Do more or fat chance Malaysia will reduce obesity, govt told

The Star Online

KUALA LUMPUR: The Government needs to be more serious in battling obesity, the Malaysian Association for the Study of Obesity says.

Its president Prof Dr Mohd Ismail Noor said that creating awareness and public education were not enough.

“At some point, the government has to be more serious about controlling the environment that encourages obesity.”

He said this yesterday after the official launch and opening of Nutrition Month Malaysia 2014 by Health Minister Datuk Seri Dr S. Subramaniam.

Dr Mohd Ismail urged the local authorities to shut down all food outlets by midnight instead of allowing them to run 24 hours.

He said the argument that these outlets were kept open for night shift workers did not hold water because many youngsters were frequenting the outlets.

He noted that some countries had imposed a tax on sweet soda drinks.

While the Government needed to be more committed in battling obesity, he added it was also everyone’s responsibility and required a multi-pronged approach.

Asked whether the Health Minist­ry would limit the number of 24-hour food outlets, Dr Subramniam said the emphasis was still on educating people about good eating habits.

“You ban them or you educate people not to use them.

“Life’s temptations will always exist but you need to educate them,” he said.

As to why the Government had yet to create the healthy environment for people to walk or expend their energy (safe walk and bicycle paths along roadways) that was planned many years ago, Dr Subramaniam said the problem was in the implementation.

“There must be greater emphasis on adhering to government policy and guidelines by local authorities,” he said.

The National Health and Morbidity Survey revealed that the rate of obesity in Malaysia had increased by almost three and a half times, from 4.4% in 1996 to 15.1% in 2011.

This puts the number of obese Malaysians at around 2.5 million.

The Nutri-Fun Land Family Carnival is held at Mid Valley Exhibition Hall 1 in conjunction with the Nutrition Month. It ends today.

Confusion over exact percentage of medical fee rise

The Star Online

PUTRAJAYA: Private medical fees are up, but there is confusion over the exact percentage of the rise.

While the Health Minister said the increase has been capped at 14.4% – less than half the amount the Malaysian Medical Association had requested – the medical schedule showed hikes of a few hundred per cent on certain fee ceilings.

Consultation fees, for instance, increased from a range of RM10-RM35 to a new range of RM30-RM125.

While the Health Minister Datuk Seri Dr S. Subramaniam said that the fees were the maximum amount that doctors were allowed to charge and they were free to charge less.

“Those (in the fee schedule) are the maximum rates. We are protecting the people from being charged exorbitantly by the private sector,” he told a press conference here on Wednesday.

On Monday, it was highlighted that the amendment to the 13th Schedule of the Private Healthcare Facilities and Services Act 1998 was implemented without sufficient publicity and awareness of the issue.

The Private Hospitals and Other Private Healthcare Facilities Regulations 2006 of the Act, which was published in the federal gazette on Dec 16 last year, provides for the maximum chargeable fees for registered medical and dental practitioners practising in private hospitals in terms of their professional fees such as consultation and performance of procedures.

These fees were based on Malaysian Medical Association (MMA) Schedule of Fees 4th Edition 2002.

Dr Subramaniam said the ministry had rejected the Malaysian Medical Association’s request for a 30% increase.

He added that the 14.4% increase was reasonable given that the inflation rate was around 23%.

He also said that the previous minister Datuk Seri Liow Tiong Lai did keep the public informed of the increase in July 2012 and the fee schedule was brought to the Cabinet and approved on October 12 the same year after consulting various stakeholders.

The Ministry directed to review the fee schedule in Sept 2010.

However, Health director-general Datuk Dr Noor Hisham Abdullah said that the 14.4% increase was the average fees for surgical and dental procedures.

He said that the doctors’ consultation charges that was increased from a range of RM10-RM35 to a new range of RM30-RM125 took into account of the rental cost in different locations.

Dr Subramaniam said that the market forces were expected to determine the fees that facilities would impose within the ambit.

“Prudent and discerning public are encouraged to seek treatment at private facilities charging reasonable rates,” he said.

The other components of the hospital charges such as fees for accommodation, laboratory investigations, nursing care, use of equipment, operation room, drugs used were not regulated due to the varying costs in operating and maintaining a private hospital at different areas, he said.

