KUALA LUMPUR – Among the nearly 200 complaints received by PKR lawmaker Sim Tze Tzin about alleged profiteering by private hospitals is one about a man who had to undergo the same operation a second time at a public hospital, after the private hospital he went to first did a botched job.
The difference in the bills from the private hospital and the public hospital which did the same procedure and more, was RM140,000, Sim said in sharing the complaints with the media.
In this complaint, the individual said that a private hospital had imposed an RM200,000 fee on their brother for surgery procedures after a road accident.
While the brother’s insurance company had shouldered the entirety of the charge, the private hospital was “unable to complete treatments” and referred the patient to “HUKM”, believed to be referring to Hospital Canselor Tuanku Muhriz UKM (HCTM).
However, the family’s tribulations were far from over as HCTM informed them that the patient would need to undergo the same surgery again due to the “unsuitability” of an iron rod inserted into his leg earlier by the private hospital.
“We were also informed that the private hospital had done an unsuccessful surgery on my brother’s thigh, with (HCTM) doctors telling us that he might require another surgery as (the surgeon at the private hospital) had left my brother’s bone ‘hanging’.
“I am disappointed as the RM200,000 paid by the insurance company was for nothing and my brother’s treatment process has been complicated (by the private hospital),” the complainant added.
The individual said the bill from HCTM was RM60,000, which was borne by Socso.
“The private hospital charged too much, as if they opted for the most expensive treatment, but my brother’s leg only became worse.”
The complaint was among 197 received by Sim who started a PKR email account aduan.pkr.hospital.insurance@gmail.com, for members of the public to send him their grievances following news of the 40% to 70% hike in medical insurance premiums to be implemented by insurance companies next year.
Sim also shared another complaint that illustrated allegations that private hospitals charge more when patients have medical insurance, as opposed to those who pay out of pocket.
The names of the private hospitals in both complaints shared with the media were redacted.
In the second complaint, a man said that he and his wife had sought cataract treatment from a doctor at a private hospital.
The man claimed that while he was charged RM3,000 per eye, his wife, who utilised her insurance policy, was slapped with a charge double the amount.
Highlighting that their operations were similar procedures executed by the same specialist, the man questioned the difference in charges, claiming: “It looks like the hospital charged such unexplainable fees and the insurance company recoups it by increasing premiums.”
“How come the insurance company did not raise any queries (over) the hospital levelling such charges? The consequence is the premium for my wife’s policy for this year is RM20,000,” the man lamented.
Previously, Association of Private Hospitals Malaysia (APHM) president Datuk Dr Kuljit Singh dismissed claims that the bill for patients with insurance or medical cards are higher than those paying out of pocket.
Kuljit asserted that this was a “common misconception” that “has to be proven”, stressing that private hospitals follow standardised charges regardless of the patient’s payment method.
Sim had previously urged Bank Negara Malaysia to investigate and review insurance companies that have issued notices of premium hikes ranging from 40% to 70% for the coming year.
Yesterday, the lawmaker said medical experts with experience in private hospitals shared with MPs on various factors that drove the increase in private healthcare charges.
These included recouping of losses after paying hefty compensation awards granted by the courts to plaintiffs in medical negligence cases, unnecessary admissions to hospital, redundant scans and screening procedures, and “overdoing” procedures”.
Insurance and takaful operators, as well as Bank Negara, have cited rising medical costs, an increasing number of insurance claims or greater utilisation of policies, as among reasons for raising premiums. – December 10, 2024
