Private Hospitals Ripping Off The Public

The following is written by VM Chandran. It details the “predatory” and rip off behaviour of private hospitals in the country, especially large, corporate owned private hospitals in the Klang Valley.  Do read Outsyed’s comments at the end.

Private Hospital care – Cost escalation,  “Hidden charges” By VM Chandran

I have heard of “1st world facilities, 3rd class mentality”. This has been an issue where people do not look after the facilities including its regular maintenance. This seems to be the “perennial disease” in Malaysia.

Now I must coin a new term, “3rd class facilities, 1st class charges,”. This is based on my experience of a week’s hospitalization at a reputed hospital in Kuala Lumpur. Save for the excellent Specialists who attended to me, the other aspects became a “nightmare”.

I have made my views known at appropriate levels in the Hospital and I cannot breach the trust to itemize the plethora of issues. There have been positive steps taken to address some of the issues by the Hospital and I hope they have the guts and determination to see it through. Much too often compromises are made along the way sacrificing the operational standards.

My other big ticket item is what I refer to as “Hidden charges” that appear in their billing that is neither drawn to attention at the point of  admission nor does it exist in any of their advertising literature.

This is a very strange action by a large outfit which is ultimately owned by our National Sovereign Fund (Khazanah?). Communication seems to be lacking and above all the consequences of this is being faced by my fellow Malaysians,  for whom the Sovereign Fund serves.

The rate this hospital charges for a single premium room is as good as a 1st class hotel. Therefore one expects that  level of facilities and services. Well!! The shortfall is unimaginable, making one wonder whether patients are being misled in their sickly hours.

So what do the rates cover?  From my experience:

1. Lodging

2. Breakfast, coffee, lunch, tea and dinner.

3. Entertainment ie TV and wifi.

TV is very restricted with mainly local channels.

No internationsl news channels or  good sports channels.
WiFi is generally weak.

I am actually stretching the boundaries of my imagination but  I cannot find any other matters to add positively. The equation  “value for money” does not exist  here.

This rate must be seen with the other charges.

This hospital last year charged an extra RM 100 per day as Nursing charges.

Looking out for it this time, I was “snookered”.

This time it appears as 2 charges Rates per day are:

1. Basic Nursing charge        RM 59.10
2. Total Dependent care
Patient                                 RM 61.10
Total    RM 120.20

A very cunning strategy indeed.

Break the charges into 2 components and build in the 20% increase.

This daily charge  has completely flabbergasted me. Why the “hide and seek”?

The daily nursing charges does not end here. Other daily cost elements “massaged” into the billing are:

Digital Bloodpressure monitor RM 40.90
Pulse oxymeter                            RM 42.80
Glucometer                                  RM100.40
Total       RM 184.10

Other daily charges are alcohol swabs at RM 5.30 whereas a box of 100 obtained outside cost RM 7.00 only.

The ear probe  to check body temperature is  billed at RM 6.00.
Effectively, with the room rates and these basic nursing charges, admission per day to a single premium room starts at around RM700 to RM800 and not RM380 as advertised. Why not be honest about it?

The question is why then are there such high room rates or why are there basic nursing charges, when it should already have been covered by the room rates?

Perhaps the Hospital should allow the patient to take their own temperature readings which is then recorded by the nurses.

Indeed for the amount of monies paid to the hospital for the “measurement” charges, the patient can easily buy the equipment and operate it himself. These are not highly sophisticated equipment that one needs to be a “rocket scientist” to operate.

Another area that I believe the country is paying the price for is the high cost of pharmaceutical items. The medication billing makes me wonder why the Hospital needs such a margin. A relatively new drug is billed at RM126 whilst at an outside Pharmacy it is at RM70.

Even at that price the Pharmacy is making its profit.

The Hospital sells it at more than 80% of what can be obtained in market.
Another shocking element which may have sparked a “heart attack”, is medical supplies. One classic example I must state, and this I have rechecked numerous times, in the hospital and with outside Pharmacies is the price of crepe bandages

What can be obtained at RM 5 is being charged at RM 50 at the Hospital.

A 1000% price difference!!!!!! Why?

These neither have short live span nor deteriorate easily.
The area where the Hospital seems to have a form of  monopoly is with drugs that can only be obtained in hospitals. Here the poor patient is left in the lurch. I wonder what margins the Hospital is working upon?

As I scan the hospital’s detailed billing, I am drawn to certain items that i am fully charged and yet not offered the option to retain them.

Examples are Dissecting Forcep at RM 23.80, Iris Scissors at RM 24.90 and Adson Dissecting forcep at RM 23.80.

There may be medical reasons as to why they are not offered to the patient after being used ie it  spreads infections. I thought such items are reusable  after they are sterilized, which should make it cheaper.

Businesses must make profit to permit the wheels of the economy  to turn. However there must be a reasonable approach and greed should not  be the main criteria. Qualitative care matched with the level of facilities and services is paramount for an affordable concept.

When there is a shortfall in standards, a good Hospital must have the mechanism to rectify it. Much too often we blame the national education system and the training the staff receives before joining them. It still does not provide a rationale, as the staff and facilities belong to the Hospital.

Constant training and retraining exercises with an adequate monitoring system should be the modus operandi. Much too often compromises are made and standards take a dive with productivity paying the price. More people are now required and costs escalate,  putting the pressure on the patients.

Failure to adopt a sensible purchasing approach keeps costs high. Corruption may be a feature, unless the Hospital is greedy to make quick profits or incompetent to negotiate the best deals.

In the end the patients become the victims and the country has the cost of living shooting through the window. The manner in which the medical cost is escalating and the way  Insurance companies seemingly condone it, puts the nation on a uphill task to manage the country particularly when its  population ages.

Something must be done now and done urgently.

V M Chandran.

My comments :  It is not likely that the Minister of Health will understand this very detailed expose of how the private hospitals rip off the unsuspecting public.

Plus it does not really affect the lives of the rural people who voted for him in his constituency.  This is a non issue for them.  So it is not of high priority.

There are other things stacked up against the public interest as well. The private medical care laws seem to favour the large corporations that run these private hospitals.

Rather “unnecessarily strict rules” are imposed which makes it difficult for new and smaller entrants to enter the market.   Hence the market is ‘monopolised’ by the large corporate players. And hence the predatory pricing for private health care. 

And for those new players who are just learning the business they have discovered how easy it is to rip off the public.

But this is Malaysia.  The people here do not have good moral and ethical values. 

Some really stupid morons sent angry comments in the earlier post  saying that it was a good thing that that fellow was jailed 10 years for insulting  Islam.  (Please do not be hypocritical – he did not insult Mickey Mouse).  

The point I made – from the Quran – is that firstly Islam cannot be insulted, secondly insult cannot be made a criminal offence.

The morons cannot understand simple concepts like these. 

This is also a country where there are sufficient numbers of morons who feel it is ok for Malaysians to pay 25%, 50% or 200% more for their cars than world market prices for the same cars.

It is very difficult to deal with morons like these.

Yet we must try.  As I said before, when a large part of the country is falling down the others have to take up the slack.