Get doctors’ views on insurance plans, says MMA

The Malaysian Medical Association (MMA) has called on insurance companies to involve doctors in designing insurance plans, citing concerns that undervalued insurance products could impact treatment decisions. MMA President Dr R Thirunavukarasu emphasized that while insurance products must be commercially sustainable, healthcare benefits must also prioritize clinical considerations.

He stressed that commercial sustainability cannot compromise clinical appropriateness, stating that insurance products require robust actuarial design, while healthcare benefits demand sound clinical design. In a statement, Thirunavukarasu highlighted a report by health think tank CodeBlue, which examined an insurance plan offering up to RM50 per general practitioner visit for consultation and medication.

While he appreciated the inclusion of primary care in medical insurance coverage, Thirunavukarasu believed that RM50 was insufficient for GP consultation and medication. He pointed out that previous benchmarks set by Selangor's Skim Peduli Sihat and Madani medical scheme were raised to RM70 after the MMA raised concerns about undervaluing primary care.

Thirunavukarasu urged insurers to reconsider the RM50 benchmark for GP consultations and medication in 2026, questioning why this amount was being re-introduced. He argued that strengthening primary care could help contain healthcare costs by facilitating earlier, appropriate treatment, thereby reducing complications, unnecessary emergency visits, and more expensive hospital care.

Thirunavukarasu stressed that primary care should be viewed as an investment in healthcare sustainability, rather than just another cost to be capped.