KUALA LUMPUR, March 7 — A former Hospital Kuala Lumpur (HKL) director questioned today why the government chose a private insurance model for its mySalam health insurance scheme that does not cover pre-existing conditions.

"I don’t know whether the government is giving the wrong signal on getting private insurance, and look at it, private care insurance already said, if you got history of past illness, you’re not in,” Dr Lim Kuan Joo told the Malaysian Health Care Conference 2019 organised by the Kingsley Strategic Institute here today.

"So the health insurance is waiting for all those working age group to get disease, then only they will pay. This is some sort of cream skimming. I do not know what the government is trying to tell us,” added the former HKL director as he moderated a session on the Malaysian health care financing scheme.

Finance Minister Lim Guan Eng has said that mySalam, which provides a one-off RM8,000 lump sum payment upon diagnosis of any of 36 critical illnesses for the bottom 40 per cent (B40), will not cover those who were diagnosed before January 1 this year.

Doctor groups have previously questioned the denial of coverage under mySalam, which is funded by Great Eastern Holdings, for those who already had health problems before January 1, saying that national health insurance is meant to be inclusive rather than exclusive like commercial insurance.

Meanwhile, Research Triangle Institute senior adviser Dr Chua Hong Teck said at today’s conference that insurance companies should cover pre-existing conditions.

"We should follow Obamacare where pre-existing conditions are covered,” he said, referring to the United States’ Affordable Care Act that was signed into law by former president Barack Obama.

Dr Chua also suggested that insurance companies in Malaysia provide family plans, rather than just individual plans.

He added that he was not in support of a social health insurance system.

"We will never be able to do it. Can you ask people right now to contribute money to social health insurance? You think people are willing to trust the government, even though it’s a new government? Will everyone contribute? No,” he said.

He suggested instead that the government continue to strengthen the current tax-funded health care system.

"What’s wrong with a tax-based system?” asked Dr Chua, adding that the government should review how much wastage there is in the Health Ministry’s facilities.

Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib, however, disagreed and proposed a compulsory national health insurance scheme, pointing out that such a suggestion appeared back in 1996 for the Seventh Malaysia Plan.

"It should provide coverage for all,” he told the conference.

"The ideal would be for a single-payer, multiple-provider system where public and private institutions would be equally accessible to the patient. This would be the most efficient and cost-effective system. This is the long-term goal.”