The new medical fees schedule was the first revision since it was regulated in 2006. The fees were recommended by the MMA since 2002, he said

Health ministry continues to monitor haze situation, says minister

MSN Malaysia News

The Health Ministry, through the respective State Health Departments, continues to monitor ailments linked to the haze, namely, upper respiratory tract infections, asthma and eye diseases.
Health Minister Datuk Seri Dr S. Subramaniam (pic) said in a statement today, that the monitoring was conducted by selected sentinel clinics in states afflicted by the haze.

He said those experiencing ailment such as cough, flu, asthma, eye problems and chronic lung infection should go to the clinic quickly if their situation worsened.

"The ministry wishes to advise the public to take preventive measures to reduce the effect of the haze including reducing physical activities outside the house, always seek to be in a building and, if forced to go out, to wear suitable nose and mouth masks.

"Furthermore, ensure air in the house/building is clean by reducing internal sources of pollution such as cigarette smoke. When driving and using air-conditioning, switch to internal air circulation operation mode," he said.

He also encouraged the public to drink plenty of water, at least eight glasses a day, and to wash hands and face with clean water after any activities.

Subramaniam said the ministry had monitored the haze in the country from 52 Department of Environment (DOE) air quality monitoring stations, since 7am on February 26.

"Based on our monitoring, several states on the West coast of the peninsula were found to be experiencing haze with unhealthy Air Pollution Index (API) readings (exceeding 100)," he said.

The areas are Nilai, Banting, Petaling Jaya and Batu Muda (Kuala Lumpur) as of 5pm today.

According to the DOE website, as of 5pm today, 19 areas recorded good API levels and 27 areas recorded moderate API readings.

The public can seek information on preventive measures through the health ministry's website at InfoSihat andMOH. – Bernama, March 4, 2014.

Subra: Medical fee cap to protect public

Free Malaysia Today

PUTRAJAYA: The fee hike for private healthcare costs is done in order to protect public interest, Health Minister Dr S Subramaniam said today.

He said the fee amendments under the 13th Schedule of the Private Healthcare Facilities and Services (Privates Hospitals and Other Private Health Facilities) Regulations 2006 would make private healthcare providers compete among themselves to provide better services.

“Under the revised fee, action can be taken against doctors who charge more than what is proposed in the schedule,” he said, adding the ministry was instructed to review the prices in 2010.

Subramaniam added that the 14% rate hike for private medical and dental practitioners was done after studying the consumer price index (CPI) for healthcare between 2002 and 2010.

“In my experience, the public will avoid any clinics which charge high fees. Thus, I believe the private hospital would not impose the maximum charges,” he said.

The revision included a spike in consultation charges from between RM10 and RM35 to RM30 and RM125 for general practitioners, and from between RM30 and RM125 to RM80 and RM235 for specialist doctors.

Fees for medical procedures have soared between 14% and 18%.

Dr Subramaniam said the Health Ministry reviewed the 13th schedule on Sept 22, 2010.

Fees for consultation and medical procedures have not been revised since 2002 and is considered low compared to other nations.

“Consultations and meetings were held. We established two committees and a working group. We then forwarded the proposal to the cabinet which approved the amendment to the 13th schedule on Oct 12, 2012,” he added.

The amended schedule fee structure, was presented to the Attorney-General’s chambers on April 29, 2013 and gazetted on Dec 16 after the cabinet’s approval.

The minister also assured Malaysians that the fee structure would not be amended again, at least for another three to four years.

“It was just gazetted last year. The people need not to worry about the increase of the fees after this,” he added.

Increase in current medical fees acceptable, says MMA

The Star Online

PETALING JAYA: The new increased medical fees following the amendment to the Private Healthcare Facilities and Services Act 1998 are considered acceptable by the Malaysian Medical Association.

Its president Datuk Dr NKS Tharmaseelan said that MMA had been waiting for the increase for 12 years as the prices of drugs, laboratory fees and petrol had increased.

"There is a misconception that GPs are raking in lots of profits when they were actually scraping the bottom of the barrel these days," he said in an e-mail reply.

More than 500 stand-alone general practitioner clinics had closed down or had been bought over by large chain-clinics or business corporations in the last few years, he said.

