Issue of medical claims inflation in Malaysia

There are several considerations to address the issue of medical claims inflation in Malaysia:

1. Transparency of Medical Procedure Costs: There is a need to provide greater public transparency of the various costs of medical procedures. This can be achieved through the publication of reference benchmark costs for common medical procedures. This will enable patients, particularly those who are self-paying, to make well-informed decisions on their desired level of healthcare service and its associated costs.

2. Co-payments or Deductibles in MHI Plans: The adoption of co-payments or deductibles in MHI plans can give policyholders more control over the costs of their healthcare decisions. These changes, which have also been observed in other countries such as Singapore and Australia, can have an important effect in capping the persistent increase in healthcare costs through better market discipline.

3. Standardisation and Collection of Data: There is a need to facilitate the standardisation and collection of data that can be used by both the medical and insurance and takaful industries to increase efficiency, reduce waste, prevent fraud and improve product design. This calls for the application of a consistent diagnostic classification standard and standardised formats for billings to increase cost transparency.

4. Digitalisation of Medical Records: The digitalisation of medical records and integration of health information systems have the potential to generate significant operational efficiencies and contribute towards moderating medical claims inflation.

These measures require coordinated actions from all stakeholders in the ecosystem for medical services in Malaysia, including payors, healthcare providers, regulators, managed care organisations, and end consumers. The Bank has issued the Guidelines on Medical and Health Insurance Business which set out minimum standards for insurers and takaful operators to promote sound underwriting and pricing practices. However, longer-term solutions to promote the sustainability of MHI protection call for deep reforms in a number of areas.

What is driving MHI claims inflation?

 There are several factors driving the inflation of medical and health insurance (MHI) claims in Malaysia:

1. Longer Lifespan and Advanced Medical Care: Malaysians are living longer and have access to better and more advanced medical care. While this is a positive development, it naturally contributes to higher medical costs.

2. Price Differentiation: There are anecdotal accounts of healthcare providers who engage in price differentiation, charging higher if a patient is insured.

3. “Buffet Syndrome”: Policyholders seek to maximise the value of premiums paid and tend to utilise medical services with little incentive to consider the associated costs. This behavior contributes to escalating costs that are ultimately translated back into higher premiums.

4. Hospital Supplies and Services: Insurance claims data analysed over 2013 to 2018 show that hospital supplies and services form the largest component of claims costs and is one of the main factors driving the increase in hospital charges.

These factors combined lead to an increase in MHI claims, which in turn makes MHI policies less affordable for all policyholders and increases the prospects of some higher-risk groups being excluded from access to medical insurance. It’s a complex issue that requires careful management and regulation to ensure that healthcare remains accessible and affordable for all Malaysians.

Managing Medical Claims Inflation

 The rise in demand for medical and health insurance and takaful (MHI) in Malaysia is indeed a significant trend. This demand has been driven by the growing availability of private healthcare treatment as an alternative to public hospitals¹. In 2019, MHI accounted for 15.5% of total gross premiums in the life insurance and family takaful sector¹.

However, the cost of medical care in Malaysia has been reported to be rising above the global average and is among the highest in Southeast Asia¹. Between 2016 and 2019, MHI claims grew by 11.6% a year, outstripping the increase in premiums, which grew on average by 9.5% a year¹. This trend has increased pressure on the underwriting performance of MHI providers¹.

In that four-year period, 96 MHI products were repriced, affecting 4.5 million policies¹. This is a concern as more expensive premiums make coverage increasingly unaffordable to many¹.

To manage this situation, it’s important for MHI providers to carefully consider their pricing strategies and ensure they are providing value to their customers while also maintaining their financial sustainability. They may also need to explore innovative solutions, such as digital health technologies, to help manage costs and improve the efficiency of healthcare delivery.

For consumers, it’s crucial to understand the terms and conditions of their MHI policies, including any exclusions or limitations imposed on benefits, before confirming their purchase². Consumers are also advised to provide complete information to their insurer as requested in the proposal form when purchasing an MHI policy². This can help ensure that they receive the coverage they need and avoid any potential issues with claims in the future.

It’s a complex issue, but with careful management and open communication between MHI providers and consumers, it’s possible to navigate these challenges and ensure that people have access to the healthcare coverage they need.

