Wednesday, January 7, 2009

Private hospitals = licence to over-charge

I was appalled when the BN government tried to privatise Institut Jantung Negara. I am all for government getting out of business. But medical care should not be a business.

We deserve competent, reliable medical care at reasonable prices. But that has become increasingly hard to find as the BN government disregards its healthcare responsibilities. The result – highly lucrative private hospitals, profit-driven doctors and astronomical medical bills.

This is my unfortunate recent experience at a private hospital in Kuala Lumpur. The bill was covered by medical insurance, but it still left a very sour taste in my mouth as I felt completely exploited and taken advantage of by the hospital.

Yes, it is a private hospital, and private entities are entitled to make fair profits. But this hospital was gouging the patients. It certainly wasn't making an honest profit because it 1) Forced patients to accept unnecessary services and 2) Over-charged for medical supplies. Besides which it was clearly not operating efficiently.

Operating efficiently can be a matter of perception, so let's stick with the facts, stating with the unnecessary services forced on patients:

a)After registration, a porter escorted us to the relevant hospital department. We were shocked when told this was compulsory. Why? Surely the hospital sign-posting is clear enough for two able-bodied adults to find their own way. Why pay someone just to do this? The savings can go towards cheaper medical bills;
b)On arriving at the ward, the nurse was very insistent on us ordering a “Complimentary meal”. Who are we kidding? The cost of the meals is surely built into the hospital charges. Meals can be made optional. Some patients coming out of anaesthesia simply cannot consume any food, some prefer home-cooked food and some wish to just go straight home-sweet-home. Waiting for a hospital meal just means more unnecessary time in the ward, which means more costs;
c)Which brings me to an interesting point. The hospital in its “Conditions of Service for Inpatients” says it will take “approximately an hour to process the bill”. Also, it says, “half day room charges are applicable … if patients are discharged after 12:00pm”. My question: if the doctor gives the patient clearance to go by 11.15am but the hospital only produces the bill at 12.15pm, is the patient liable to pay the extra half day charge? And is this why the nurses are so keen to have the patients eat the “complimentary meal?”
d)Then, there was a “complimentary” toiletry kit at the bedside comprising a plastic water jug, small towel, shampoo, soap, powder, comb, toothbrush, toothpaste and toiletry bag. That “complimentary” word again. How about just having the convenience store downstairs stock toiletries at reasonable prices?
e)And finally, two bottles of “complimentary” water. Again, unnecessary cost, not to mention the environmental impact. Surely the hospital can instal water coolers;

The gouging does not end there, Besides the unnecessary items, the hospital over-charges for medical supplies. Just two examples: a) RM10 for a pair of surgical gloves. A quick search on the internet shows US$90 for 200 pairs, or about RM1.70 per pair. The hospital was charging 6x as much!; b) RM3 for cotton buds. The doctor used the grand total of 3 sticks. I think I can buy an entire pack for RM3;

The over-charging was clear only because I asked for the detailed bill, which, by the way, took 10-15 minutes to produce. The hospital usually just gives a summary bill, which presumably most patients just sign because it's covered by insurance. Isn't it normal, good business procedure to show the detailed bill when requesting payment?

Even with the detailed bill, three items were not adequately explained (i) gaseous supply; (ii) medication; (iii) nursing procedure. We did not use any gas, nor take any medication and there was no observation by the nurses.

Private hospitals are taking advantage of a captive, disadvantaged market. People who are ill just want to get better. They don't have the time or energy to shop around or argue. This is when new laws are appropriate – to protect the weak and level the playing field. The BN government, instead of chasing poor families to belt-up, should come up with a law to force private hospitals to clean up their acts.

Until it does, you and I end up paying for the higher costs and the unjustified profits. You don't notice the cost at first, because it's covered by your medical insurance. But the insurance company needs to make money too. Ever notice how your medical insurance premiums keep going up? It's in our interest to keep private hospital charges fair.

Some insurance companies have been pushing the hospitals to be fairer. Help them to help you. If you have a similar experience and agree with me, write to your insurance company so they have the facts to help them negotiate.


WY Kam 甘永元 said...

1. Hospitals overcharge and being inefficient in order to maximise their profits (from you or insurers).

2. Insurers, consequent of hospitals' overcharging, would need to reap higher premiums from you.

3. the only total loser in this scenario is you, the consumer.

There's no good alternative to the exhorbitant private medical healthcare, as our public healthcare system is just as dipilated. God saves my country, please, indeed!

Anonymous said...

I think as far as private care is concern, it is difficult to say what is fair and what is not as one always has a choice of which hospital you choose to go. There are the VIPs who demand to be
taken care of like in a 5 or 6 star hotel. This brings me to the core
question of health care for the masses. The government must upgrade all government subsidized health care services so that patients are
confident to walk into a government hospital and not even think of
paying for exorbitant private healthcare. The often complaints of
government hospitals are the long waiting list, lack of rooms/beds and
the declining quality of doctors and nurses

Anonymous said...

I should have studied harder to be an eye dr. My mum had her eye checked by a specialist at a private hospital and bill was....RM100+ for 10 mins of that Wall St is no more gold mine, should be eye dr :)