Fragmented system

The Star: THE healthcare financing system in Malaysia is currently too fragmented, with individuals relying on separate resources, including the public and private healthcare sector, the Employees Provident Fund (EPF), the Social Security Organisation (SOCSO), private health insurers and the pension fund.
Government hospitals and clinics have a non-profit making policy, while the private sector operates according to separate fees, within a profit margin.
“EPF covers part payment for catastrophic illnesses, which is limited to 10% of the member's savings. SOCSO covers only employment-related illnesses and accidents or traumas. Both EPF and SOCSO cease coverage when their members are retired,” explains Dr Kananatu Krishnan, adviser, Health Solutions (SE Asia) Sdn Bhd.
Many people now rely on private insurance as an alternative financing source.
“The most common schemes are group insurance schemes through co-operatives and employer-employee collective agreements, which cover scheduled illnesses for selected age groups,” says Dr Kananatu.
He adds that private health insurance is risk-rated, with premiums increasing with age or selected risk factors. (Risk-rated means certain criteria are used to determine your eligibility for a policy or the amount of premium to be paid.)
Our healthcare financing system is not without its weaknesses.
“With the current system, most retirees are left in the lurch (at a time when) quality of life has to be maintained. There is no social security scheme to support them when their needs are greater, except the government hospitals and clinics,” says Dr Kananatu.
Malaysia should also strive to have a one-tier healthcare system, where access to quality is more uniform. Currently, we have a two-tier system where “if you can afford it, you go to a private hospital for faster service and so forth, but if you can't afford it, you go to a government hospital,” says Tan Sri Datuk Dr Abu Bakar Suleiman, former director-general in the Health Ministry and currently president of International Medical University.
He stresses that government hospitals do not provide inferior care compared to private hospitals, but there are differences in terms of patient satisfaction and comfort.
Dr Kananatu also points out that the current system subsidises the poor as well as the rich. “This kind of misuse and abuse in the healthcare financing scheme exists even today, and this has to be rectified.”