KUALA LUMPUR (Dec 10): Malaysia is looking at implementing the diagnosis-related group (DRG) system to contain skyrocketing private healthcare costs early next year, and the Ministry of Health is speeding up its study on the issue, said Prime Minister Datuk Seri Anwar Ibrahim.
DRG is a healthcare financing method that classifies patients based on the type and complexity of their medical cases, rather than itemising each charge.
Anwar said the current cost of medical services in private hospitals is "too high and unreasonable", and requires regulation.
"We cannot allow a spike (in medical costs), but a small increase is acceptable. It is hard for us to agree to such increases," Anwar told the lower house of Parliament during the parliamentary question time on Tuesday.
This move comes as Malaysia faces an inflation rate of around 12.5% for medical services, one of the highest in recent years.
Health Minister Datuk Seri Dzulkefly Ahmad said discussions on implementing the DRG are actively underway to enhance the transparency of patient treatment charges, and address rising medical costs, which is a key factor contributing to increased premiums for medical insurance, Bernama reported.
"Through the DRG system, we can adopt a framework where private hospital charges will align with this system, thus helping to curb excessive inflation.
"This does not mean we are imposing price controls. It is not price control. It is a good reform in healthcare financing," Dzulkefly was reported as saying at a press conference after officiating the International Medical Device Exhibition and Conference 2024 here.
Dzulkefly also said most advanced countries, including the US, South Korea, Japan and European nations have already adopted the DRG system.
"Advanced countries use this approach to establish cost pricing for medical procedures. This will be the focus of further discussions. With this system, no one can impose charges deemed excessively high," Dzulkefly was quoted as saying.
Govt mulls review of private healthcare law
Meanwhile, Anwar said the government will consider reviewing the Private Healthcare Facilities and Services Act 1998, which regulates and controls private healthcare services in Malaysia.
As a short-term solution to address medical inflation and the resulting spike in medical insurance premiums, Anwar said Bank Negara Malaysia (BNM) and MOH will implement measures to prevent undue burdens on the public.
BNM is the agency that supervises and regulates the insurance industry.
MOH is also studying whether hospitals should cover part or all of the costs for patients returning for the same procedures within a specific timeframe.
"In countries like the US, if a patient undergoes a stent procedure, there are guarantees that the patient will remain stable for two or three years," he noted. "If they return with the same issue, the hospital may be required to cover part or the entire cost."
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