主日信息记录：安静 Be still

马可福音

Mark 

4:35 And the same day, when the even was come, he saith unto them, Let us pass over unto the other side.

当那天晚上，耶稣对门徒说：“我们渡到那边去吧！”

4:36 And when they had sent away the multitude, they took him even as he was in the ship. And there were also with him other little ships.

门徒离开众人，耶稣仍在船上，他们就把他一同带去，也有别的船和他同行。

4:37 And there arose a great storm of wind, and the waves beat into the ship, so that it was now full.

忽然起了暴风，波浪打入船内，甚至船要满了水。

4:38 And he was in the hinder part of the ship, asleep on a pillow: and they awake him, and say unto him, Master, carest thou not that we perish?

耶稣在船尾上，枕着枕头睡觉。门徒叫醒了他，说：“夫子，我们丧命，你不顾吗？”

4:39 And he arose, and rebuked the wind, and said unto the sea, Peace, be still. And the wind ceased, and there was a great calm.

耶稣醒了，斥责风，向海说：“住了吧！静了吧！”风就止住，大大地平静了。

4:40 And he said unto them, Why are ye so fearful? how is it that ye have no faith?

耶稣对他们说：“为什么胆怯？你们还没有信心吗？”

4:41 And they feared exceedingly, and said one to another, What manner of man is this, that even the wind and the sea obey him?

他们就大大的惧怕，彼此说：“这到底是谁，连风和海也听从他了？”

经文回顾反思：

他们真的没信心吗

靠着经验门徒中有经验丰富的渔夫 （拥有船队那种）

他们见过耶稣行神迹

也知道耶稣的生活经验是一名木匠

他们知道叫醒耶稣， 问的是 （你不管吗do you not care） 心里他们知道耶稣管得了 

为什么当风浪平静了耶稣依然责备门徒没有信心，：

耶稣的责备难道是门徒没有寻求他的帮助吗？

耶稣真的不管吗？耶稣有别的选择当时还有别的船为什么选了跟门徒的船。

如果耶稣不在乎门徒的话在危机过后为什么依然教训门徒？

在最后一段门徒们竟然是 （比现实中害怕的事）更恐惧（Fear, 敬畏）

“我们渡到那边去吧！”门徒好像忘了耶稣已经定了方向。

Is ok to be fear, yet 神与你同在！ 一直都在！

Be still by hill song

藏我在翅膀荫下

遮盖我在你大能手中

当大海翻腾 波涛汹涌

我与你展翅 暴风上空

父你仍作王 在洪水中

我要安静 知你是神

我灵安息 在基督里

你大能 使我安然信靠

当大海翻腾 波涛汹涌

我与你展翅 暴风上空

父你仍作王 在洪水中

我要安静 知你是神

当大海翻腾 波涛汹涌

我与你展翅 暴风上空

父你仍作王 在洪水中

我要安静 知你是神

补充：既或不然的信心

Daniel 

3:17 If it be so, our God whom we serve is able to deliver us from the burning fiery furnace, and he will deliver us out of thine hand, O king.

即便如此，我们所侍奉的 神能将我们从烈火的窑中救出来。王啊，他也必救我们脱离你的手；

3:18 But if not, be it known unto thee, O king, that we will not serve thy gods, nor worship the golden image which thou hast set up.

即或不然，王啊，你当知道我们决不侍奉你的 神，也不敬拜你所立的金像！”

－－－－总结－－－－

当风暴来临时，我们常常感到无助和害怕。就像耶稣的门徒一样，我们也会在生活中遇到各种挑战和不确定性。让我们从马可福音第四章35-41节中汲取一些深刻的教训，看看耶稣如何平息风浪。

1. **生活中的风暴**：

   - 生活中常常会有突如其来的风暴，包括考验、不确定性和困难。

   - 正如门徒们一样，我们也会面对威胁我们稳定和安全的情况。

   - 这些风暴可能让我们感到恐惧，摇摆不定，甚至质疑自己的生存。

2. **耶稣的平静**：

   - 在风暴中，耶稣在船尾睡觉。

   - 与门徒的恐慌形成鲜明对比。

   - 虽然他们担心性命，但耶稣保持镇定。

3. **门徒的求助**：

   - 门徒叫醒耶稣，说：“夫子，我们丧命，你不顾吗？”

   - 他们的请求表明他们的绝望和怀疑。

   - 他们知道耶稣行过神迹，但仍然质疑他是否关心他们。

4. **耶稣对自然的权柄**：

   - 耶稣斥责风，命令海平静。

   - 瞬间，风停了，大海平静了下来。

   - 他展示了对自然力量的掌控能力。

5. **对信仰的责备和质问**：

   - 耶稣问门徒：“为什么胆怯？你们还没有信心吗？”

   - 他们的恐惧与他对上帝主权的坚定信任形成对比。

   - 他鼓励他们加深信仰。

6. **门徒的敬畏**：

   - 门徒惊讶地问：“这到底是谁，连风和海也听从他了！”

   - 他们认识到耶稣的神圣权柄，但仍然难以完全理解。

7. **应用于我们的生活**：

   - 像门徒一样，我们也会遇到风暴——无论是身体、情感还是属灵的。

   - 耶稣在这些试炼中与我们同在，即使他似乎“在睡觉”。

   - 我们被呼召要相信他，知道他能掌管我们的风暴。

请记住 Hillsong 的歌词：

```

藏我在翅膀荫下

遮盖我在你大能手中

当大海翻腾 波涛汹涌

我与你展翅 暴风上空

父你仍作王 在洪水中

我要安静 知你是神

```

此外，但以理在但以理书第三章17-18节中的坚定信仰也传达了类似的主题：

- 即使上帝不从火炉中拯救我们，我们也不会妥协。

- 这提醒我们，信仰不取决于结果，而是要无论如何都信靠上帝。

愿在生活风暴中寻求平安和信仰的人得着！ 

Jehovah Rapha and the Crisis at Rafah Crossing

In the Bible, Jehovah is known as "Jehovah Rapha," meaning "The Lord who heals" (Exodus 15:26). This name highlights God's role as a healer, providing not only physical healing but also spiritual and emotional comfort. The Israelites, during their time in the wilderness, faced numerous hardships and challenges. Whenever they called upon Jehovah, He healed and saved them in various ways. This healing extended beyond physical recovery to include the restoration and comfort of their souls.

