KUALA LUMPUR – The Private Healthcare Facilities and Services Act 1998 (Act 586) needs to be amended before any cost control mechanisms, such as a payment model for diagnosis-related groups (DRG), are implemented, said Health Minister Datuk Seri Dr Dzulkefly Ahmad.
Dr Dzulkefly said that the amendment is necessary to address the rising insurance premiums and medical charges at private healthcare facilities.
He said the ministry is aiming to amend the act in the second quarter of next year.
“We can’t be too hasty in implementing cost control mechanisms, even though the Prime Minister, Datuk Seri Anwar Ibrahim, believes it needs to be expedited.
“We need to amend (Act 586) first before we can implement things like DRG. It may take some time to ensure that it is done properly and smoothly.
“This is important to do our best to achieve the set healthcare value, fair for insurance companies, private hospital operators and everyone,” he told the media in the Dewan Rakyat today.
Dr Dzulkefly said the amendment will also involve all industry players, including the Attorney General’s Chambers (AGC).
He added that the amendment to the act is more likely to give his ministry room to set ‘measures’ for medical charges and provide fairness to all parties.
“I can’t say there is power (for the Health Ministry to monitor private hospitals) but we will create an amendment that will allow a way to (control) a certain procedure or to be charged reasonably within a certain range.
“That won’t allow anyone to charge (arbitrarily) more or less like that. Not because they are charging arbitrarily but there will be a measure or matrix.
“So this will not allow moral hazard but more towards transparency in (the implementation) of DRG itself, (setting) the price of medicines. We hope that there will be effective and good changes,” he said.
Yesterday, Anwar said that Bank Negara Malaysia (BNM) and the Health Ministry will establish controls to ensure that medical insurance premiums will not rise too steeply to the extent of burdening the people and leading to increase in inflation.
He said that BNM, together with the Finance and Health Ministries, is currently looking into it and will issue strict guidelines to ensure that medical and health insurance and takaful (MHIT) providers, as well as insurers and takaful operators (ITO), take several factors into account.
Anwar was replying to Suhaizan Kaiat (PH-Pulai) who wanted to know the government’s measures to address the rise in medical insurance premiums by 40 to 70% and the 12.6% inflation rate in the country’s medical costs in 2023, more than twice the global average of 5.6 per cent.
The Prime Minister said that among the reasons for the increase in medical costs are the price of medicines as well as new medical equipment and the increasing wage and salary rates.
Anwar gave the example of a large company that sells medicines for RM5,000 to Malaysia due to monopoly and lax control but then sells the same drug in Thailand for only RM1,500.
Therefore, he said the government would introduce guidelines on standardising costs known as diagnosis-related groups (DRGs) regarding reasonable costs such as for magnetic resonance imaging (MRI) or computerised tomography scan (CT Scan) besides amending the Private Healthcare Facilities and Services Act 1998 (Act 586). — December 11, 2024