15% medical inflation overstates true costs, says private hospitals group

Association of Private Hospitals Malaysia president Dr Kuljit Singh says the official figure includes higher utilisation rate.

According to Bank Negara Malaysia, the country’s medical cost inflation rate rose to 15% in 2025, exceeding the global average of 10% and Asia-Pacific’s 11%.

KUALA LUMPUR:

 A private hospital group has challenged the widely cited 15% medical inflation rate for Malaysia in 2025, arguing that it overstates the true cost growth by including claims-driven utilisation.

Dr Kuljit Singh, president of the Association of Private Hospitals Malaysia (APHM), said that the figure, derived from insurance claims, does not purely reflect price increases.

“We (APHM) have done our own studies and found that the 15% sometimes is not the real inflation figure because it encompasses utilisation rate,” he said in a panel discussion on healthcare reform at the 2026 Malaysia Economic Forum here.

“This medical inflation figure is actually calculated based on insurance claims. It is not measured separately from insurance claims. It’s a little bit skewed; it is not an accurate figure,” he said, linking the rise to more patients making claims using their medical cards.

According to Bank Negara Malaysia, Malaysia’s medical cost inflation rate rose to 15% in 2025, exceeding the global average of 10% and Asia-Pacific’s 11%.

This surge, driven by technology, non-communicable diseases, and an ageing population, has resulted in 30% to 50% increases in medical insurance premiums.

The government is set to roll out a base medical and health insurance and takaful (MHIT) plan next year to provide Malaysians with affordable and sustainable protection against major healthcare expenses, while helping manage rising private healthcare costs.

Commenting on the base MHIT, Kuljit said it could curb excessive claims by giving patients more responsibility.

“Today, medical cards are used like a credit card. They would want to claim almost everything,” he said.

He noted that some private hospitals are already moving towards value-based care, tracking patient outcomes and investigating anomalies to improve efficiency.

Also on the panel, Dr Ramesh Rajentheran, operating partner of TVM Capital Healthcare, warned that Malaysia should not treat the current package of health financing and payment reforms as the final endpoint.

“The first mistake would be to believe that the current set of reforms is the endpoint. It’s actually a starting point,” he said.

Ramesh said future reforms must address critical issues such as insurance access for seniors and people with pre-existing conditions, and whether coverage should be mandatory.

“What happens if you have a pre-existing condition? Can you get health insurance? What happens if you’re over 65? Should we make it mandatory? These are all the things that at some point we will have to address,” he said.

He also said that the success of technical reforms would hinge on implementation, citing upcoding and code inflation issues seen internationally once diagnosis-related groups and fee schedules are introduced.

“Implementation is actually the key. And you have to be very nimble in anticipating and solving the problems,” he said. - FMT