Groups concerned over healthcare financing system

KUALA LUMPUR: The Finance Ministry is targeting to announce more details on the Health Protection Fund by this month but concerned parties have complained that they have not be consulted about the scheme and are concerned it will affect the country’s healthcare financing system.

They asked why the Health Ministry was not involved in deciding the healthcare financing scheme, claiming that it appeared that the Finance Ministry had bulldozed it.

A source said the Finance Ministry was working towards its launch sometime this month and more details would be revealed soon, but declined to say more.

But Citizens’ Health Initiative member Dr Chee Heng Leng, a healthcare analyst said there has not been any engagements with NGOs that focuses on health, healthcare services and healthcare financing systems.

“Has the ministry considered the impact of such a short term measure on the whole healthcare financing structure of the country, as well as the long-term direction of the healthcare sector?” she asked.

Dr Chee said private health insurance was risk rated and not community rated in that those with pre-existing conditions would not be covered or covered with higher premiums while older people would pay higher premiums – these would impact access and equity and weaken the health coverage.

Finance Minister Lim Guan Eng announced in his Budget 2019 speech on Nov 2 the creation of the fund which will provide free protection against top four critical illness up to a sum of RM8,000 and up to 14 days of hospitalisation benefits starting in January.

However, on Nov 24, he said the protection would be extended to 36 major critical illnesses.

The hospitalisation income cover would be at RM50 per day or RM700 per annum, he said.

Great Eastern Life Insurance has agreed to contribute the initial seed funding of RM2bil to the fund, which would be managed by Bank Negara Malaysia, he said.

Dr Chee also asked if the ministry had consulted the Health Ministry because it did not come across as such.

“Why did the Finance Ministry announce a wide-sweeping intervention which has a great impact on the health sector? For observ- ers looking in from outside, it looks like the Health Ministry is not involved in this,” she said.

Before the Budget 2019 was announced, Health Minister Datuk Seri Dr Dzulkefly Ahmad had denied in Parliament of any social health insurance scheme or the involvement of a private insurance company but Lim announced the Health Protection Fund under the purview of the Finance Ministry during his speech.

Former Sungai Siput MP (2008 to 2018) Dr Michael Jeyakumar Devaraj said Parti Sosialis Malaysia’s (PSM) letters of request for a meeting with the Finance Ministry in November and December went unreplied.

He said there should be engagements held with health focused NGOs, scholars and activists.

“Healthcare is complex. Anything that promotes private interests can undermine the public sector,” he said.

Dr Jeyakumar said he had also met with Dr Dzulkefly earlier but he did not have the details.

On Nov 16, it was reported that foreign insurers will be given the option to divest their stakes in their Malaysian units or contribute to the B40 National Health Protection Fund, to comply with a Bank Negara ruling to sell at least 30% of their stakes to local parties.

The foreign ownership limit for Malaysian insurers was set at 70% in 2009 under the financial liberalisation policy.

Higher foreign shareholdings were accorded on a case-by-case basis.

When contacted, Dr Dzulkefly said the ministry would meet with the Finance Ministry soon on this and would respond with more comments later.