PETALING JAYA: Bank Negara Malaysia (BNM) dan Kementerian Kesihatan (KKM) perlu campur tangan dan segera memainkan peranan lebih proaktif dalam mengawal selia operasi pentadbir pihak ketiga (TPA) yang kini beroperasi tanpa sebarang kawalan.
PETALING JAYA: Bank Negara Malaysia dan Kementerian Kesihatan perlu campur tangan dan segera memainkan peranan lebih proaktif dalam mengawal selia operasi pentadbir pihak ketiga yang kini beroperasi tanpa sebarang kawalan.
“Kelewatan dalam pemprosesan tuntutan insurans serta keperluan prakelulusan yang berlebihan oleh syarikat insurans turut menjejaskan akses pesakit kepada rawatan segera, terutama bagi penyakit kritikal. Katanya, pihaknya berpandangan, peningkatan kos rawatan di hospital swasta bukanlah berpunca daripada yuran profesional doktor kerana ia dikawal oleh Jadual Ke-13 KKM, sebaliknya dipengaruhi oleh perkhidmatan dan bekalan hospital .
“Akibatnya, pesakit sering berada dalam keadaan serba salah dan terpaksa mendapatkan rawatan sebahagian di hospital swasta sebelum berpindah ke hospital kerajaan disebabkan had kewangan dan sekatan polisi, yang seterusnya mengganggu kesinambungan rawatan perubatan mereka,” katanya. “Negara yang berjaya mengaplikasikan DRG adalah mereka yang mempunyai sistem insurans kesihatan nasional dan pelaksanaannya dilakukan secara berperingkat.
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