MySalam - RM400m premium for a RM3m payout?

LETTER | An open letter to Tun Dr Mahathir Mohamad,

Dear Tun Dr Mahathir,

Three weeks ago, a 48-year-old lorry driver with stage 4 cancer of the colon came to see me as he was in financial distress. He had been the sole breadwinner and family finances were deeply in the red ever since his diagnosis about two months ago. As he was a BR1M recipient in 2018, I downloaded the application forms for MySalam and filled them in for him (as I had made the clinical diagnosis of colon cancer with obstruction before referring him to the Ipoh General Hospital. (Asking the GH to fill up the forms would have taken another six to eight weeks). 

The reply from MySalam WhatsApped to him after a week was - "[...] dukacita dimaklumkan bahawa tuntutan penyakit kritikal anda telah ditolak disebabkan  kemasukan hospital bukan kerajaan. Salah satu syarat tuntutan adalah penyakit mestilah didiagnos di hospital kerajaan [...]."

This Tun, is the DNA of insurance companies – deny liability first and try and turn people off. This could be one of the reasons that as of July 22,  just over RM1 million has been paid out under the MySalam scheme. This comprised 108 approved claims for critical illnesses (RM864,000) and 941 approved claims for hospitalisation (RM50 per day for a maximum of 14 days). These figures are from the Ministry of Finance.

Tun, we paid Great Eastern Bhd RM400 million to cover the B40 population for a year. It looks like Great Eastern will pay out less than RM3 million this year. Clearly, the rakyat is not getting our money’s worth.

This is precisely why PSM wrote to Lim Guan Eng in November 2018, and again in January 2019 urging him to consult other parties, do a proper actuarial study and consider other alternatives such as using Great Eastern’s payment of RM2 billion to defray the co-payments required of patients going to government hospitals. 

However Lim, in his wisdom, didn’t engage us – didn’t even get one of his staff to meet up with us to get our views. That was when we sent a memorandum endorsed by 40 organisations to you reiterating the same points.

Well Tun, the performance of MySalam over the past six months shows that the largest beneficiary is Great Eastern itself which received a payment of RM400 million for insurance cover for the B40 population for 2019, but will likely only pay out RM3 million or so to the Malaysian public for 2019.

We would like to urge you to set up an independent committee to look into the MySalam scheme and if necessary call it off and channel the RM2 billion to the Ministry of Health to help patients with their co-payments required of them in government hospitals. 

Getting the opinions of the MMA, the Health Ministry and citizen groups working on health-related issues would be a good idea too.

The writer is PSM chairperson.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.