Twentytwo13

Preventing potential profiteering in private hospitals: A delicate life and death balance

Private healthcare providers in Malaysia play a crucial role in society, offering specialised services, advanced technologies, and often quicker access to care.

At the same time, they are a business entity, and like any other business, they must be financially viable to sustain operations to continue providing those services.

However, the core question lies in how to balance the profit-making aspect of private hospitals with their moral responsibility to serve the community’s healthcare needs.

Firstly, private hospitals are indeed in business, but their service is one of the most vital for the rakyat’s wellbeing. Healthcare, particularly when it comes to life-saving or critical treatments, is not like other sectors. Ethical concerns arise when profits seem to take precedence over patient care, or when essential services are priced in a way that limits access for people who need it the most.

Secondly, for private hospitals to remain financially stable, they must generate profit. These profits fund research, maintain state-of-the-art equipment, pay skilled professionals, and ensure the hospital can continue to operate. Without this financial stability, a hospital would be unable to provide high-quality care or invest in innovations that can save lives.

The concern arises when hospitals take advantage of their monopoly or market position to charge exorbitant prices for basic care. Healthcare is often urgent, and patients may not have the luxury of comparing prices or seeking alternatives. In this sense, when the business side of hospitals starts to conflict with patient welfare – such as charging excessively for necessary procedures or treatments – it becomes a moral issue.

A fundamental question is whether the private healthcare sector is accessible to all, or just those with sufficient financial resources or insurance coverage. In many countries, private hospitals cater to a certain demographic, often excluding lower-income groups. This creates a divide in healthcare access, which undermines the principle of health as a basic human right.

The line between profit and service to humanity becomes blurred when there are large disparities in the quality of care that different segments of society can access.

Therefore, to ensure that the business side of private healthcare does not overshadow the ethical obligation to serve the public good, several measures could be considered.

Most importantly, encouraging or requiring private hospitals to provide clear price lists and be more transparent about their costs would help reduce the potential for price gouging. This way, patients and insurance holders can make informed decisions. Furthermore, price caps on essential services could ensure that hospitals aren’t profiting excessively at the expense of patients’ wellbeing.

Additionally, private hospitals should be encouraged to adopt a stronger sense of social responsibility. This could involve offering financial aid to low-income patients, working with the government to subsidise care, or providing certain services at discounted rates to ensure that healthcare remains accessible to a broader population. Ethical guidelines for healthcare businesses could be enforced to encourage this.

Furthermore, private hospitals can be incentivised or regulated through collaboration with government healthcare programmes. For example, tax incentives or public funding could be given to hospitals that provide a percentage of their services at lower costs for disadvantaged populations.

Ultimately, the key is finding a balance between profitability and patient care. Hospitals should be allowed to generate income to cover their operational costs and reinvest in better healthcare services, but this should not come at the cost of basic human rights to access life-saving or essential healthcare services.

Some private hospitals already engage in charitable work or offer reduced rates for the underprivileged, and such practices could be made more widespread.

Undeniably, while private hospitals do play a vital role in the healthcare ecosystem, ensuring their services align with the principles of service to humanity requires careful regulation, transparency, and ethical considerations.

The line between profit and service to humanity should be clearly drawn by encouraging hospitals to balance their need for financial sustainability with their duty to provide quality, accessible care. By doing so, private healthcare can continue to thrive while serving the greater good.

Thus, the issue of whether private hospitals should be charged under the Price Control Anti-Profiteering Act 2011 is complex, given the nature of the healthcare sector.

Last November, Health Minister Datuk Seri Dzulkefly Ahmad said the government would make it mandatory for private healthcare facilities to display medication prices to enhance transparency, adding this initiative would be implemented under the Act. A month later, Dzulkefly said the diagnosis-related group pricing system to regulate private hospital bills will most likely be rolled out by the second quarter of this year.

In general, profiteering refers to the act of charging excessively high prices for goods or services, especially in situations where consumers have limited options. The law aims to protect consumers from such exploitation.

In principle, if a private hospital is found to be raising prices inappropriately, such as increasing costs without justification (e.g., after a reduction in taxes, supply costs, or other operational changes) or using their position to exploit patients, then, yes, private hospitals should theoretically be subject to the Price Control Anti-Profiteering Act. However, healthcare services involve many variables, such as medical expertise, infrastructure, equipment, and medications, all of which contribute to the overall cost structure. These complexities make pricing transparency and fairness more difficult to regulate compared to other sectors.

The question of whether private hospitals should be charged under the act would depend on how the law is interpreted. Under the Act, the focus is on preventing “undue profiteering” following market changes, such as tax reductions. The law’s application to hospitals is not always clear-cut due to the special nature of medical services and the often urgent or critical needs of patients, which may limit their ability to shop around for alternatives.

Thus, private hospitals may not be fully immune from prosecution under the Price Control Anti-Profiteering Act, but they may have more leeway to justify price increases. Unlike typical goods and services, hospitals often cite various factors that contribute to pricing – such as the costs of medical professionals, specialised equipment, high-quality care, and operational overheads. As a result, proving that a hospital’s pricing is unjustifiably inflated or constitutes profiteering can be more difficult.

Moreover, certain private hospitals may be able to argue that their pricing is based on factors not directly addressed by the Act, such as market forces specific to the healthcare sector (e.g., the need for cutting-edge medical technology, patient care costs, etc.). This could create a kind of de facto immunity unless there’s direct evidence of clear abuse or illegal profiteering.

There is a valid argument that the laws could be amended to better address the healthcare sector and prevent potential profiteering in private hospitals. While the Price Control Anti-Profiteering Act addresses general profiteering, it may not sufficiently account for the unique dynamics of the healthcare industry, which includes insurance models, emergency services, and the often non-competitive nature of private hospitals in certain areas.

Private hospitals could be required to clearly outline pricing for medical procedures, including the breakdown of costs for consultations, tests, treatment, and aftercare.

It will be prudent to implement caps or clear regulations on how much profit hospitals can make, particularly on essential treatments or life-saving procedures, which could reduce the risk of exploitation. The law could be tailored to more clearly define what constitutes excessive profiteering in healthcare services, particularly in situations where insurance holders are involved. This might address concerns of unjustified price hikes.

Finally, the creation of an independent body to oversee hospital pricing and ensure fairness in medical costs could complement existing laws.

In conclusion, private hospitals could be charged under the Act if they are found to be exploiting consumers with unjustified price hikes, though the unique nature of healthcare makes enforcement challenging. There may be a case for amending the law to allow for better regulation of hospital pricing, ensuring that consumers are protected from potential profiteering while balancing the need for hospitals to maintain financial viability.

The views expressed here are the personal opinion of the writer and do not necessarily represent that of Twentytwo13.