Healthcare is expensive. More so, this complaint is often heard about private hospitals.
Yet, there’s also no denying the high percentage of patients who still choose to go to private hospitals for consultation and treatment. In Malaysia, a survey finds that only 13% of patients availed of free medication covered by the public healthcare system while 87% of patients got the same medication from private healthcare institutions.
For Datuk Dr Kuljit Singh, President of the Association of Private Hospitals in Malaysia (APHM), the perceived “economically irrational pricing” of private hospitals is but a misconception.
Cost of private and public care is the same
The cost of care in public and private hospitals in Malaysia does not differ, just as the quality of treatment and the facilities available in both sectors are the same. What patients need to understand is the extent of support received by hospitals that impact the way they price their services.
Compared to public hospitals that receive funding from the government, private hospitals are “on their own”. They are left to sustain their operations and profits because they do not receive any support from the government; hence, patients pay for every equipment, service, and professional fee. Healthcare cost in public hospitals is perceived as lower because the government shoulders most, if not all, the expenditures incurred.
Likewise, comparing the cost of care in Malaysia and other countries in the region would yield that treatments in Malaysia are still way cheaper. “If [patients] look at it at this angle, private hospitals are not at all expensive,” argues Dr Singh.
It’s a matter of preference
While Malaysia’s healthcare system can be described as robust and satisfactory, patients differentiate between private and public hospitals through the comfort, efficiency, and doctor preference they receive – factors that add to the total cost of private healthcare, thus, cost they should not complain about.
Private hospitals are expensive because there is a cost associated with complying to regulations on patient safety, and private hospitals have extra preventive measures in place in case of emergency situations, such as a standby medical team and 24X7 monitoring. But these measures don’t come cheap at all. As Dr Singh notes, “excellent care comes with a high cost as well” even when clinical outcomes may be the same for both private and public hospitals.
Private hospitals offer comfort and personalised care, which patients may not find in government-funded institutions that are focused on serving more patients rather than the quality of care each patient gets.
On a similar note, private hospitals boast of more efficient data management as compared to public hospitals. As of writing, only a few government hospitals in Malaysia use electronic medical record (EMR) systems despite being the first to adopt this technology). A greater number of private hospitals, on the other hand, have been using EMR systems extensively. Costly, yes, but EMR system proves to be a huge help for private healthcare staff to manage patient information easily, thereby translating to better patient experience.
After all, patients, especially when they can afford the cost, chase the quality of care they are paying for, just like how consumers choose to dine at a Michelin-restaurant for the experience over another restaurant that serves the same menu options.
The government should have a say… or not?
Apart from justifying healthcare cost to patients, private hospitals in Malaysia are burdened to articulate this cost to the government, despite the latter’s knowledge of how expensive it could be to maintain a hospital.
In Malaysia, private doctors are required by law to follow the ceiling price for professional fees regardless of expertise and experience. The government also moves to control drug prices at private healthcare institutions.
However, Dr Singh believes that the government should not interfere with how the private healthcare sector operates. For one, private hospitals “take a lot of burden from public hospitals”. The Malaysian government sends patients to private hospitals only on a case-by-case basis and in special emergency circumstances.
Also, the private health sector significantly contributes to the government’s income. For instance, there are around 200 private hospitals in Malaysia that provide jobs to thousands. Medical tourism, bulk profits of which come from private healthcare institutions, generates a lot of income for the government as well, not to mention the taxes private hospitals pay that benefit the general population.
The government and private hospitals can work together to reach more patients who need care, highlights Dr Singh. To relieve public hospitals of the burden of the overwhelming number of patients waiting for treatment, the government can subsidise patients’ treatment at private facilities. This way, more patients will receive access to care, government hospitals will feel less overwhelmed, and private hospitals will have better use of their facilities.
Dr Singh observes that despite many new public hospitals built in the past 15 years, patients still suffer long waiting time to get much-needed treatment. Besides, the overall cost of buying services from private healthcare institutions is far cheaper than building new government hospitals, considering the difficulties in retaining doctors and healthcare staff and maintaining the facilities.
Such an arrangement will be the best way forward. Both parties can discuss the cost of care with a shared goal to have a sustainable relationship for the benefit of patients. Contrary to what the government may think, private hospitals are keen to share resources and help more patients the best they can while pursuing sustainability in their organisations.