Today, the Rafah Crossing, which connects the Gaza Strip and Egypt, is a place marked by pain and unrest. Due to ongoing conflicts and bombings, the situation at Rafah Crossing is dire. Thousands of residents have been forced to leave their homes, seeking refuge and humanitarian aid. Despite continuous efforts by the international community to provide assistance, the instability of the situation poses significant challenges to the supply of essential goods and the evacuation of people.

In this context, the significance of Jehovah Rapha becomes particularly important. In the face of the trauma caused by war and conflict, people need not only material aid but also spiritual healing and comfort. Jehovah Rapha reminds us that God is a healer who cares for every wounded soul, offering them peace and restoration.

Authorities should reflect on their actions and strive to find peaceful solutions to reduce civilian suffering and casualties. The international community should also actively intervene, providing more humanitarian aid to help those affected by the conflict. As Jehovah Jireh, the Lord who provides, God will prepare everything needed. In the current crisis, believers can rely on God's provision and protection, seeking inner peace and strength.

Balancing Co-Payment Features in Malaysian Healthcare: A Delicate Equation

1. The Role of Co-Pay: A Double-Edged Sword

• Understanding Co-Pay: Co-Pay is an individual's upfront payment before insurance coverage. They discourage unnecessary utilization of private hospitals for minor cases.
• The Catch: While deductibles promote cost-consciousness, they can inadvertently push patients toward public hospitals. Striking the right balance is crucial.

2. Co-Insurance: A Middle Path

• Co-Insurance Defined: Co-insurance involves cost-sharing—patients pay a percentage (e.g., 5%) of medical costs. It encourages financial responsibility without outright denial of care.
• Empowering Patients: Co-insurance empowers individuals to take ownership of their healthcare expenses, ensuring both patient and insurer share the cost of healthcare.

3. The Stop Loss Safety Net

• When Bills Skyrocket: What if medical bills become overwhelming, even with co-insurance? Enter the stop loss provision.
• How It Works: Stop loss sets a maximum financial burden for the insured. Beyond that threshold, the insurer steps in, preventing catastrophic costs.

4. Government Responsibility and Safety Nets

• Subsidizing Stop Loss: To enhance affordability, the government could subsidize stop loss features for eligible applicants.
• MediSave-Like Policy: Imagine a “MediSave”-like policy—a public fund for medical and accidental risks. It would provide a safety net for Malaysians.
• Collaboration with Banks: Interest-free loans for medical risks could further bolster financial security.

5. Demographic Challenges and Social Equity

• Aging Population: As our population ages, families may struggle to afford essential needs beyond healthcare.
• Proactive Policymaking: Addressing these challenges ensures a sustainable and equitable healthcare system.

Conclusion: Orchestrating a Harmonious System

Balancing co-payment features requires finesse. Policymakers must consider affordability, access, and social impact. By thoughtfully designing policies, fostering transparency, and collaborating across sectors, we can create a resilient healthcare symphony that serves all Malaysians.

Balancing Affordability and Access: The Malaysian Healthcare Dilemma

1. Historical Evolution of Insurance Policies in Malaysia

• The roots of insurance in Malaysia extend back to the 19th century during the colonial era. The pioneer was the Oriental Life Assurance Company, established in 1819.
• Over time, insurance companies experimented with various approaches, including deductibles, coinsurance, and stop-loss provisions. These aimed to strike a balance between cost containment and coverage.
• Recent trends, however, indicate a shift toward policies that allow near-full 100% claims. Insurers now compete to offer comprehensive medical health insurance coverage.

2. Effectiveness Assessment: Copayments and Beyond

• Policymakers must assess the impact of different cost containment mechanisms. Copayments, in particular, warrant scrutiny.
• Copayments: These involve cost-sharing between insurers and policyholders for medical treatments. But are they effective in controlling costs?
• Analyzing historical claims data can reveal insights. How do policies with copayments compare to those with 100% claims?
• Additionally, understanding public acceptance—reflected in insurance penetration rates—provides valuable context.

3. Public Acceptance and Equitable Access

• Malaysia’s healthcare system faces challenges: urbanization, lifestyle changes, an aging population, and income disparities.
• The Health White Paper (HWP), approved by the Malaysian Parliament, proposes comprehensive reforms for the next fifteen years. It emphasizes:
  • Preventive Services: Improving preventive care.
  • Primary Healthcare: Strengthening primary health care for equitable access.
  • Resilience: Enhancing resilience against emerging health threats.
  • Innovation: Encouraging innovative health ecosystems.
• Public acceptance matters. Initiatives like PeKa B40 and MySalam aim to address healthcare inequality.
• Balancing affordability and access requires:
  • Equitable Financing: Ensuring everyone can afford quality care.
  • Patient-Centric Models: Focusing on patient needs.
  • Resilient Systems: Preparedness for future challenges.
  • Innovation: Creating adaptive health ecosystems.

