Medical Insurance Premiums: A Growing Concern for Families and Healthcare Equity
The Impact of Rising Premiums
The Federation of Private Medical Practitioners’ Associations has warned of far-reaching implications for families, high-risk patients, and overall healthcare equity when medical insurance premiums increase by between 40% and 70% as expected next year. The increase in insurance premiums is a reflection of the claims burden on insurers, which is attributable to various factors.
Industry Practices and Systemic Issues
According to Dr. Shanmuganathan Ganeson, president of the Federation of Private Medical Practitioners’ Associations, hospital billing practices could significantly escalate expenses, with creative accounting adding thousands of ringgit to patient bills. Additionally, fraudulent claims by policyholders or the concealment of pre-existing conditions during policy applications are significant concerns.
Pharmaceutical Industry and Regulatory Costs
The pharmaceutical industry consistently increases drug prices each year, even as government-controlled doctors’ fees have remained stagnant for decades. Expensive regulatory costs, such as those imposed by the National Pharmaceutical Regulatory Agency for drug licensing and registration, also add to consumer prices.
Lawyers and Medical Negligence
Lawyers for medical negligence cases, who seek astronomical claims and in so doing push up medical indemnity premiums, further contribute to the overall cost burden.
Poor Performance of Lawmakers
Dr. Ganeson attributed the increase in insurance premiums, above all, to the poor performance of lawmakers and lack of foresight in health policy formulation and implementation. He emphasized that civil servants in authority, who opt for safe retirement and confirmed pensions, do not lift a finger and are not forthright with their political masters of the day to advise them correctly without fear or favor.
Private Healthcare Providers
Private healthcare providers are in a fix regarding controlling costs and improving efficiency amid the rising premiums. Specialist fees have not been reviewed for years while their indemnity costs continue to rise significantly. For instance, obstetricians face annual premiums as high as RM80,000.
Predictions and Concerns
Dr. Ganeson predicted a noticeable decline in demand for private medical services due to the premium hikes, especially among high-risk groups who leave the private healthcare system. He stressed that the rising costs of medical care negatively affect healthcare providers, policyholders, and overall healthcare equity in the country.
Conclusion
The significant burden that a 40% to 70% increase in premiums would place on individuals and families, especially those already struggling with the rising cost of living, is bound to be devastating. Ten percent of per capita income for medical insurance would be reasonable. If it goes higher, many would invariably depend on public healthcare. Going to private facilities would become a luxury.
FAQs
Q: What are the main factors contributing to the increase in medical insurance premiums?
A: The main factors contributing to the increase in medical insurance premiums include hospital billing practices, fraudulent claims, pharmaceutical industry prices, regulatory costs, and lawyers for medical negligence cases.
Q: What is the expected increase in medical insurance premiums?
A: The expected increase in medical insurance premiums is between 40% and 70%.
Q: How will the increase in premiums affect healthcare providers and policyholders?
A: The increase in premiums will negatively affect healthcare providers, policyholders, and overall healthcare equity in the country.
Q: What can be done to address the issue of rising medical insurance premiums?
A: Addressing the issue of rising medical insurance premiums requires strong leadership in the Health Ministry to unravel the systemic issues contributing to the problem.