Concerns about insurance scheme for B40 group

I refer to the article “Insurance scheme for B40 group to be tabled in October”, published on Aug 5. Deputy Health Minister Dr Lee Boon Chye was quoted as saying that the scheme is to help the B40 group obtain treatment at government and private hospitals.

Lee also mentioned that “as an example, the government could provide insurance protection of between RM10,000 and RM20,000 a year per family for their hospital bills”.

I am very concerned about the proposal for the following reasons:

1) This scheme has not been discussed in detail with the stakeholders, namely the public and medical associations, particularly the doctors, pharmacists and allied healthcare personnel.

Any scheme that is planned and implemented without consultation with stakeholders is going to be fraught with gaps and difficulties and may fail, resulting in tragic consequences.

2) The insurers, be they government-linked entities or private entities, will need to be profitable lest the scheme fail, translating into less care provided than at current levels.

3) If government and private hospitals are to charge normal rates under this scheme, taking the current levels of charges made by private hospitals, RM10,000 to RM20,000 per family per year would be totally inadequate if even one or two family members are admitted to hospital just once in that year. What happens when the insurance coverage is exhausted?

4) The disease burden in the B40 group is significant and includes non-communicable diseases which are increasing at stratospheric rates. Any insurance scheme to cover the B40 group would need to be massive.

5) Finally, instead of insurance to treat diseases, wouldn’t it be far more economical and cost effective to start with insurance for preventive measures and screening strategies which could later on be enhanced to hospital treatment?

There are many questions but no clear and proper answers. I hope the Pakatan Harapan government will not let history repeat itself, as the previous administration’s 1Care proposal ended due to its opacity.

Dr John Teo is an FMT reader.

The views expressed are those of the author and do not necessarily reflect those of FMT.

Insurance scheme for B40 group to be tabled in October