Penang, November 17:

Beginning next year, foreigners will have to pay much higher charges for medical treatment in Malaysia’s state-run hospitals — a move that will hit the country’s two million migrant workers the hardest. Dr Chua Soi Lek, health minister, announced recently that foreigners would no longer enjoy health subsidies given to locals. Instead, they would be regarded as ‘full payment patients’. He said the new rates would be based on the Malaysian Medical Association (MMA) schedule of fees for private practitioners and hospitals.

Migrant workers are already paying substantially higher fees than Malaysians at state-run hospitals. From June last year, they have been charged the same rate as local ‘first class’ patients, which can be about 10 times higher than what most other Malaysian patients pay.

The first-class rates in state-run hospitals are, however, still much lower than private sector fees. A caesarian section procedure in a private hospital, for instance, would cost $600 compared to the state-run hospital’s first-class fee of $267. However, the usual rate that most local patients would pay at a state-run hospital is $26.

By comparison, the average take-home pay of a migrant worker ranges from $133-$160 per month, inclusive of overtime (assuming a 12-hour work day). Chua said the government decided to impose full payment after discovering that foreigners had cheated to get treatment as well as to reduce the ‘flooding’ of foreign workers in the government hospitals. He pointed out that, after first-class charges were imposed in government hospitals, the number of outpatients dropped from more than 500,000 to 337,000. But the number of patients warded rose from 50,000 to 64,000; many of these, he said, had used false documents and vanished before settling their bills. “We must move away from our total dependence on foreign workers,” he was quoted as saying. The Malaysian government spends two percent of gross domestic product on health care.

Employers have expressed alarm at the prospect of even higher medical fees for migrant workers. They are afraid that higher costs will scare off both investors and foreign workers as well as increase their operating costs. Even without the new higher rates, migrant workers still have to pay a string of charges upon entering Malaysia. First, they have to pay for a medical check up in their source countries. When they arrive in Malaysia, they are required to take another medical test at a clinic approved by FOMEMA Sdn Bhd, a private firm awarded a government monopoly concession for the ‘monitoring and supervision’ of the mandatory medical checks of foreign workers. These medical checks are usually carried out by private general practitioners, who are paid by FOMEMA for the work they do. FOMEMA bills employers $48 for the medical tests for each male worker and $50 for each female worker. In most cases, the employers deduct these charges from wages, says the employment agent.