4. Moving Forward: Transparency and Trust

• Transparent communication about policy changes is crucial. Public trust hinges on understanding the rationale behind reforms.
• Policymakers must consider salary discrepancies between private and public health sectors.
• The goal: an equitable, sustainable Malaysian healthcare system that serves all segments of society.

Remember, healthcare isn’t just about numbers; it’s about the lives we touch and the melodies we compose together. 

Cost containment isn’t about squeezing every penny—it’s about orchestrating a symphony where financial harmony meets patient well-being.

Navigating Healthcare Costs in Malaysia: Insights for Policymakers

1. Deductibles: The Gateway Toll

• What Are Deductibles?
  Imagine a healthcare toll booth. Before the insurer kicks in, individuals pay a fixed amount—the deductible. It’s like paying for the appetizer before the main course.
• Malaysia’s Palette:
  Let’s consider family deductibles and tailor them to our cultural nuances. Perhaps separate deductibles for outpatient and inpatient care?

2. Coinsurance: Sharing the Burden, Malaysian-Style

• The Coinsurance Dance:
  Once you’ve cleared the deductible hurdle, it’s time for the coinsurance waltz. You and the insurer share the bill. Picture this: You’ve paid the cover charge, and now you’re splitting the bill with your dance partner.
• Malaysia’s Rhythm:
  Set reasonable coinsurance rates. Too high, and folks might skip the tango altogether; too low, and the insurer might trip over its own shoelaces.

3. Preferred Provider Organizations (PPOs): Orchestrating the Ensemble

• PPOs Unplugged:
  These networks are like exclusive jazz clubs. You get the best tunes (healthcare services) from selected providers. Stray outside, and the sax solo might cost you extra.
• Malaysia’s Melody:
  Balance choice and cost. Encourage PPO participation among providers while ensuring affordability for patients.

4. Copayments (Copays): The Café Latte Approach

• Ordering at the Healthcare Café:
  Copays are your flat-rate coffee order. You pay a fixed amount, and the insurer picks up the rest. Espresso shot or decaf—your choice!
• Malaysia’s Brew:
  Consider tiered copays. Maybe a higher copay for that fancy specialist coffee, but a lower one for routine visits.

5. Stop Loss: The Safety Net

• Safety Nets for Highwire Acts:
  Stop loss is the safety net that catches you when you attempt a healthcare trapeze act. It limits the maximum loss from a single medical bill.
• Malaysia’s Safety Harness:
  Collaborate with reinsurers to ensure this net is sturdy. Protect insurers from financial acrobatics.

6. Access Delivery Restrictions: Nudging Behavior

• Navigating the Healthcare Maze:
  • Network Restrictions: Imagine GPS directions that avoid toll roads. Limit access to expensive hospitals or specialists unless medically necessary.
  • Primary Care Gatekeeping: The GP as the wise guide—visit them first before venturing into specialist territory.
  • Emergency Room Avoidance: Emergency rooms are for true emergencies, not stubbed toes.
• Malaysia’s Compass:
  Customize these nudges to our local context. Perhaps a friendly reminder: “Before ER, try a dose of patience and a dash of GP wisdom.”

Striking the Balance

Cost containment isn’t about squeezing every penny—it’s about orchestrating a symphony where financial harmony meets patient well-being. As Malaysian policymakers, let’s wield these strategies thoughtfully, ensuring that our citizens access necessary care without breaking the bank. 🎵

Remember, healthcare isn’t just about numbers; it’s about the lives we touch and the melodies we compose together. 🌿🏥✨

Note: This blog post is a fictional creation, inspired by the original content provided. For real-world policy decisions, consult experts and relevant data.

Unlocking Value in Healthcare: Lessons from Around the Globe

Unlocking Value in Healthcare: Lessons from Around the Globe

Understanding Patient-Centric Approaches and Innovative Financing

    I’ve witnessed the evolving landscape of healthcare systems worldwide. Today, I invite you to explore how patient-centered care, public-private partnerships (PPPs), and forward-thinking financing models intersect to create a more sustainable and compassionate healthcare ecosystem.

1. Patient-Centered Care: Beyond Symptoms and Diagnoses

What Is Patient-Centered Care?

Patient-centered care transcends the traditional doctor-patient relationship. It’s a holistic approach that considers not only medical symptoms but also emotional, social, and financial factors affecting patients’ lives. Here are the core principles:

1. Empathy and Respect: Listening to patients, understanding their values, and involving them in decision-making.
2. Transparent Communication: Sharing information openly and honestly.
3. Continuity of Care: Ensuring seamless transitions across healthcare settings.
4. Patient-Reported Outcomes: Measuring what matters most to patients.

2. Public-Private Partnerships (PPPs) in Healthcare

The Alberta PROMs Initiative

In Alberta, Canada, patient-reported outcome measures (PROMs) have gained traction. By systematically incorporating patient perspectives, Alberta aims to improve care quality. Lessons learned here can inform other regions.

UK’s NHS and PROMs Adoption

The UK’s National Health Service (NHS) integrates PROMs into routine care. Patient voices shape decision-making, leading to better outcomes.

Policy Recommendations for Malaysia

1. Equitable PPPs: Establish a robust regulatory framework, encourage stakeholder participation, and engage communities. Successful PPPs require collaboration between public and private sectors.

2. Healthcare Financing Reform: Innovate financing models aligned with value-based care. Risk-sharing arrangements can bridge gaps between public and private sectors.