On Monday, an online news portal highlighted that amendment to the 13th Schedule of the Act was published in the Federal Gazette on Dec 16 last year and implemented in a hush-hush manner.

It reported that the new consultation fees for a general practitioner had increased to between RM30 and RM125, as opposed to RM10-RM35 previously, while a visit to a specialist now costs up to RM235 for consultation alone, nearly double the previous cap of RM125.

Fees for medical procedures, however, increased between 14-18%.

Dr Tharmaseelan also said that while the increase did not reflect inflation rates since 2002, fees on newer procedures were not included in the revised schedule as proposed by MMA and would be left unregulated.

MMA president Datuk Dr NKS Tharmaseelan.

He also said that doctors do not get all the fees charged for services - for short surgical procedures, the ratio might be 40:60 of the total bill for specialist and hospital respectively while for more complex procedures and long staying patients, it might be as low 20-25% for specialist, while the rest were hospital charges.

Moreover, third-party administrators such as managed care organisations (MCOs) often negotiate a discount of 10% to 15% on doctors' fees for hospitals without the consent of the doctors.

"There should be more transparency about the charges," he said.

Medical Practitioners Coalition Association of Malaysia president Dr Jim Loi said that in the past, a general practitioner in a standalone clinic was able to earn a monthly net income of RM40,000 in the Klang Valley, but it had since dropped to RM15,000.

He added it posed a challenge to them as they too had to pay mortgages and send their children to colleges.

He said the more worrying trend was the increase in drug prices - including generic drugs - every few months and doctors had been absorbing the cost.

Federation of Malaysian Consumers Association deputy president Muhammad Sha'ani Abdullah said that the Government must justify the high fee increase.

He said that currently, there were doctors who still charge RM15 for consultation and if that was the case, that should be made the fee for the lower ceiling.

"Why must the lower ceiling increase from RM10 to RM30? That is a 300% increase," he said adding that it was considered price-fixing when the price is set higher than the market floor price.

He also said that drug supply should be made open tender and not monopolised by Pharmaniaga Bhd.

D-Day on doc’s fees

theSundaily

KUALA LUMPUR: Private hospitals and clinics will know tomorrow whether they can increase, with immediate effect, their fees for medical consultation and procedures.

Health Minister Datuk Seri Dr S. Subramaniam will make the announcement after the ministry's post-cabinet meeting.

This was the response of Health Director-General Datuk Dr Noor Hisham Abdullah when asked to comment on a local news portal's report today on the possibility of a fee hike following the amended 13th Schedule of the Private Healthcare Facilities and Services Act 1998 which was gazetted on Dec 16 last year.

"The minister will inform the media tomorrow on the ministry's stand on the issue," he said.

Doctors in the private sector have not had an increase in their fees for the past 15 years and neither has the ministry drawn up any new schedule of fees for them.

The Malaysian Medical Association (MMA) had last year asked for a 30% increase in consultation and procedural charges, but had to put it on hold following a public outcry.

MMA president Datuk Dr N.K.S. Tharmaseelan said today that doctors needed an increase in view of the rise in living and operating costs.

"It's been a long time since the last increase," he added.

General practitioners get between RM30 and RM50 per consultation while specialists charge between RM50 and RM80.

Tharmaseelan had earlier been quoted as saying that it was a misconception that doctors were rich and greedy.

"Many doctors are scraping the barrel with the rising utility bills, rentals and salaries (for staff). Quite a few have even quit practice as it's too expensive to maintain a clinic," he said.

On average, the operating cost for a general practitioner to run a clinic in Kuala Lumpur is about RM20,000 per month.

Tharmaseelan said a general practitioner, for instance, charges between RM45 and RM50, including medication, for a patient having cough and cold.

He said a fee increase is necessary for doctors to cover their "basic costs" in view of mandatory rulings like paying minimum wage.

Now, doctors are also required to have medical indemnity insurance, hire radiographers and engage waste disposal contractors for their clinics, he added.

Private clinics, hospitals to charge more after minister gazettes new fee structure, says report

The Malaysian Insider

An amendment to the 13th Schedule of the Private Healthcare Facilities and Services Act 1998 is set to push medical fees in private clinics and hospitals by several fold, said a report.

