Experts are calling for increased public awareness about health insurance and takaful products, urging consumers to understand exactly what they are signing up for and to select only the coverage they truly need.
Many health insurance and takaful policies include treatments that are unlikely to be necessary for most patients, which contributes to higher premiums, according to industry professionals. As a result, patient education is crucial to empower individuals to make informed decisions when purchasing value-based healthcare policies, said Datuk Dr Kuljit Singh, president of the Association of Private Hospitals Malaysia (APHM).
“This will help reduce the financial burden on both patients and the healthcare system,” Dr. Kuljit emphasized. He added that APHM has consistently advocated for value-based healthcare, which includes using generics, appropriate implants, and excluding unnecessary high-cost treatments like robotics when not needed. However, he stressed that quality care and patient safety remain top priorities.
Dr. Murallitharan Munisamy, managing director of the National Cancer Society of Malaysia, agreed that value-based healthcare plans could be an effective solution to combat rising medical costs. He explained that premiums are often inflated by treatments that most patients will not require.
“Insurance policies tend to be comprehensive, which naturally makes them more expensive,” Dr. Murallitharan said. “If the government introduces value-based healthcare plans for specific conditions—such as diabetes, heart attacks, or appendicitis—premiums could be kept low and affordable, even for the underprivileged.”
However, he warned that the simplicity of such packages could confuse consumers who may not fully understand their risks or know what to prioritize when selecting a plan. He stressed the importance of government-led education efforts to help people make better choices.
Moreover, Dr. Murallitharan pointed out that the premiums for these plans should be flexible and able to adjust over time. “Medical costs, like those for heart surgeries, are likely to rise in the future, and these changes must be reflected in the premiums,” he explained, noting that the government must factor in medical inflation.
Dr. Zafrina Burukan, a general practitioner at BeHealth Clinic in Bandar Utama, emphasized the importance of evidence-based treatments, ensuring that patient health is the top priority. She cautioned against the misconception that unlimited coverage equates to unnecessary testing. On the other hand, limited coverage does not mean patients should be undertreated, she clarified.
“It’s essential to explain to patients why certain tests or procedures are necessary. Patients should always be given the information to make informed decisions,” Dr. Zafrina said.
She also highlighted the need to assess existing programs like Peka B40 and Iltizam Selangor Sihat, noting that too many schemes could create confusion for the public. “The more schemes there are, the more confusing it becomes,” she added.
Datuk Indrani Thuraisingham, vice president and legal adviser of the Federation of Malaysian Consumers Associations (Fomca), called for universal access to value-based healthcare plans, regardless of income. She cited Thailand’s healthcare scheme, where locals pay only 30 baht (approximately RM3.90) and tourists 300 baht (about RM39) for healthcare services.
“All segments of society should be able to afford these plans,” she stated, adding that Fomca had recently submitted a memorandum to the Public Accounts Committee urging the government to leverage existing mechanisms, such as the Employees Provident Fund (EPF) or Social Security Organisation (Socso), to support healthcare accessibility.
With increasing living costs affecting both B40 and M40 groups, Indrani called for a tiered approach to ensure that basic healthcare is accessible to everyone.
Mohideen Abdul Kader, president of the Consumer Association of Penang, suggested that the government should focus on improving public healthcare infrastructure rather than introducing more healthcare schemes. “Investing in expanding public hospitals will allow more people to access quality healthcare services,” he said.
As discussions around healthcare policy continue, experts agree that addressing both education and accessibility is essential to creating a more sustainable and equitable healthcare system for all Malaysians.
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