THE Federation of Malaysian Consumers Associations (Fomca) urges the government to take progressive action to regulate and monitor the operations of insurance firms acting as managed care organisations (MCOs).

The recent news of ING Insurance’s proposed new terms for private healthcare specialists as part of their panel network is further evidence that healthcare is becoming more of a trading commodity rather than an essential service for the public good.

We are very much concerned over the projection of the insurers’ influence (as bulk purchaser of healthcare services) into fee-setting and, in extreme cases, even into clinical judgment and treatment protocol.

The diagnosis of a patient must be left to the professional judgment of doctors and not dictated by MCOs. And healthcare cannot be traded like a commodity, for it is not.

It is the right of every consumer to have equitable access to basic quality healthcare and it is the role and responsibility of the state to provide its people with such amenities to sustain a quality and productive life.

The problem with insurance firms acting as MCOs is not about doctors’ fees. It is about these firms denying patients their rights to unhindered professional healthcare treatment.

We call for the government to develop comprehensive laws and guidelines to regulate and monitor the operations of MCOs, and for such regulations to be incorporated in the Private Healthcare Facilities and Services Act 1998.

The government should continue to play a provider role, in addition to an enhanced regulatory role in a mixed public/private healthcare system which needs to be functionally integrated. At present, there are no specific laws to govern MCOs, apart from compulsory registration imposed by the Health Ministry.

DATUK MARIMUTHU NADASON President, Fomca

Source: NST – January 15, 2008