News portal Malaysiakini said the amendment was gazetted on December 16 last year without much fanfare, as even members of parliament were not informed.

But the report said the health minister is legally not required to consult MPs, as spelt out by Section 106(2) of the same act, giving the minister powers to amend prices in the schedule after consulting the health director-general.


The increase in medical costs involved fees charged by doctors, from general practitioners to specialists and surgeons.

The new charge for a clinic consultation is now between RM30 and RM125, as opposed to RM10-RM35 previously.

A visit to a specialist may now cost up to RM235 for consultation alone, double the previous cap of RM125, while fees for medical procedures will be increased between 14–18%.

Several MPs with medical backgrounds have spoken out against the increase and the manner in which it was rushed through.

"As a former medical practitioner, I feel this drastic price increase is not warranted... the rakyat are already suffering from all kinds of price hikes," PKR's Wangsa Maju MP, Dr Tan Kee Kwong told Malaysiakini.

Sungai Siput MP Dr Jeyakumar Devaraj, however, said that while stiff competition among general practitioners would mean the fee hike would not be followed, the same would not be the case with medical procedures.

Dr Jeyakumar also criticised the government's investment in private healthcare, saying it was a serious conflict of interest as the government should be focusing on improving public hospitals. – March 4, 2014.

Malaysia aims to break into medical tourism market in big way

New Straits Times

NEW YORK: Since the general character of the tourism industry is gradually compartmentalising itself into highly specialised money-spinning segments, tourism experts are busy devising strategies that would open up these individual segments for them.
Malaysia, for example, is eyeing the medical tourism sector which is inherent with considerable revenue-generating potential as patients in developed western countries, particularly in the United States (US), are looking for good quality but low-cost sites which offer not only medical services but also have attractive tourism attributes.

"As a corporatised agency funded by the Malaysian Government, we are promoting healthcare travel and are positioning Malaysia as a preferred healthcare destination,” explained Kuala Lumpur-based Malaysia Healthcare Travel Council (MHTC) chief executive Dr Mary Wong, in an interview with Bernama at the ongoing three-day New York Times Travel Show (NYTTS).

At the NYTTS, she also presented at a seminar, a book titled 'Patients Beyond Borders' by Josef Woodmann, considered a valuable source of information about facilities along with important contacts for tests/treatment, etc., available in Malaysia.

Wong, whose organisation has participated in a number of international travel and tourism shows worldwide, in conjunction with Tourism Malaysia, believes the medical travel industry is “bound to grow tremendously” because of rising healthcare costs, heightened health awareness and better information available in developed countries about treatment options.

“Many patients in western countries have to wait before they are even examined by the medical care facilities. As you can imagine, this can be fatal if there is any terminal illness involved.

We can provide good, almost immediate care. We have drastically cut down waiting time for patients,” she said.

Although Malaysia has a well-developed healthcare infrastructure, supported by state-of-the-art equipment, many experts in the US often question the availability of sufficient number of medical doctors and other experts. “We have adequate number of doctors to support our healthcare system. Indeed, we have 5,000 new well-trained medical graduates each year.

Besides, our medical force gets an additional 1,000 specialised medical experts each year. Indeed, we are trying to target one doctor for a population of 400 people,” she maintained.

Wong said healthcare tourism would generate “substantial contribution” for Malaysia’s economy, accounting for some RM594 million, in terms of revenue in 2012.

“In 2013, the revenue is estimated to reach RM688 million, according to tentative estimates,” she added.

For the health-conscious traveller, Malaysia offers a unique combination of good quality, low-cost healthcare and an attractive tourist destination, Wong observed. While visiting Malaysia, the traveller can also undergo medical check and use facilities involving preventive wellness, spas, cosmetic and dental surgery, etc.

While Singapore may have built a reputation for itself as a medical tourist destination, it is rapidly losing this advantage because of rising costs and faces fierce competition from other countries, including Malaysia, thanks to their much-lower medical and hospitalisation costs.

Five-star hotels in Malaysia are also much cheaper.

Wong said that as an English-speaking country, Malaysia also offered the ease of direct communication between patients and attending doctors and medical staff at hospitals.

