending as insurance companies and takaful operators blame private hospitals for not keeping costs down.
Private hospitals, according to a senior medical specialist, invest in technology and machinery to provide the best service and treatment, so patients who seek treatment at these hospitals also expect a certain level of service and care. It is surely fair to explain to the public, or at least policyholders, why healthcare costs continue to rise and why they are being singled out for increased costs.
Co-payment does not consider how people will always choose the cheaper alternative without considering the consequences of having a serious illness and not having enough money to pay the 5% co-payment.
For example, if a person spends three months in a hospital and incurs costs of RM300,000, their co-pay is RM15,000. It is likely that many policyholders will not have emergency cash reserves, as according to the National Strategy for Financial Literacy 2019-2023, 52% of Malaysians have difficulty raising RM1,000 in an emergency.
How many policyholders are there? Furthermore, more than four-fifths of Malaysians who claim to save do so only to meet their immediate needs.
Some co-pay policyholders may have to pay even more as there is no cap on the hospitalisation amount. The situation gets worse since, starting next year, insurance and takaful operators will not be permitted to offer new non-co-payment products, according to the Medical and Health Insurance/Takaful Business Policy document.
What is the individual seeking protection and some semblance of assurance insuring for if not against life’s vicissitudes when he or she is ill or disabled? If policyholders are unable to afford their co-payments, will the public healthcare system be able to cope?
This article first appeared in Star Biz7 weekly edition.
