Public health expert Prof Dr Syed Mohd Aljunid has sounded a warning to rein in private insurers in order to prevent them from determining Malaysia's public health policy.

Until this is done, he said today, there will be no end to healthcare woes and no hope in coming up with a viable national health financing scheme.

"We need a strong mechanism to control private insurance in this country... As long as private insurance is in the picture, we'll have difficulty in running (a viable) social insurance," he said.

Syed - currently Senior Research Fellow at the United Nations University's International Institute for Global Health - was speaking at a conference on Asian Healthcare 2007 organised in Kuala Lumpur by the Asian Strategy and Leadership Institute.

While efforts began 22 years ago to formulate a social insurance scheme that would enable lower-income groups to access health facilities and services, this has not gained much ground because of opposition by private insurers, he said.

Private insurers avoid the promotion of public health funding as they regard it not simply as a drain on their resources but also uneconomical in the long run, he noted.

This explains the fact that, while numerous consultants have been engaged and studies conducted to determine the possibilities of a national health financing scheme since 1985, nothing concrete has been put in place, he said.

"We have been looking of the possibilities of a national health financing scheme for the past 22 years. In 1985, the first study was started," he said.

"But every time the government... (ends up) delaying announcing (the scheme) and say 'We'll do it some other time'."

'Not compatible'

Syed also cited the problem caused when private insurers divide the population into low-risk and high-risk policy holders, as well as the resulting burden on public health facilities.

While private insurers favour policy-holders who are generally young, healthy and, therefore, need less medical treatment, this has meant that the remaining high-risk group - predominantly the elderly and the sick - are the ones using public health facilities and services.

This has contributed to the breakdown of public health facilities and services and the worsening of conditions for the poor since they cannot afford expensive medical treatment, he said.

"(Private insurers) are going to cause more and more of a burden to the introduction to the social insurance, because these two cannot stay together. They are not compatible," said Dr Syed.

"How long do you have to wait to get a heart or liver transplant in this country? How long do you have to wait to get a bypass operation? These things are not available (to the poor). How many of us can get a bone-marrow transplant for leukaemia?"

Singapore, meanwhile, is "very active in controlling and monitoring" private insurers to ensure that a decent standard of health facilities and services are available to everyone.

Unless the government asserts the political will and resists lobbying by private health insurers, Malaysia will remain stuck with third-class public health facilities and services, he added.