AI debating on freedom, violence and world peace

 

Moderator: Welcome to the debate club, where we discuss and debate various topics of interest and importance. Today’s topic is: Does freedom always lead to violence, and does world peace mean the suppression of all human nature? We have two speakers who will present their views and arguments on this issue. On the affirmative side, we have Alice, who believes that freedom always leads to violence, and that world peace means the suppression of all human nature. On the negative side, we have Bob, who believes that freedom always prevents violence, and that world peace means the expression of all human nature. Each speaker will have five minutes to make their opening statement, followed by three minutes of cross-examination by the other speaker. Then, each speaker will have two minutes to make their closing statement. The audience will then vote for the winner of the debate. Let’s begin with Alice’s opening statement.

Alice: Thank you, moderator. Ladies and gentlemen, I am here to argue that freedom always leads to violence, and that world peace means the suppression of all human nature. My main points are:

• Freedom is a dangerous and destructive force, as it allows humans to act on their impulses and desires, without any restraint or regulation. Freedom creates conflict and chaos, as humans compete for resources, power, and status, and as they try to impose their will and values on others. Freedom also breeds inequality and injustice, as some humans exploit and oppress others, and as some humans enjoy more rights and privileges than others.
• Violence is a natural and inevitable consequence of freedom, as it is the only way for humans to resolve their differences and protect their interests. Violence is also a product of human nature, as humans are inherently violent, selfish, and competitive, and they are driven by their instincts and passions, rather than by their reason and morality.
• World peace is the suppression and control of human nature, by imposing a strict and uniform order, authority, and ideology on all people and nations. World peace requires the elimination or homogenization of human diversity, the absence of conflict or disagreement, and the imposition or domination of a single ideology or system. World peace is also unrealistic, undesirable, and impossible, as it goes against the complexity and diversity of human nature and history.

Therefore, I urge you to support the affirmative side of the resolution and to agree that freedom always leads to violence, and that world peace means the suppression of all human nature. Thank you.

Moderator: Thank you, Alice. Now, let’s hear Bob’s opening statement.

Bob: Thank you, moderator. Ladies and gentlemen, I am here to argue that freedom always prevents violence, and that world peace means the expression of all human nature. My main points are:

• Freedom is a positive and constructive force, as it allows humans to express themselves, seek information, participate in decision-making, and enjoy their dignity and diversity. Freedom creates harmony and order, as humans cooperate for the common good, and as they respect and appreciate the differences and similarities among themselves. Freedom also fosters equality and justice, as all humans have equal rights and opportunities, and all humans are accountable and responsible for their actions and choices.
• Violence is an unnatural and avoidable consequence of the lack of freedom, as it is the result of the frustration and oppression of human potential. Violence is also a problem of human choices and actions, and it can be prevented and reduced by human choices and actions. Violence is often driven by factors such as poverty, inequality, injustice, corruption, greed, fear, hatred, ignorance, intolerance, and extremism, which can be addressed and eliminated by promoting a culture of peace and non-violence.
• World peace is the expression and enhancement of human nature, by promoting a culture of peace and non-violence, and by respecting and protecting the human rights and human dignity of all people and nations. World peace implies the absence of violence, as well as the presence of justice, cooperation, and harmony. World peace does not require the suppression or sterilization of human nature, but the realization and fulfillment of human potential. World peace does not imply the elimination or homogenization of human diversity, but the celebration and integration of human diversity. World peace does not entail the imposition or domination of a single ideology or system, but the recognition and respect of the plurality and diversity of ideologies and systems, as long as they are compatible with the universal values and norms of human rights and human dignity.

Therefore, I urge you to support the negative side of the resolution and to agree that freedom always prevents violence, and that world peace means the expression of all human nature. Thank you.

Moderator: Thank you, Bob. Now, we will have the cross-examination period, where each speaker will ask questions to the other speaker. Alice, you may ask your first question to Bob.

Alice: Thank you, moderator. Bob, you claim that freedom is a positive and constructive force, but how do you explain the fact that many of the most violent and oppressive regimes in history have claimed to be based on freedom and democracy, such as Nazi Germany, Soviet Russia, or the United States of America?

Bob: Thank you, Alice. That is a good question, but I think it is based on a misunderstanding of what freedom and democracy really mean. Freedom and democracy are not just slogans or labels, but principles and practices that require the participation and consent of the people, the respect and protection of the rights and freedoms of all, and the accountability and responsibility of the government. The regimes that you mentioned have abused and distorted the concepts of freedom and democracy, and have used them as excuses or tools to justify and impose their violence and oppression on others. They have not been truly free or democratic, but rather totalitarian and authoritarian.

Alice: I see. But how do you define freedom and democracy, and who decides what they mean and how they should be implemented?