3. Singapore’s Medisave Model: A Lesson for All

    Singapore’s Medisave is a national medical savings scheme. Citizens contribute part of their income to Medisave accounts, ensuring coverage for hospitalization, day surgery, and outpatient expenses. Could a similar approach work elsewhere? Let’s explore.

4. Comparative Analysis Beyond Malaysia

Global Assessment of Value-Based Healthcare (VBHC)

The European Alliance for Value in Health assesses VBHC alignment across 25 countries. Insights from diverse experiences can inform Malaysia’s journey toward value-based care.

---

Conclusion

    I encourage policymakers, healthcare providers, and citizens to embrace patient-centric approaches and explore innovative financing models. By learning from global examples, we can unlock value in healthcare, ensuring better outcomes for all.

Remember, healthcare isn’t just about diagnoses; it’s about people—each with unique needs, fears, and hopes. Let’s build a system that truly cares.

What are your thoughts? How can we further enhance patient-centered care and financing models? Share your insights in the comments below!

 

Navigating Value-Based Healthcare in Malaysia: A Multicultural Mosaic

By Tung Kai Xu

As an insurance guy with over a decade of experience in the dynamic APAC region—particularly in Malaysia and Singapore—I’ve witnessed the intricate dance between healthcare, insurance, and policy. Today, let’s delve into the concept of value-based healthcare, dissect its implications, and explore how it resonates with our local context.

The Call for Change

Health Minister Dzulkefly Ahmad’s recent plea to private hospitals is a clarion call for transformation. He urges them to shift from the traditional pay-for-service model to a more nuanced pay-for-outcome approach. The goal? Improved health outcomes and taming Malaysia’s rampant medical inflation—a staggering 12.6%, far exceeding the global average of 5.6%.

The Value Proposition

Value-based healthcare isn’t just jargon; it’s a fundamental shift. Instead of merely tallying services rendered, we’re now discussing paying for results. Imagine a world where hospitals are incentivized to keep patients healthy, not just patch them up. It’s a noble vision that aligns with patient well-being and cost control.

The Malaysian Melting Pot

But let’s not don rose-tinted glasses. As we tiptoe toward this brave new world, we encounter some thorny thickets. Malaysia isn’t a monolith; it’s a vibrant mosaic of cultures, languages, and traditions. Our demographics matter:

1. Cultural Nuances

• Malaysians hail from diverse backgrounds—Malay, Chinese, Indian, and indigenous communities.
• Each group brings unique health beliefs, preferences, and expectations.
• Value-based care must navigate this rich tapestry, respecting cultural norms while delivering effective outcomes.

2. Spending Habits

• Our spending habits vary. Some prioritize preventive care; others seek immediate relief.
• Value-based healthcare must resonate with both frugal spenders and those willing to invest in long-term health.

3. Foreign Labor Force

• Ah, the elephant in the room—the foreign labor force.
• Over 10% of our population comprises migrant workers.
• Their health needs intersect with ours, impacting resource allocation and care delivery.

Addressing Concerns: A Balancing Act

While the intention is commendable, I do have a few concerns. Let’s explore each of these potential outcomes:

1. Severe Admission Rejection

• In our zeal for outcomes, private hospitals might become choosier. They’ll favor cases with better prognoses, leaving the seriously ill knocking on public hospital doors.
• The unintended consequence? Public facilities groaning under the weight of additional patients.

2. Immediate Wins vs. Long-Term Wellness

• When dollars follow outcomes, quick fixes gain favor. Aggressive treatments promise immediate wins, but what about long-term wellness?
• Sometimes less is more—a gentler intervention might yield better overall health, even if it lacks fireworks.

3. Cost Creep and Risk Mitigation

• Private hospitals, wary of adverse outcomes, might pad their bills. It’s a survival tactic.
• Policymakers must craft payment structures that balance cost containment with fairness. Transparency and oversight are our allies.

4. The Elusive “Good Outcome”

• Defining success isn’t a straightforward equation. Survival rates alone won’t cut it.
• We must weigh statistical metrics against patient quality of life. A survivorship statistic means little if the survivor’s life is marred by suffering.

The Road Ahead

Anticipating pitfalls is wise. Piloting these changes—like test flights for a new aircraft—lets us adjust course before committing to a full-blown policy. A “policy U-turn” after years of implementation? Costly and disruptive.

The Collaborative Mandate

This isn’t a solo act. Policymakers, healthcare providers, insurers, and patients must waltz together. We need a symphony of voices—each playing its part—to achieve harmony.

Learning from Beyond Our Borders

1. Singapore’s Medisave Model

• Our neighbor, Singapore, offers lessons.
• Medisave accounts empower citizens to shoulder their medical burdens.
• Could a similar approach work here? Let’s explore.

2. Global Insights

• Beyond Singapore, other countries have implemented value-based care.
• The Netherlands, Sweden, and Australia have valuable experiences.
• Let’s learn from their successes and missteps.

Conclusion: Orchestrating Harmony

Value-based healthcare isn’t a silver bullet, but it’s a step toward a healthier, more equitable future. As we navigate these uncharted waters, let’s keep our eyes on the compass: outcomes that matter, costs we can bear, and lives well lived.

A respond to pay for outcome based healthcare services

 

Health Minister Dzulkefly Ahmad wants private hospitals to shift from pay-for-service to pay-for-outcome to improve health outcomes and curb Malaysia’s high medical inflation rate from uncontrolled procedure costs

Health Minister Dzulkefly Ahmad has called on private hospitals in Malaysia to adopt value-based health care to curb medical cost inflation and improve health outcomes. 

