Public Strain, Private Gain: Rethinking Malaysia's Dual Healthcare Model

New Straits Times

24-04-2025

Malaysia's public healthcare system is widely regarded as one of the best in the world, especially when compared to the underperforming public systems in some developed nations, such as the United States.
However, with the rise in population and an increasingly aging demographic, demand for healthcare services has begun to outstrip supply, putting immense pressure on the public system.
As a result, private healthcare providers have stepped in to fill the gaps. Offering timely and efficient services, the private sector is purportedly to complement the public system and ensures continued access to quality care where delays or limitations may exist.
However, recent developments have been concerning. As waiting times in public hospitals grow longer due to increased demand, many patients have no choice but to turn to private healthcare for timely treatment. Unfortunately, some private practitioners have taken advantage of this urgency by charging exorbitant fees, knowing that patients are desperate to avoid delays, especially for surgeries and critical care. This growing trend of profiteering highlights a troubling shift where timely access to healthcare is being monetised at the expense of those most in need.
Horror stories have begun to emerge from Malaysia's private hospitals, raising questions about whether profit is overtaking patient welfare. In one documented case, private facilities were found to charge as much as RM120,000 for bypass surgery—double what's charged at government-backed institutions.
A recent case involving a routine hernia procedure drew public attention after the patient received a 13-page hospital bill amounting to nearly RM19,000—with line items that included RM6.30 for disposable ear probe cover. Health policy experts, such as those from the Galen Centre, estimate that up to 70% of private hospital charges fall under unregulated categories, raising questions about transparency and pricing practices.
In other instances, it has been alleged that patients in need of urgent care—such as a young mother requiring an emergency C-section—were delayed or turned away until substantial deposits were paid. There have also been unverified reports of elderly patients being kept in intensive care units longer than medically necessary, allegedly to inflate bills. While these particular cases are difficult to independently verify, they reflect growing public anxiety over profit-driven practices and the potential erosion of ethics in private healthcare.
These disturbing accounts from private healthcare are far from isolated. While these institutions project polished images of care and compassion, behind the sterile white walls lies a harsher reality—one where desperation is exploited, and urgency is monetised. Doctors, once regarded as noble healers, are now seen by some as baying for the flesh of patients, demanding exorbitant sums before life-saving treatment is even considered.
This descent into opportunism reflects a chilling betrayal of the Hippocratic Oath—a vow grounded in compassion, ethics, and the sanctity of life. Increasingly, it appears that many in the private healthcare sector are no longer bound by that oath, but rather by an 'Oath of Hypocrisy'—where profit takes precedence over principle.
In this shadowy theatre of modern medicine, healing has become a business transaction. Vulnerability is priced, pain is packaged, and urgency comes with a surcharge. If this trend continues unchallenged, the medical profession risks losing the very soul that once set it apart—the moral compass that made it sacred.
To mitigate the financial burden imposed by private healthcare, many Malaysians have turned to insurance to manage escalating hospital charges. However, private hospital costs have risen so steeply—driven by unchecked medical inflation and questionable billing practices—that insurance companies themselves are struggling to absorb the burden. Unable to sustain the rising payouts, they were forced to raise premiums significantly. In 2025, some policyholders saw their premiums spike between 40% and 70%, a direct consequence of the unsustainable cost escalation within the private healthcare sector.
With medical inflation reaching 15% in 2024—well above the global average of 10%—insurance coverage increasingly falls short. Patients are often asked about their insurance status before receiving treatment, fuelling concerns about unnecessary tests and inflated bills. In response to growing public outcry, Bank Negara Malaysia stepped in during December 2024, introducing measures to cap annual premium increases at 10% for most policyholders and mandate that any hikes be spread over at least three years.
Despite these interventions, the system remains heavily skewed against the average patient—trapped between long queues in under-resourced public hospitals and the rising cost of care in the private sector. The result is a widening healthcare divide, where access to timely and quality treatment increasingly depends on one's ability to pay.
The government must intervene decisively and play its rightful role in reforming what has become an abysmal and increasingly unequal healthcare system. However, its ability to act boldly is constrained by deep-rooted legacy issues, many of which are not the making of the present government. Over the years, successive administrations have enabled the expansion of private healthcare, often at the expense of strengthening the public system.
Government-linked entities such as Khazanah Nasional own major private hospital chains including Pantai, Gleneagles, and Prince Court through IHH Healthcare. Agencies like MARA, Tabung Haji, and various state-owned GLCs have invested in private hospitals and medical tourism.
To make matters worse, public hospital specialists are allowed to moonlight in private hospitals or charge private fees under the Full Paying Patient scheme—further weakening the already overstretched public healthcare system. These entanglements must be addressed honestly and urgently. Without breaking free from this conflicted legacy, any pledge to fix the public healthcare system will ring hollow. In order to fix the public healthcare system, the government must tackle the issues very proactively
The strains in Malaysia's dual healthcare system are becoming increasingly visible signs of a structure under pressure and in need of recalibration. While the private sector continues to grow, the public system, which serves the vast majority, faces mounting challenges. This imbalance, if left unaddressed, could erode public trust and widen the gap in healthcare access. If we are to uphold the principle that healthcare is a right, not a luxury, the government must step forward with resolve and vision. In the next article, I will outline practical measures to strengthen our public healthcare system—before these cracks become too wide to mend.