Petaling Jaya, May 19 – A cancer epidemiologist has criticized private insurers for making it extremely difficult for cancer patients to access benefits amid soaring treatment costs.
Professor Nirmala Bhu Pathy, a Public Health Physician at the University of Malaya Medical Center (UMMC), said cancer patients are often forced to submit extensive evidence of their illness in order to qualify for insurance, resulting in lower insurance payouts. He said it could be delayed. important treatment.
Dr. Nirmala gives a ‘D’ grade to those involved in helping cancer patients who do not do enough to provide patients and their caregivers with convenient access to the resources they need. I was.
“Patients say it’s very confusing. They’re so frustrated that they cry all the time. to raise and reap the benefits of it would have to prove very difficult.
“And I believe that responsibility should not lie with patients or their caregivers, but with outsiders who can help access these resources,” Dr. Nirmala said of the Galen Center for Health and Social Policy. said at the Oncology Summit 2023 hosted by Sponsored by Takeda Malaysia on March 10th.
“From an organizational level, they (stakeholders who should serve patients) need to make the organization more people-friendly, and they need individuals to help patients from the outside. I think we can do it.”
Understand the insurance policies that are important for obtaining new medicines
Dr Nirmala said the current healthcare funding mechanisms are not effective and need to be changed.
Rather than just assessing the number of people receiving treatment, we also need to consider the negative impact that longer waiting times have on patients and caregivers, known as ‘chronotoxicity’.
Dr Nirmala also stressed the need to integrate new drugs into health insurance. He emphasized that while some old insurance schemes are still in place, there is a lack of awareness and understanding of person-to-person insurance contracts.
“The new insurance plans that are now on sale claim to cover many medicines, but many people still use the old insurance plans. And I’m no expert, but from what I’ve seen, a lot of the drugs are not covered, because even I have old health insurance. and it was only recently upgraded.
“In other words, insurance literacy does not exist. Insurance literacy must start at the individual, interpersonal level. The insurance industry needs more engagement to ensure it is user-friendly.” It claims to be user friendly, but it really isn’t.
“This is why a financial navigator is needed to develop a better understanding of how insurance and policies are used,” said Dr Nirmala.
Financial Navigator: Tailored support for the unique needs of cancer patients
Dr. Nirmala, who has advocated the role of a financial navigator to support cancer patients and their families with the costs associated with treatment, said the importance of making such figures available to patients to meet their individual needs. reiterated sexuality.
“I don’t know how well you know your finances. This is different from traditional, narrower financial counseling. , I believe some form of financial counseling is already underway, right?
“The aim is usually to help patients who cannot afford to pay their medical bills or who need NGO links to help with funding related to cancer treatment. It’s something that’s going on at the community level.
“But financial navigation is much more than that. It is a larger program. defined regardless of whether the patient is treated in a hospital or in a private hospital.
“In private hospitals, the needs are very different. Many people pay out-of-pocket for insurance. How do I get an insurance claim?How do I get a refund?What are the costs?
“But for public hospitals, much of it is covered. Of course, not all treatments are covered. You need to be connected to an organization that can provide you with personalized care.
“Patients also need help on how to get back to work, how to get back to work, etc., so it’s more important than financial counseling.
Fundamentally, Dr. Nirmala believes it is important for cancer patients to have a financial navigator that covers the entire cancer treatment process, including post-treatment.
Financial Navigators help patients plan their finances by assessing their financial situation, budgeting for cancer-related expenses, and providing advice on how to make the most of existing assets.
Financial planners are also required to connect individuals with financial assistance and assist with the necessary paperwork, Dr Nirmala said. In addition, the team helps patients return to work and find employment.
Dr. Nirmala’s proposal emphasizes the importance of helping patients regain their identity beyond being a cancer patient by reintegrating them into society through employment. The proposal is the result of several years of work with patients and financial stakeholders, including Bank Negara Malaysia, to determine necessary actions.
Collaborative approaches, advocacy programs and initiatives by industry can help ensure broader and more sustainable access to innovative medicines for low-income patients.
To improve patient reach, Takeda has introduced two “weapons” to its approach. One for the public health system, where the cost of patient care is shared with the government, and the other for the private system, where the patient and insurance company share the cost. .
“Takeda is committed to expanding sustainable access to our innovative medicines in Malaysia,” said Jeong-hoon Justin Kim, country manager for Takeda’s Malaysia and Singapore. increase.