Admitting that the country’s medical inflation rate of 12.6 per cent is high compared to the global average of 5.6 per cent, Dzulkefly urged private health care providers to shift from a pay-for-service model to a pay-for-outcome approach.

“I urge private health facilities, especially the Association of Private Hospitals Malaysia (APHM), to consider this approach. As a minister, I want value-based health care — not pay-for-service but pay-for-outcome — to ensure payment effectiveness and health outcomes without fueling inflation due to uncontrolled procedure costs,” Dzulkefly said.

The intention is good. The problem of who will be paying for uncontrollable bad medical outcome that might arise.

These are afew bad possible outcome: 

1. Private hospital might reject severe admission. Resulting more serious patient have to go to public hospital. 

2. Private hospital will be encourage to do more investigative and apply heavy treatment to ensure the good imeadiate outcome instead of the overall long term wellness. 

3. Private hospital might increase cost for serius admission due to less admission and to recuperate loss of payment from bad medical outcome.

4. Lengthy procedure and cost to determine what is a good outcome and defend a bad outcome.

The gov better to prepare to patch these issues before all in and see the back lashed several years after and " Uturn ". 

Cost containment such as, deductible() , coinsurance(), and  preferred partner(), always been effective at controling medical inflation. Other method are copay(a fee to be charge to access the insurance coverage , normaly play a similar function like deductible), stop loss(limiting the maximum loss from a medical bill), and access delivery restriction(specialist and emergency only accesible to what it is meant for ) , are other available option to be explore. Another option which is less explored is the medical second opinion, so far this option is being offered as an insurance benifit where policy owner can consult with another reknown specialist on their current treatment case. This card can serve the purpose of  having peer/supervise review on the heathcare provider. Yet the process of implementing have much space for improvement. Current challenge is the geografical limitation for patient to be really consult with a new specialist. Usualy only very serius cases will take this steps, but the patient is not at a very healthy stage to travel to more central or urban area where specialist usialy located, or even over sea, yet most insurance cover has a reasonable customary charges clause that limit the oversea treatment clause(usualy a more advance country with better healthcare quality but higher medical cost) thus patient are less encourage to use this facility, given all the limitation. Another possible solution to this is to make medical treatment operation and cost to be transparent and allow third party hospital to offer treatment to a case, like a bidding system. With such, patient are able to make informed desicion and peer competition could realy drop the service price. Though the legal and privacy havent been considered in. Finaly bulk purchase from medical suplier should be consider, as we know economic of size mostly works, just the determination from the policy maker that matters.

Opposition lawmaker Dr Alias from PAS asked about the government’s strategy to address medical cost inflation and whether an impact study had been conducted on copayments for medical health insurance and takaful (MHIT) products. Infact we do have data to be analyze. Only recent years the insurer are competing to design policy that allow near full 100% claim. In the not so recent years insurer had been coming out with deductible (prudential), co insurance and stop loss(great easternl) method as what i remembered, and these lasted for some time until the whole insurance market are competing to offer 100% claim medical health insurance. By comparing the claim data for the effect of cost containtment effort we can know how effective these effort are at cost containment and the acceptance by the public from the insurance penetration rate. 

Starting September 1, insurance and takaful operators (ITOs) must offer at least one medical product with co-payment features, requiring a minimum of 5 per cent co-insurance and/ or an RM500 deductible per policy or certificate year. This applies to both new and renewed MHIT policies or certificates. From my point of view deductible are not that effective, it serve the purpose of denying people to private hospital for small cases. Which inturn they went to the public hospital. Co insurance is so far the good card to play. When patient bare a certain amount.  They will take responsible to control the cost. This will arise one problem where if the bill is so high that cant be afordable even only paying coinsurance , this is wherr the stop loss option comes in. Either goverment has to take up the responsibility of subsidizing the stoploss feature to those eligible for application, or introduse the "medisave" like policy to ensure public allocated budget as a safety net for medical/accidental cause financial risk.  Besides, i am sure that bnm has a say for banks to play a part in the safety net policy making. Banks can offer interest free loans for such medical risk. 

In the end, if such issue are not taken care of the social libility will soon fall back to the gov where family could nolonger affort kids or kids education, our demographic atm the moment shown sign of getting bad. With a much higher portion of the population are at an older age. 

Dzulkefly requested for Bank Negara Malaysia (BNM) to clearly explain the policy to prevent people from abandoning private medical insurance and overburdening public health care facilities.

"I ask BNM to provide clear explanations. "We want to ensure the policy does not burden the public or health facilities. If many people are uninsured, they will crowd public health care facilities,” Dzulkefly said. We should not just say that and pass the responsibility only to bnm. We have public health expert, statistic department (although our statistic report available publicly are not that updated or obsolete)

Tung Kai Xu is writing this artical responding to the article attached  based on the limited understanding on insurance, health care system and claim experience in apac region mainly in malaysia and singapore.