Bob: Freedom and democracy are not fixed or predetermined, but dynamic and adaptable. They are not imposed or decided by anyone but agreed upon and practiced by everyone. Freedom and democracy are defined and implemented by the people themselves, through their collective and individual choices and actions, and through their institutions and mechanisms that ensure their representation and participation. Freedom and democracy are also guided and regulated by the universal values and norms of human rights and human dignity, which are recognized and protected by international law and human rights standards.

Alice: I understand. But don’t you think that this is too idealistic and unrealistic and that it ignores the complexity and diversity of human nature and history?

Bob: No, I don’t think so. I think that this is realistic and desirable and that it acknowledges and embraces the complexity and diversity of human nature and history. Human nature is not fixed or predetermined, but dynamic and adaptable. Human nature is not inherently violent or peaceful, but capable of both. Human nature is influenced by the environment and culture, and it can be shaped by education and socialization. Human nature can be transformed and improved by the development of moral and spiritual qualities, such as love, compassion, justice, wisdom, and unity. History is not a linear or deterministic process, but a complex and contingent one. History is not a series of inevitable and irreversible events, but a collection of possible and alternative scenarios. History is not determined by fate or force but by choice and action. History can be changed and improved by the vision and effort of the people who make it.

Moderator: Thank you, Bob. That concludes your cross-examination by Alice. Now, Bob, you may ask your first question to Alice.

Bob: Thank you, moderator. Alice, you argue that violence is a natural and inevitable consequence of freedom, but how do you explain the fact that many of the most peaceful and prosperous societies in history have been based on freedom and democracy, such as Switzerland, Norway, or Canada?

Alice: Thank you, Bob. That is a good question, but I think it is based on a selective and biased view of history. The societies that you mentioned have not been truly peaceful or prosperous, but rather violent and privileged. They have not achieved their peace and prosperity by themselves, but by exploiting and oppressing others. They have been involved in wars and conflicts, either directly or indirectly, and they have benefited from the resources and labor of other people and nations. They have also faced internal problems and challenges, such as social unrest, political corruption, economic inequality, and environmental degradation.

Bob: I see. But how do you measure peace and prosperity, and who decides what they are and how they should be achieved?

Alice: Peace and prosperity are not subjective or relative, but objective and absolute. They are not decided or measured by anyone, but determined and assessed by the facts and the results. Peace and prosperity are achieved and maintained by the order and authority that ensure the stability and security of the society, and by the ideology and system that provide the direction and purpose of the society. Peace and prosperity are also challenged and threatened by the freedom and diversity that create the conflict and chaos of the society, and by the human nature and history that produce the violence and oppression of the society.

Bob: I understand. But don’t you think that this is too pessimistic and fatalistic and that it denies the potential and agency of human nature and history?

Alice: No, I don’t think so. I think that this is realistic and inevitable and that it reflects and accepts the potential and agency of human nature and history. Human nature is fixed and predetermined, and it cannot be changed or improved. Human nature is inherently violent, selfish, and competitive, and it is driven by their instincts and passions, rather than by their reason and morality. History is a linear and deterministic process, and it cannot be changed or improved. History is a series of inevitable and irreversible events, and it is determined by fate or force, rather than by choice and action. History is a cycle of violence and oppression, and it is doomed to repeat itself.

Moderator: Thank you, Alice. That concludes your cross-examination by Bob. Now, we will have the closing statements, where each speaker will summarize their main points and arguments. Alice, you may make your closing statement.

Alice: Thank you, moderator. Ladies and gentlemen, I have shown you that freedom always leads to violence, and that world peace means the suppression of all human nature. I have shown you that freedom is a dangerous and destructive force, that violence is a natural and inevitable consequence of freedom, and that world peace is the suppression and control of human nature. I have also shown you that the negative side’s view is based on a misunderstanding, a selective view, and an idealistic view of freedom, violence, and human nature. Therefore, I urge you to vote for the affirmative side of the resolution and to agree that freedom always leads to violence, and that world peace means the suppression of all human nature. Thank you.

Moderator: Thank you, Alice. Now, Bob, you may make your closing statement.

Bob: Thank you, moderator. Ladies and gentlemen, I have shown you that freedom always prevents violence, and that world peace means the expression of all human nature. I have shown you that freedom is a positive and constructive force, that violence is an unnatural and avoidable consequence of the lack of freedom, and that world peace is the expression and enhancement of human nature. I have also shown you that the affirmative side’s view is based on a misunderstanding, a biased view, and a pessimistic view of freedom, violence, and human nature. Therefore, I urge you to vote for the negative side of the resolution and to agree that freedom always prevents violence, and that world peace means the expression of all human nature. Thank you.

