Former Malaysian Health Minister Dr. S. Subramaniam has expressed concerns over the Ministry of Health’s (MOH) shift towards private sector involvement in healthcare, which he believes may sideline the poor. Speaking at a conference, Dr. Subramaniam supported some government policies, such as the Madani Scheme, which aims to expand access to private general practitioners (GPs) for low-income groups. However, he criticized the Rakan KKM initiative and the development of a basic private health insurance product, which he believes may favor the rich over the poor.
Dr. Subramaniam argued that the Rakan KKM initiative, which will charge patients above cost, may lead to a two-tiered system where public hospital facilities prioritize those who can afford to pay, potentially leaving those who cannot afford it with reduced access to services. He also criticized the Medical and Health Insurance/Takaful (MHIT) initiative, which he believes strengthens private health insurance rather than addressing social protection gaps directly.
Dr. Subramaniam attributed the policy direction to a “philosophical shift” within the MOH, influenced by a World Bank approach rather than the World Health Organization’s (WHO) principles. He emphasized that the WHO’s approach prioritizes the needs of everyone, whereas the World Bank’s approach is driven by economic outcomes and profit.
In response to Dr. Subramaniam’s concerns, Dr. Yap Wei Aun, director of the Health Transformation Office at the MOH, explained that Rakan KKM aims to create “additional lines and additional capacity” to benefit all patients, rather than allowing patients to “skip lines.” Dr. Yap said that the initiative will charge patients at cost, with excess revenue used to optimize capacity and benefit all patients.
The Rakan KKM initiative is expected to start mid-year at a handful of hospitals, mainly in the Greater Klang Valley region, and will cover high-demand areas such as cardiology, oncology, and orthopaedics. The government has also been negotiating with private insurers to link their financing schemes to Rakan KKM. Despite these assurances, Dr. Subramaniam’s concerns highlight the need for careful consideration of the potential impact of private sector involvement on healthcare accessibility and equity.