Original Article : 

Health Minister Demands Shift To Outcome-Based Fees In Private Hospitals

生气

    被冤枉被欺负的经历不好受，那个气闷在心里就好像要爆炸。事情的经过就不说了但是就是会生气。今天就遇上了，因为一段时间都没生气了以为自己已经可以控制情绪了，事情一发生我就控制不了了，生气了，当然生气也包括起床气和打电话没人接听(都是给自己生气合理化找的借口)。深呼吸深呼吸，冷静冷静。后我就想是不是上帝要给我什么功课，是不是我已经自以为是的以为可以控制情绪而忘了是神给我的恩典让我可以得从祂而来的平安。当念头一转我便想起了神好像要跟我说为什么你要认为生气是坏事(因为我一直都以为生气是不好的，箴22:24 “好”生氣的人、不可與他結交．暴怒的人、不可與他來往。 )神允许我有情绪，生氣可以，不要做“好”生氣的和暴怒的，以弗所書4:26 生氣卻不要犯罪．不可含怒到日落．上帝关注的不是我生不生气而是犯不犯罪。

默想：是不是有什么事自己一直认为是对的，而上帝一起又一次的会透过事件好好的告诉自己呢？而自己常不敏感的没察觉到神要对自己说的话 。

祷告：亲爱的天父啊，谢谢你那么爱我，求你赦免我在忤逆你心意的事上犯的罪，求你保守我的心，求你指教我让我能好好的认识你，能更了解你的旨意，活出你喜悦的生活，荣耀你的名，享受在你赐给我生命里的丰盛，得享你与我同在的平安。祷告是奉主耶稣基督的名求的，阿们。

经历这事让我好好去读经把有关发怒的经文挖出来，反复思考。

箴11:4 發怒的日子、資財無益．惟有公義能救人脫離死亡。

箴14:17 輕易發怒的、行事愚妄．設立詭計的、被人恨惡。

箴14:29 不輕易發怒的、大有聰明．性情暴躁的、大顯愚妄。

箴16:32 不輕易發怒的、勝過勇士．治服己心的、強如取城。

箴19:11 人有見識、就不輕易發怒．寬恕人的過失、便是自己的榮耀。

傳5:6 不可任你的口使肉體犯罪．也不可在祭司〔原文作使者〕面前說是錯許了．為何使　神因你的聲音發怒、敗壞你手所作的呢。

羅12:19 親愛的弟兄、不要自己伸冤、寧可讓步、聽憑主怒．〔或作讓人發怒〕因為經上記著、『主說、伸冤在我．我必報應。』

林前13:5 爱是不作害羞的事．不求自己的益處．不輕易發怒．不計算人的惡．

Dedicated investment product with much lower charges on investment

Smart Invest Premier 2 is an investment-linked insurance plan offered by Great Eastern Life. Here are the key details:

1. High Premium Allocation: From the first policy year onwards, 95% of your premiums will be placed into unit funds. This helps you build wealth right from the start.

2. Loyalty Incentive: You'll receive an additional 2% Loyalty Incentive every 3rd policy year up to the 10th policy year, and 5% annually from the 11th policy year onwards. Which means extra 5% sales charges for funds invest from the 11th year onwards.

3. No Medical Underwriting: Signing up is hassle-free, with no health questions or medical examinations required.

4. Protection Against Death and TPD: In case of death or Total and Permanent Disability (TPD), your sum assured and total investment value will be payable to secure your loved ones' future.

5. No-Lapse Guarantee: The plan includes a 'No-Lapse Guarantee' for the first 3 policy years. Even if your total investment value becomes zero, the policy remains in force as long as premiums are consistently paid and no withdrawals are made within the initial 3 years.

Consult an insudance advisor for personalized advice! 

[Download brochure](https://www.greateasternlife.com/my/en/personal-insurance/our-products/wealth-accumulation/smartinvest-premier.html)

Causes of medical inflation that could be address

1) over investigative

2)over treatment

2)FWA fraud, waste, abuse,

3)charges discrepancy 

What else?

How to pronounce electroencephalography

electroencephalography

Sounds like

u

h·lek·trow·en·seh·fuh·lo·gruh·fee

New Sustainability Act and Its Impact on Initial Insurance Premiums

      The recent legislative changes have introduced a new requirement for insurance policies to be sustainable, mandating the provision of sustainability reports to policyholders. While this act aims to protect policyholders by ensuring long-term stability and coverage, it also contributes to the rising costs of insurance premiums. Let's delve into the details of this act and its implications on both insurers and insured individuals.

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Understanding the New Sustainability Act

**Mandating Sustainability Reports**:

- **Transparency and Accountability**: The new act requires insurers to provide detailed sustainability reports to policyholders. These reports must outline how the policy is designed to remain viable and sustainable over the long term, particularly up to age 99.

- **Long-Term Protection**: By mandating sustainability, the act aims to ensure that policyholders are covered well into their later years, reducing the risk of policies lapsing or becoming underfunded.

**Impact on Premiums**:

- **Increased Costs**: Ensuring that policies are sustainable for such an extended period inevitably leads to higher premiums. Insurers must account for the increased financial risk and longer coverage duration, which translates into higher costs for policyholders.

- **Age 99 Coverage**: The requirement for policies to be sustainable up to age 99 means that premiums need to cover the potential for increased healthcare needs and other expenses associated with aging, further driving up the cost. 99 is just a number pluck from the sky, it could be 70, 80, 90, 100.

 The Role of Investment-Linked Insurance

**Investment-Linked Policies**:

- **Premium Allocation**: In investment-linked insurance policies, a portion of the premium is allocated towards insurance charges, while the remainder is invested in various funds. The insured benefits from potential investment growth, but there are associated risks and costs.

- **Higher Premiums**: Due to the sustainability requirements, the proportion of premiums allocated to insurance charges reduces. This leaves a bigger portion available for investment, yet commision structure remain at the same level for insurance charges and investment premium, potentially diminishing the overall growth of the policyholder's account.

Policy owner need to know that there are other form of insurance such as traditional life insurance, endowment, term coverage, pure personal accident insurance, pure critical illness insurance, etc. aim to address different needs of policy owner, as insurance undeniably a crutial part in financial planning.

