Materia Medica Malaysiana

PAY FOR YOUR HEALTH

The proposed National Health Insurance (NHI) scheme is scheduled to take off at the end of next year, with most Malaysians required to make mandatory contributions.
A consultant has been appointed to identify details under the scheme.
These include:
• the quantum of payment;
• criteria and ceiling for contributions;
• the collection mechanism;
• the nature of basic health packages; and,
• how the ministry will pay clinics and hospitals.
The scheme will also prepare specialised packages for members who want better service.
Those exempted from payment include the one million civil servants, about 200,000 disabled, 1.8 million elderly, 435,000 pensioners, 250,000 hardcore poor and an undetermined number of unemployed.
The Health Ministry is in the midst of identifying groups in the private sector exempted from payment.
Private sector staff deemed ineligible for free treatment will participate as paying members in the Essential Healthcare package under the scheme.
Ministry Planning and Development Division Evaluation and Plan Formulation Unit head Dr Rohaizat Yon said contributions could begin once paying members were identified.
"It’s a single national healthcare financing system with a single fund manager," he told a Medical Law conference today.
The conference, themed "Current developments and future implications", was organised by LexisNexis and the Malayan Law Journal Sdn Bhd.
Dr Rohaizat said the NHI would be managed by the National Healthcare Financing Authority.
"Its implementation is viable and sustainable and in line with Vision 2020," he said.
The scheme would provide better care, access to facilities and financial risk management in the event of ill health.
As for healthcare providers, there would be better incentives to cover the rural population, greater opportunities, improvement in the reimbursement system, increased efficiency and better use of new technologies.
The healthcare system would see greater integration, efficiency and quality, besides optimal resource utilisation and focus on preventive programmes.
The main objective of the NHI was to mobilise "risk sharing", pooling of resources (community-rated system) and better management of health expenditure.
"It is also to enhance efficiency and quality, to have greater integration in health both in the public and private sectors and to have better regulation of health care providers," he said.
All this would lead to greater sharing of responsibility and accessibility to quality healthcare.
During the panel discussion, Malaysian Employers Federation economist Azizah Talib questioned the rationale behind the NHI as the private sector was meeting most of the healthcare requirements of workers.
She said 98 per cent of companies provided medical consultation and treatment to executives, 96 per cent provided hospitalisation benefits, 57 per cent medical and hospitalisation and 53 per cent dental benefits.
She said they also bore 54 per cent of the medical expenses of executive staff, with 92 per cent of companies allowing executives to seek treatment either at government or private hospitals.
As for non-executives, she said 97 per cent of private companies provided medical consultation and treatment, with 40 per cent extending benefits to dependents.
Azizah said 55 per cent of private companies bore the medical expenses of non-executives while 22 per cent bore medical consultation and treatment expenses up to a pre-determined limit.
She said collective agreements between private sector unions and employers usually included free medical treatment from a panel of doctors.
At present, she said, employers also had to bear the Employees Provident Fund contribution of 11 per cent and Social Security Organisation contribution of 1.75 per cent.
"Will the new health insurance plan be an additional burden to employers?" asked Azizah who added that employers also had to pay for a general health insurance policy for workers.
Dr Rohaizat said the ministry was in the midst of ironing out some of these issues with the authorities.