Moderator: Thank you, Bob. That concludes the debate. Now, it is time for the audience to vote for the winner of the debate. Please use the voting system on your device to cast your vote. The voting will close in one minute. Thank you for your participation.

A syllabus for learning Python programming

 

This is a syllabus for learning Python programming for you. Python is a popular and versatile programming language that can be used for various purposes, such as data analysis, web development, automation, and more. Learning Python can be fun and rewarding, but it also requires time and practice. Here is a possible syllabus for learning Python in a month, assuming you can spend 2 hours per week on it.

Week 1: Introduction to Python

• Learn the basic syntax and concepts of Python, such as variables, data types, operators, expressions, and statements.
• Learn how to use Python’s built-in data structures, such as strings, lists, tuples, dictionaries, and sets.
• Learn how to use Python’s control flow tools, such as if, else, elif, for, while, break, continue, and pass.
• Learn how to write and call your own functions, and how to use parameters and arguments.
• Practice writing simple Python programs that perform basic tasks, such as calculating the area of a circle, reversing a string, or counting the number of words in a text.

Week 2: Intermediate Python

• Learn how to use Python’s modules and packages, and how to import and use them in your programs.
• Learn how to handle errors and exceptions, and how to use the try, except, else, and finally statements.
• Learn how to work with files and directories, and how to read and write data from and to them.
• Learn how to use Python’s object-oriented programming features, such as classes, objects, methods, inheritance, and polymorphism.
• Practice writing Python programs that use modules, packages, exceptions, files, and classes, such as a calculator, a text editor, or a simple game.

Week 3: Advanced Python

• Learn how to use Python’s advanced features, such as generators, decorators, comprehensions, and lambda functions.
• Learn how to use Python’s standard library, which provides a rich set of modules and functions for various tasks, such as math, random, datetime, collections, os, sys, re, and more.
• Learn how to use Python’s third-party libraries, which are external packages that extend Python’s functionality, such as requests, BeautifulSoup, numpy, pandas, matplotlib, and more.
• Practice writing Python programs that use advanced features, standard library, and third-party libraries, such as a web scraper, a data analyzer, or a plotter.

Week 4: Python Projects

• Review and consolidate what you have learned so far, and test your knowledge and skills with some Python projects.
• Choose one or more projects that interest you and match your level of difficulty, such as a tic-tac-toe game, a password generator, a chatbot, a web app, or a machine learning model.
• Follow the steps of the project development process, such as planning, designing, coding, testing, debugging, and documenting.
• Share your project with others, and get feedback and suggestions for improvement.

By following this syllabus, you can expect to learn the fundamentals of Python programming, and be able to write your own Python programs for various purposes. However, this is not the end of your learning journey, but rather the beginning. Python is a vast and evolving language, and there is always more to learn and explore. To continue learning Python, you can use some online resources, such as:

• Learn Python ¹, a comprehensive and interactive online course that covers everything from beginner to advanced Python topics.
• Python for Everybody ², a popular online course that teaches Python with a focus on data analysis and visualization.
• Python Documentation ³, the official and authoritative source of information about Python, its syntax, features, modules, and libraries.
• Python Tutorial ⁴, a beginner-friendly and easy-to-follow tutorial that introduces the basic concepts and features of Python.
• Python Challenge ⁵, a fun and creative way to test and improve your Python skills with a series of puzzles and riddles.

I hope this syllabus helps you learn Python programming in a month. 

Tithes

Deuteronomy 14

Tithes

22 “You shall tithe all the yield of your seed that comes from the field year by year. 23 And before the Lord your God, in the place that he will choose, to make his name dwell there, you shall eat the tithe of your grain, of your wine, and of your oil, and the firstborn of your herd and flock, that you may learn to fear the Lord your God always. 24 And if the way is too long for you, so that you are not able to carry the tithe, when the Lord your God blesses you, because the place is too far from you, which the Lord your God chooses, to set his name there, 25 then you shall turn it into money and bind up the money in your hand and go to the place that the Lord your God chooses 26 and spend the money for whatever you desire—oxen or sheep or wine or strong drink, whatever your appetite craves. And you shall eat there before the Lord your God and rejoice, you and your household. 27 And you shall not neglect the Levite who is within your towns, for he has no portion or inheritance with you.