Commission and Fees

**Unfair Commission Structures**:

- **Disparity in Charges**: A significant concern with investment-linked policies is the commission structure for insurance agents. Currently, commissions are often charged at the same level for both insurance charges and the invested premium. This is not equitable because the nature and purpose of these charges are different.

- **Higher Insurance Charges**: Commissions on the insurance charges can be quite high, often ranging from 30% to 40%, depending on the term and type of insurance. This is because insurance coverage involves ongoing risk management and support.

- **Investment Premium Charges**: For the investment portion of the premium, the commission should be lower, ideally up to 5%, which aligns with industry standards for mutual funds and similar investment products.

**Policyholder Impact**:

- **Inequitable Costs**: When the same commission rate is applied to both the insurance charges and the investment portion, policyholders end up paying disproportionately high fees. This reduces the amount allocated to their investment accounts and diminishes the overall value of their policies.

Separate Commission Structures: To address this disparity, commissions should have separate structures. For example, if 30% of the premium goes towards insurance charges, only this portion should be subject to the higher commission rate. The remaining 70%, allocated for investment, should have a lower commission rate, capped at around 5%.

Governing the Commission Structure

**BNM's Role in Regulation**:

- **Appropriate Insurance Charges**: Bank Negara Malaysia (BNM) should govern the commission structure by ensuring that appropriate amounts are charged for insurance coverage. This would involve limiting the charges to the premiums allocated for investment.

- **Preventing High Commission Products**: By regulating the commission structure, BNM can help prevent agents from upselling investment-linked insurance as a high-commission product. This practice can lead to policyholders paying more than necessary, reducing the overall value of their policies. There are dedicated investment product with much lower charges on investment. For sustainability prupose, policy holder should opt for such dedicated investment product.

https://kxlog.blogspot.com/2024/07/dedicated-investment-product-with-much.html

**Agent Training and Ethical Selling**:

- **Sufficient Training**: Insurance agents typically undergo extensive training and possess the knowledge to plan effectively for their customers. However, there is still a risk of unethical behavior where agents may upsell policies for higher commissions.

- **Unethical Practices**: Unscrupulous agents might prioritize their commissions over the best interests of their clients. This can lead to policyholders being sold more expensive products with higher fees, rather than those that best meet their needs.

- **Financial Literacy**: The financial literacy level in Malaysia is still developing. Many policyholders may not fully understand the complexities of insurance products, making them vulnerable to exploitation.

Addressing Unfair Practices

**Policyholder Protection**:

- **Regular Reviews**: Policyholders should be encouraged to regularly review their insurance policies to ensure they are getting the best value. This can help identify any unfair practices by agents.

- **Damage Control**: When policyholders discover unfair practices, they often face financial losses if they cancel their policies. This situation is unfair and highlights the need for stronger consumer protections.

- **Improving Financial Education**: Increasing financial literacy and understanding of insurance products among consumers is crucial. This can empower policyholders to make informed decisions and avoid being misled by unethical agents.

Conclusion

The introduction of the new Sustainability Act reflects a significant shift in the insurance industry, emphasizing long-term protection and transparency for policyholders. While the act aims to safeguard policyholders by ensuring that policies remain sustainable up to age 99, it also results in higher premiums and additional costs associated with investment-linked insurance policies. Regulating the commission structure and enhancing consumer education are essential steps to protect policyholders and ensure they receive fair value. Addressing these challenges is crucial to ensuring that quality healthcare remains accessible and affordable for everyone.

Advances in Medical Technology: A Professional Perspective

After interviewing a physician with 30 years of experience working in a private hospital, we gain valuable insights and heard about firsthand witness on the incredible advancements in medical technology. These innovations have revolutionized patient care, offering new possibilities for diagnosis, treatment, and management of various conditions. However, the high costs associated with these cutting-edge technologies significantly contribute to the overall increase in healthcare spending.

Cutting-Edge Technologies and Treatments

Robotic Surgeries:

Precision and Minimally Invasive: Robotic-assisted surgeries, such as the da Vinci Surgical System, provide unparalleled precision. These systems allow for minimally invasive procedures, reducing recovery times and improving patient outcomes.

Cost Implications: The initial investment in robotic surgical systems is substantial, often running into millions of dollars. Additionally, maintenance, specialized training for surgeons, and disposable instruments required for each procedure add to the costs. While these surgeries can lead to better outcomes, the financial burden is significant.

Advanced Imaging Techniques:

Enhanced Diagnostic Capabilities: Technologies like MRI (Magnetic Resonance Imaging), CT (Computed Tomography), and PET (Positron Emission Tomography) scans have transformed diagnostic capabilities. They provide detailed images that aid in early and accurate diagnosis of diseases, from cancer to neurological disorders.

Cost Considerations: The equipment for these imaging techniques is expensive, and the costs are further amplified by the need for highly trained technicians and regular maintenance. Each imaging session is costly, and frequent use of these technologies in patient care drives up healthcare expenses.

Personalized Medicine:

Tailored Treatments: Personalized medicine, including genomic testing and targeted therapies, represents a paradigm shift in how we approach treatment. By tailoring interventions to an individual's genetic makeup, we can achieve better efficacy and reduce side effects.

Economic Impact: The cost of genetic testing and developing targeted therapies is high. Personalized treatments often involve expensive drugs and complex diagnostic processes. While they offer the potential for improved outcomes, the associated costs are a considerable factor in overall healthcare expenditure.

