Fee difference: Just amend rules, cancer society tells health minister

KUALA LUMPUR: The National Cancer Society of Malaysia has urged the health ministry to quickly reverse the 2017 amendment to the Fees (Medical) Order which makes it mandatory for cancer patients to be charged first-class rates.

National Cancer Society of Malaysia medical director Dr M Murallitharan.

Dr M Murallitharan, the organisation’s medical director, said Health Minister Dr Dzulkefly Ahmad’s recent comments to the press that he hoped to review the matter as soon as possible were counter-intuitive.

“All that needs to be done is to remove that regulation because what it does is penalise Malaysians and that’s a very unfair thing to do,” Murallitharan told FMT on the sidelines of the World Cancer Congress.

The government was recently urged to undo the 2017 amendment to the law, which now forces cancer patients to pay high rates for treatment at public hospitals if they are referred there from private or university hospitals.

Previously, cancer patients referred to public hospitals from a private doctor could choose between third-class, second-class or first-class type treatments, which vary significantly in terms of consultation and medical fees.

Concerns have long been raised on the rule which was implemented by the previous administration last year. The issue was brought under the spotlight again by the Galen Centre for Health and Social Policy at a public forum last Sunday.

The public policy think tank noted that referrals from a private practitioner today would often come up to RM375. In some cases, the difference could be a staggering RM6,500. It also pointed out that it was unfair to “punish” patients with first-class costs.

Murallitharan, a health practitioner himself, told FMT that it was “not a big task” for the new government to repeal the amendment.

“You can’t make the argument that you don’t want to do this because you are gaining revenue from it.

“This is only a small group of patients. Whatever revenue you make from this is small and insignificant,” Murallitharan said.

Under Section 4 of the Fees Act 1951, any changes to schedules passed into law, such as the Fees (Medical) Order, require them to be put forth in the Dewan Rakyat.

Murallitharan noted that although public care in Malaysia, which is considered one of the best in the region, was largely subsidised, the public sector was still burdened by treatment costs and limited access to doctors in public hospitals.

“While treatment is RM1, what happens is that when a lot of people take advantage of this, there is a higher waiting time to be treated. So it is a good thing when some of them go to the private sector instead, lifting the burden somewhat.

“Of course, at some point, they may run out of money or insurance and return to the public hospitals. Why are we penalising them for something like access to healthcare which is a right for all?

“Don’t create these concepts of first-class citizens and second-class citizens. We don’t need this. Why should they have to pay so much more just because of a different letterhead?

“That’s not fair at all,” Murallitharan said.

He welcomed Dzulkefly’s assurance that the government would continue to provide access to affordable and high-quality healthcare despite increasing costs but said it had a long way to go before the current system could be considered first-class.

Murallitharan said it was time Malaysia looked to other high-income countries such as South Korea, Australia and Japan to benchmark its healthcare practices for cancer, adding that even within the Asean region, it was not doing that well.

“To be honest, we have plans to improve our services for cancer, but we’re not there yet. We have to do better.

“We’re not even the best in Asean. In terms of cancer control, even Thailand is much better than we are, so it’s time we looked at these countries to see how we can improve our services and maintain our affordable prices.”