Get doctors’ views on insurance plans, says MMA

The Malaysian Medical Association (MMA) has called on health insurers to involve doctors in the creation of insurance plans, warning that underpriced schemes could sway treatment choices. MMA president Dr R Thirunavukarasu emphasized that while insurance products must be commercially viable, clinical appropriateness should also be considered.

He stressed that clinical governance must guide commercial governance, stating that "commercial sustainability cannot come at the expense of clinical appropriateness." A report by health think tank CodeBlue highlighted an insurance product offering up to RM50 per general practitioner consultation and medication, with premiums as low as RM55 a month and a RM3,000 deductible.

Thirunavukarasu appreciated the inclusion of primary care in medical insurance coverage but deemed RM50 insufficient for GP consultations and medication. He pointed out that Selangor's Skim Peduli Sihat and Madani medical scheme had initially set limits at RM50 and RM60, respectively, which were later raised to RM70 after MMA's concerns.

In 2026, he questioned why RM50 was being used again as a benchmark for GP consultations and medication. Thirunavukarasu argued that strengthening primary care could help control healthcare costs by ensuring patients receive appropriate treatment early, thereby reducing complications, unnecessary emergency visits, and more expensive hospital care.

He viewed primary care as an investment in healthcare sustainability, not merely another expense to be capped.