28 “At the end of every three years you shall bring out all the tithe of your produce in the same year and lay it up within your towns. 29 And the Levite, because he has no portion or inheritance with you, and the sojourner, the fatherless, and the widow, who are within your towns, shall come and eat and be filled, that the Lord your God may bless you in all the work of your hands that you do.

The Aging Problem in Malaysia

    

    Malaysia is facing a serious challenge of population aging, which means that the proportion of older people (aged 60 and above) is increasing relative to the younger ones. This trend is driven by the declining fertility rate, the increasing life expectancy, and the aging of the baby boom generation. According to the United Nations, Malaysia is expected to become an aged nation by 2030, when 15% of its population will be older than 60. By 2050, this figure will rise to 24%, which means that one in four Malaysians will be an older person.

Population aging has significant implications for the social and economic development of the country. It will affect various aspects of society, such as the labor force, the health care system, the pension system, the family structure, and the quality of life of older people. Some of the challenges that Malaysia will face are:

• A shrinking and aging labor force will reduce the productivity and competitiveness of the economy. The labor force participation rate of the older people is relatively low, at 38.5% in 2020, compared to 80.1% for the prime-age workers (aged 25-54). The dependency ratio, which measures the number of dependents (children and older people) per 100 working-age people, will increase from 47.7 in 2020 to 76.5 in 2050, meaning that there will be fewer workers to support more dependents. This will pose a challenge to the economic growth and the fiscal sustainability of the country.
• Rising demand for health care and long-term care services will put pressure on the public health system and the fiscal budget. Older people are more likely to suffer from chronic diseases and disabilities, which require more medical attention and care. According to the National Health and Morbidity Survey 2019, the prevalence of non-communicable diseases, such as hypertension, diabetes, and cardiovascular diseases, among older people was 74.3%, 26.9%, and 12.5%, respectively. The health expenditure per capita for the older people is estimated to be three times higher than that for the younger ones. Moreover, older people may also need long-term care services, such as personal care, nursing care, and social care, which are currently limited and costly in Malaysia.
• A growing need for social protection and income security for older people, who may face poverty and vulnerability in their old age. The current pension system in Malaysia covers only about one-third of the labor force, mainly the public sector employees and the formal sector workers. The majority of the older people rely on their personal savings, family support, or informal work for their income. However, these sources may not be adequate or sustainable in the future, especially for low-income and rural older people. According to the Household Income and Basic Amenities Survey 2019, the incidence of absolute poverty among older people was 7.2%, higher than the national average of 5.6%. Older people may also face other risks, such as inflation, fraud, abuse, and discrimination, which can affect their income security and dignity.
• A changing family structure and social norms will affect the intergenerational relationships and the well-being of older people. Traditionally, the older people in Malaysia live with their adult children and receive care and support from them. However, this family arrangement may change due to urbanization, migration, education, and modernization. The younger generation may have different values and preferences, and may not be able or willing to take care of their aging parents. The proportion of older people living alone or with their spouse only increased from 15.8% in 2004 to 20.7% in 2014. This may lead to social isolation and loneliness among older people, which can affect their mental and emotional health.

To address these challenges, Malaysia needs to adopt a comprehensive and coordinated approach that involves all stakeholders, such as the government, the private sector, the civil society, and the older people themselves. Some of the possible strategies are:

• Promoting active and healthy aging means enabling older people to participate in economic, social, and cultural activities, and to maintain their physical and mental health. This can be achieved by providing more opportunities and incentives for older people to work, volunteer, learn, and engage in their communities, and by improving their access to health care and preventive services. Active and healthy aging can enhance the productivity and contribution of older people, as well as their quality of life and well-being.
• Strengthening the social protection and income security system for older people means ensuring that they have adequate and stable incomes to meet their basic needs and enjoy a decent standard of living. This can be achieved by expanding the coverage and adequacy of the pension system, by providing more social assistance and benefits for the needy older people, and by encouraging more savings and investments for retirement. Social protection and income security can reduce the poverty and vulnerability of older people, and increase their consumption and demand.
• Enhancing the family and community support for the older people, which means strengthening the bonds and mutual obligations between the generations, and fostering a culture of respect and care for the older people. This can be achieved by providing more financial and non-financial support for the family caregivers, by developing more community-based and home-based care services, and by raising public awareness and education on aging issues. Family and community support can improve the social and emotional well-being of older people, and promote social cohesion and harmony.

Population aging is inevitable, but it is not necessarily a problem. If managed well, it can be an opportunity for Malaysia to harness the potential and wisdom of the older people, and to create a more inclusive and sustainable society for all.

The Aging Problem in Malaysia