Posted by BLee > 2024-07-21 10:00 | Report Abuse

Very well written, got a question; is 'introduce co-payment options for medical and health insurance' is an option for the general public? Every year, I am 'burning' few $k hoping Not to make any claim. Saving of 1 or 2 $k over several years, will it able to pay the difference in co-payment if required? It all boil down to affordability...and a good policy.

Posted by DividendGuy67 > 2024-07-22 00:03 | Report Abuse

I think the Junior Doctor needs to see the bigger picture and check his facts before rambling.

For example, B40 ownership of private medical insurance is not significant, for the simple reason that their low household income of 2k per month, 3k per month, 4k - nearly all of that if not more goes to the basic necessities of life like food, petrol, clothes, etc and there's not enough leftover to buy private individual medical insurance. The realities is that if hospitalization is required, they go to government hospitals where the services are free. The segment impacted will be the M40s and the T20s who owns these individual private medical insurance policies.

My contacts in the insurance industry tells me that the financial situation in the medical insurance pools is at crisis levels already. Many of the companies have been losing monies in these insurance pools for nearly 3 years in a row now. They have tried to pass the higher claims costs to customers, but it didn't seem to have worked. The claims outweighs the premiums received, the shareholders have to bear the costs of administration expenses, staff salaries, all operating expenses and pay their distribution commissions ... the shareholders are worried because they are bleeding continuously.

The root cause seems to be the increase in private hospital utilizations and higher prices charged by these private hospitals to the insurance companies. Anecdotes are if you have an insurance policy, these private hospitals will suddenly give you more diagnostic tests, higher end treatment, better quality drugs that costs more because in the past, the insurance companies bear 100% of all of these costs if you have an insurance policy. And these private hospital profits keep rising each year.

And they tell me BNM has tried everything. The private hospitals raise their charges every year. But the insurance companies find it conflicting to do the same thing to their customers every year. Instead, they increase prices only once every few years and as a result, those insurance pools keep gradually losing monies.

The root cause is also the design of the benefits of these policies. Many of the coverages are "as charged". Hospital supplies. Drugs. Operating theatre. etc. The private hospitals and their highly paid doctors have discretion on what choices to recommend to patients. Of course, once the insurer foots 100% of the bill, the patient should get the best, the one with the highest margins to the hospitals.

So, I don't blame BNM at all or the insurance companies. We need to get to the root cause as to why the insurance medical pool keeps losing monies for past years. My friend tells me this won't get better this year, insurance companies are projected to continue to lose monies in their medical pool. Soon, he said we will enter into an insurance crisis.

So, BNM has to intervene and this is their intervention. Totally understand the doctors wants the best for their patient, but what if the best treatment comes at prohibitively expensive cost where the medical insurance pool loses monies and insurers have no choice but to pass on the higher costs back to the customers? Is this sustainable? Why can't MOH cap the treatment costs of these private hospitals which sounds to me like the root cause in the first place? Why must these private hospitals charge so much to patients when they have insurance, vs no insurance?

Posted by moneySIFU > 2024-07-22 10:17 | Report Abuse

well said, DividendGuy67