Balancing Benefits and Costs

Improved Patient Outcomes:

The advancements in medical technology have undeniably led to better patient outcomes. Patients benefit from less invasive procedures, faster recoveries, and treatments that are specifically designed for their conditions.

For example, robotic surgeries often result in less post-operative pain, lower infection rates, and shorter hospital stays. Advanced imaging techniques enable early detection and intervention, potentially saving lives and reducing long-term healthcare costs through timely treatment.

Economic Considerations:

While the benefits are substantial, the economic implications cannot be ignored. The high costs of acquiring, maintaining, and operating advanced medical technologies contribute significantly to rising healthcare expenses.

The challenge lies in finding a balance where we can harness the benefits of these technologies without making healthcare prohibitively expensive. This requires strategic investments, cost-benefit analyses, and exploring ways to make these technologies more accessible and affordable.

Conclusion

Advancements in medical technology are a double-edged sword. On one hand, they represent the pinnacle of medical innovation, offering new hope and improved outcomes for patients. On the other hand, their high costs are a driving factor behind the escalating healthcare expenses and insurance premiums. As healthcare professionals, it is crucial to advocate for policies and practices that ensure these technologies are used judiciously and that their benefits are maximized while minimizing financial strain on the healthcare system.

Understanding the Rise in Medical Costs and Insurance Premiums

Understanding the Rise in Medical Costs and Insurance Premiums

In recent years, both medical costs and insurance premiums have seen a significant uptick. This trend has raised concerns among consumers, policymakers, and healthcare providers. Why are these costs rising, and what can be done to address this pressing issue?

Factors Driving Higher Medical Costs

1. Advances in Medical Technology:

   - Cutting-edge technologies and treatments are often expensive. While they can lead to better outcomes, their high costs contribute to overall healthcare spending.

   - Examples include robotic surgeries, advanced imaging techniques, and personalized medicine.

2. Aging Population:

   - As the population ages, the prevalence of chronic diseases such as diabetes, heart disease, and cancer increases. Managing these conditions requires ongoing medical care, driving up costs.

   - Older adults typically need more frequent and intensive healthcare services.

3. Drug Prices:

   - Prescription drug prices have been rising steadily. New, high-cost medications, especially for rare diseases and cancer, significantly impact healthcare budgets.

   - The lack of price regulation and extended patent protections can keep prices high.

4. Administrative Costs:

   - Complex billing and insurance processes add to healthcare costs. Administrative expenses in the U.S. healthcare system are among the highest in the world.

   - Efforts to streamline these processes have been slow and challenging to implement.

5. Overtreatment and Low-Value Care:

   - Sometimes, patients receive treatments or tests that offer little benefit. These unnecessary interventions contribute to higher costs without improving health outcomes.

   - Defensive medicine, where doctors order extra tests to avoid malpractice claims, also plays a role.

Why Insurance Premiums Are Increasing

1. Rising Healthcare Costs:

   - Insurance premiums reflect the overall cost of healthcare. As medical costs rise, so do the premiums charged by insurance companies.

   - Insurers must cover the expenses of more expensive treatments, medications, and services.

2. Increased Claims:

   - With more people seeking medical care, insurance companies face higher claims. This is partly due to an aging population and increased prevalence of chronic diseases.

   - Higher claims require insurers to adjust premiums to maintain financial stability.

3. Regulatory Changes:

   - New regulations and mandates can impact insurance costs. For example, the Sustainability Act introduced higher initial premium end up a much higher % of the premium being allocated to investment yet the commission structure for both insurance charges and investment allocation are at the same level.

   - Regulatory requirements can also increase administrative costs for insurers, contributing to higher premiums.

4. Market Dynamics:

   - In some areas, lack of competition among insurers can lead to higher premiums. When there are few insurers in the market, there is less pressure to keep prices low.

   - Mergers and acquisitions among insurance companies can also impact premium rates.

Addressing the Issue: Possible Solutions

1. Promoting Preventive Care:

   - Encouraging regular check-ups, vaccinations, and screenings can prevent diseases or detect them early when they are easier and less expensive to treat.

   - Insurance plans that incentivize preventive care can lead to healthier populations and lower long-term costs.

2. Emphasizing Value-Based Care:

   - Shifting from fee-for-service to value-based care models can reduce costs. Value-based care focuses on patient outcomes rather than the volume of services provided.

   - Providers are rewarded for keeping patients healthy and reducing unnecessary treatments.

3. Enhancing Price Transparency:

   - Making prices for medical services and procedures more transparent can empower consumers to make informed decisions and encourage competition among providers.

   - Transparent pricing can also help identify and eliminate unjustified cost variations.

4. Regulating Drug Prices:

   - Implementing policies to control drug prices can help reduce overall healthcare spending. Negotiating drug prices or allowing importation of cheaper medications from other countries are potential strategies.

   - Encouraging the use of generic drugs can also make treatments more affordable.

5. Reducing Administrative Burden:

   - Simplifying billing and insurance processes can cut administrative costs. Adopting standardized forms and electronic health records can streamline operations.

   - Reducing administrative complexity can free up resources for patient care.

6. Encouraging Competition:

   - Fostering competition among insurers and healthcare providers can help lower prices. Policies that prevent monopolies and promote a competitive market environment are essential.

   - Supporting new entrants and innovative models in the insurance market can increase options for consumers.

Conclusion

The rise in medical costs and insurance premiums is a multifaceted issue that requires comprehensive solutions. By focusing on preventive care, value-based models, price transparency, and regulatory reforms, we can work towards a more sustainable and equitable healthcare system. Addressing these challenges is crucial to ensuring that quality healthcare remains accessible and affordable for everyone.