Dr Rajeentheran Suntheralingam, Urologist, Damansara Specialist Hospital (DSH)
Dr Musa Mohd Nordin, Paediatrician, DSH
Dr Ahmad Faizal Mohd Perdaus, Respirologist, DS
Dr Sng Kim Hock, Neurologist, Pantai Medical Centre (PMC)
As active members of the Association of Specialists in Private Medical Practice (ASPMP) we felt obliged to respond to several of the concerns raised by the Galen Centre on the Base MHIT proposition.
We are not cherry picking but felt that the following 3 issues in Part II of our rebuttal, stand out as critical in our authentic understanding of the proposed Base MHIT plan.
The mainstream press did pick up some of our initial thoughts in the following piece:
https://www.thestar.com.my/news/nation/2026/01/23/private-hospitalsback-reset-push
4. On Market Competitiveness and Value Proposition
On Galen Centre’s statement: “Comparable health insurance products are already available and are, in fact, cheaper than the base MHIT plan with similar or even better coverage.” https://theedgemalaysia.com/node/790414
This comparison commits the classic error of comparing apples with oranges while ignoring the orchard. Existing “cheaper” plans achieve their price points through precisely the market failures the MHIT seeks to correct: aggressive risk selection, pre- existing condition exclusions, non-portability, and nonguaranteed renewal. All that glitters is not gold – what appears to be a better deal often conceals dangerous limitations.
Furthermore the Base MHIT is not meant to compete with comprehensive, high-premium private plans. It is a standardized, no-frills product designed for portability, guaranteed renewal, and lifetime coverage – features often absent or limited in the current market. Its value lies in long-term security and preventing discrimination against the elderly or those with pre-existing conditions, addressing critical market failures.
The Base MHIT’s revolutionary value proposition rests on four pillars largely absent from the current market:
1. Lifetime guaranteed renewability regardless of health status
2. Standardized benefits preventing the “fine print exclusions” that render many policies useless when needed
3. Portability across employers and life circumstances
4. Community-rated premiums for the basic plan, ensuring intergenerational solidarity
The higher apparent premiums reflect actual risk pricing rather than risk avoidance. This honest pricing is essential for system sustainability. The RM10,000-15,000 deductible in the Standard-Plus plan specifically targets a critical market gap: affordable catastrophic coverage for middle-income families currently one health crisis away from poverty.
Cheap things are not good, and good things are not cheap. The MHIT prioritizes sustainable protection over marketing gimmicks, recognizing that a healthcare financing system must withstand decades of demographic and epidemiological change.
5. On Coverage Adequacy and Clinical Appropriateness
On Galen Centre’s statement: “The risk is that Malaysians purchase the plan believing they are protected, only to discover that they are underinsured when illness strikes… treating conditions like dengue and respiratory tract infections, such as pneumonia, as outpatient.”
This concern confuses a base plan with a comprehensive solution. The MHIT explicitly positions itself as the foundation upon which additional coverage can be built, not as the complete answer for every medical scenario.
Attempting to cover every possible healthcare need within a basic plan would render it financially unsustainable and ultimately unavailable to those who need it most.
The outpatient classification for conditions like dengue represents evidencebased medicine, not benefit restriction. Modern clinical protocols increasingly favor outpatient management with close monitoring over automatic hospitalization, which reduces hospital-acquired infections and preserves inpatient capacity for truly critical cases. The MHIT’s design aligns with this clinical evolution while acknowledging that severe cases would appropriately trigger inpatient benefits.
Furthermore, uncomplicated mild community-acquired pneumonia in younger healthier individuals can be treated as outpatient. Let us allow the practicing clinicians to decide what is best in various clinical scenarios.
Regarding coverage limits, the RM100,000-300,000 ranges cover approximately 95% of hospitalizations based on current Malaysian cost data.
For the remaining 5% of extraordinarily complex cases, the plan deliberately interfaces with the public system – a sensible design recognizing that exceptionally rare, high-cost conditions represent a national solidarity concern rather than an insurable risk.
Perfect is the enemy of good. The relentless pursuit of absolute perfection often prevents us from completing something good, delaying progress and achieving less than we could by settling for “good enough” or making incremental improvements. It’s a reminder that striving for flawless results can lead to procrastination, anxiety, and inaction, whereas accepting a highquality, but not perfect, outcome allows for completion and real-world impact.
Waiting for a perfect plan that covers every conceivable scenario would mean never implementing any reform. The Base MHIT represents the “good” that can be achieved now, with mechanisms for evolution as evidence and experience accumulate.
6. On the Root Drivers of Medical Inflation
On Galen Centre’s statement: that the MHIT Base plan is “not addressing the root drivers of medical inflation”:
This critique conflates two separate policy objectives. The Base MHIT is a financing mechanism, not a direct price control tool. Its primary goal is to reshape how care is paid for.
As reiterated by the Health Minister, the MHIT plan alone is insufficient to rein in medical inflation, and broader reforms are essential (The Edge, 22nd January 2026) https://theedgemalaysia.com/node/790320
The MHIT is only one of the strategies in the broader RESET strategy which has seen private insurance premiums surge by 40% to 70%. The strategy aims to overhaul the private healthcare system to ensure it remains sustainable, affordable, and accessible.
The RESET strategy encapsulates five strategic thrusts to address challenges in Malaysia’s private healthcare system through 11 initiatives. This perspective underestimates the sophisticated sequencing embedded in the MHIT proposal. The White Paper explicitly positions the Base MHIT as the enabling catalyst for precisely the systemic reforms the Galen Centre advocates. The chain is only as strong as its weakest link, and Malaysia’s healthcare system has long suffered from a weak financing link that undermines all other reform efforts.
Malaysia’s healthcare system must master sustainable basic financing before attempting the more complex reforms of price regulation and system integration. The Base MHIT represents those essential first steps. Towards a More Constructive Dialogue
The Galen Centre performs an invaluable service by rigorously scrutinizing healthcare reforms. However, their critique of the Base MHIT plan employs an unrealistic standard – judging a foundational financing reform against the criteria of a fully realized, comprehensive healthcare transformation.
The proof of the pudding is in the eating. Rather than rejecting the plan for what it isn’t, stakeholders should engage with what it is: Malaysia’s most serious attempt to create a sustainable pathway toward universal health coverage (UHC). The plan contains ample provisions for review, adjustment, and evolution based on real-world experience.
As Malaysia stands at this healthcare crossroads, we would do well to remember that he who refuses to reform, refuses to benefit. The Base MHIT plan deserves implementation, careful monitoring, and iterative improvement – not rejection based on theoretical imperfections. It represents not the end of the reform journey, but the essential beginning of a wiser, more sustainable healthcare future for all Malaysians.
Vision without action is merely a dream. Action without vision just passes the time. Vision with action can change the world.
The Base MHIT represents that crucial marriage of vision (UHC) with action (immediate implementable steps).
Conclusion: A Smooth Sea Never Made a Skilled Mariner
The very complexities and difficult trade-offs identified are not reasons to abandon the voyage, but essential conditions for developing a more resilient, equitable, and sustainable healthcare system.
We live in difficult times, especially with the current medical inflation that our healthcare is facing. We need to chart our course to calmer waters, and to set our sails to a healthier future.
With the Base MHIT, the country is not shifting costs aimlessly but is wisely learning to sail in the storm it can no longer avoid, steering purposefully toward the horizon of universal, sustainable healthcare (UHC).