“The traveller should have no problem sharing his or her concerns with doctors and healthcare staff. Malaysian hospitals also offer a combination of Eastern and Western medicine,” she noted.

Asked why Malaysia was 'Johnny-come-lately' in the medical tourism sector, she said her organisation, which was formed only a few years ago, had aggressively pushed for medical tourism in 2011.

“But because of our unique advantages, both governments and patients in developed countries will, invariably, appreciate our cost and other advantages,” she added.

The top 10 foreign nationalities which visited Malaysia in 2012 for medical treatment were Indonesia (375,499), India (22,350), Japan (17,775), China (15,407), United Kingdom (13,366), US (12,158), Libya (11,872), Bangladesh (11,594), Australia (10,369) and Nepal (10,031).

The popular treatments sought in Malaysia are cardiology, oncology, orthopaedic, obstetrics and gynaecology, urology, otolaryngology, gastroenterology, reconstructive surgery, health screening and second opinion.

Tourism Malaysia’s New York office, led by its vice-president, Ahmad Johanif Mohd Ali, had a busy Saturday at the NYTTS as hordes of American visitors descended on the show venue to witness the various cultural and culinary presentations made by the entire world vying to get a slice of the American tourism market.

He told Bernama there was “great interest” amongst American tourists for Malaysia, based on the large turnout of inquisitive visitors who not only came to witness the colourful Malaysian cultural dances at the stage but also sought information, brochures and other materials at the Malaysia stand. -- BERNAMA

Lee calls for early introduction of mental healthcare policy in workplaces

The Malay Mail Online

KUALA LUMPUR, March 2 ― Mental Health Promotion Advisory Council member Tan Sri Lee Lam Thye has called for an early introduction of guidelines for promoting mental healthcare in workplace

He said the guidelines were aimed at reducing the increasing number of employees who were likely to suffer anxiety, depression and mental stress due to job pressure.

He said the guidelines would ensure the happiness and well-being of workers and their families through initiatives to promote good mental health in workplaces.

He noted there was an increasing number of executives and workers who were likely to suffer from anxiety, depression and mental stress, in relation to their jobs and working lives.

“In line with this, it might be timely for the government to expedite the introduction of guidelines for mental healthcare promotion, to enable implementation of basic measures for adoption and implementation by employers in workplaces,” he said in a statement here today.

Elaborating, Lee said employers should utilise the safety and health committees at workplaces to examine and identify the current mental health of employees and promote mental healthcare measures.

He said employers should consider the specific nature of mental health problems, the consideration of individual worker privacy and formulate a fundamental programme on mental wellbeing for employees.

He also called on the government to provide more benefits such as insurance coverage for the mentally-ill, and income tax relief for parents or relatives who had to take care of the mentally-ill. ― Bernama

Health Ministry: Be wary of heat stroke

Free Malaysia Today

KUALA LUMPUR: The Health Ministry has called on Malaysians to be alert towards early signs of heat stroke in the wake of the current hot and dry weather.

Its director-general Dr Noor Hisham Abdullah told Bernama heat stroke happens when the body temperature exceeds 40.5 degree Celcius.

A normal human being’s temperature is at 37.0 degree Celcius.

“Among the early symptoms of a heat stroke are a throbbing headache, nausea, lack of perspiration despite the hot weather and a fast pulse.

“Other signs are weak muscles, spasms, vomiting, dry and reddish skin and seizures and blackouts,” he said.

Noor Hisham said the high temperature invited complications to the nervous system of the brain, which could result in coma and could cause death.

The Meteorological Department, prior to this, had said the hot and dry weather in the country currently was worse than last year and was expected to continue until mid-May.

Noor Hisham said prolonged exposure to the hot weather, not drinking enough water and dehydration were among the causes of heat stroke.

As such, he suggested placing anyone suffering from a heat stroke in a shaded and cool area.

“The high temperature can be reduced by placing the victim under a fan and wiping his body with a wet towel.

“The patient can also be placed in a pool of water to reduce his temperature and cool him down,” he said.

Noor Hisham also urged the public to avoid leisure activities under the sun and to drink a large quantity of water, at least 2.5 litres a day.

-Bernama