Deregulate medical fees a bold move

By Doreenn Leong

The government’s decision to deregulate private medical practitioners’ consultation fees is seen as a bold step as this will supposedly enable people to choose their doctors based on competitive rates.

 Surely, deregulating the fee structure augurs well for the medical practitioners who may be impeded by low fees currently.

There are already calls for the government to state a minimum consultation fee to prevent private doctors from undercutting one another.

According to Medical Practitioners Coalition Association of Malaysia former president Dr Peter Chan, these doctors, if they resort to undercutting one another, would compromise their professional fees.

How about the interest of consumers? What is stopping doctors from setting a high price where other doctors in similar field would follow suit? Consumers would have limited choice if they want a good doctor at reasonable fees.

As such, there should be a cap on the fees to curb greedy doctors from charging exorbitant fees. Doctors can charge lower fees if they want to remain competitive.

Granted that medical cost is rising rapidly every year and if no measure is being placed to ‘control’ doctors’ fees, consumers will have to bear the escalating costs and at one point, may no longer have access to reasonable healthcare.  Essentially, the higher medical costs will result in higher insurance premiums.

As it is, Bank Negara Malaysia has emphasised on the importance of addressing the issue of rising medical inflation.

According to Aon 2020 Global Medical Trend Rates Report, Malaysia is projected to have the highest increase in medical benefit costs in Asia Pacific in 2020 with a 14% rise in cost, although this is a slight drop in rate of 16% in 2019.

The rise in medical inflation in Malaysia and other countries in the region is partly due to unregulated rules.

Prior to the recent proposal to deregulate the fees, the doctors’ fees are regulated but other components of private hospital charges are not. Consumers have to bear the brunt of the high cost, normally ‘hidden’ under ‘other charges’ whenever they receive treatment in private hospitals.

Currently, fees charged by doctors in private hospitals for consultation and performance of procedures are regulated under the 13th schedule of the Private Healthcare Facilities and Services Regulations.

Other components of hospital charges not regulated include fees for hospital stay, laboratory investigations, nursing care, use of equipment and operation rooms and drugs.

Recently, the health ministry has agreed to abolish the control over consultation fees under Act 586.

With the control of consultation fees abolished, doctors can now determine their own consultation fee rates,” he said in a statement on Friday (Dec 6).

The abolition of the fee control will include all registered facilities (in the Seventh Schedule) and licensed facilities (13th Schedule), said Dzulkefly.

The fees for GPs and dentists, as stated in the Seventh Schedule, have not changed in 27 years and doctors have been calling for the fee harmonisation as provided for in the 13th Schedule of the regulations when it was revised in 2013.

In 2013, the consultation fee was gazetted for medical officers working in private hospitals under the 13th Schedule, but was overlooked for GPs and dentists working in private clinics under the Seventh Schedule.

The government’s decision to allow doctors, dentists and specialists in private clinics and hospitals to fix their own charges after general practitioners in standalone clinics complained that the current fees of RM10 to RM35 have not been revised since 1992, while doctors at private hospitals who have the same qualifications have been charging between RM30 and RM125 per consultation.

Meanwhile, specialists’ fees cost up to RM235 for first consultation and between RM60 to RM105 for subsequent visits.

For the new fees to effect, the current regulations need to be amended first.

The government’s move to deregulate the fee emulates Singapore’s decision to withdraw its guidelines on fees since April 2007, allowing private doctors to set their own consultation fees.

However, Singapore’s Health Ministry published a benchmark fee structure for common surgical procedures, in November last year, to help patients make better-informed decisions. But there was none on doctors’ consultation fees.

England and Australia’s private practitioners are free to determine their own fees althobugh the Australian Medical Association publishes an annual List of Medical Services and Fees, it servses only as a recommendation.

In Japan, medical fees are regulated and reviewed every two years.

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