Rakan KKM is MOH’s latest plan to keep doctors. Here’s why it might not work

My oh my, what a busy month/year/decade (???) it’s been for doctors in Malaysia. The fact that they’re constantly underpaid and overworked isn’t exactly breaking news anymore. In fact, if you’ve ever had to wait 6 hours at a Klinik Kesihatan just to get a Panadol, you’ve probably witnessed the issue firsthand.

But lately, shit kinda has been hitting the fan with one thing after another making headlines. Between contract doctors still stuck in career limbo, horror stories of 45-hour shifts going viral and oh, that small matter of Singapore allegedly poaching our doctors with fat RM30k/month salaries, it seems like the whole system is haemorrhaging talent, morale, resources, patience, trust and just about anything else you can think of.

But what really capped off these recent events was when out of nowhere, the Health Ministry launched something called Rakan KKM. It’s meant to give our specialist doctors a reason to stay in public service by letting them earn more instead of meloncat-ing to private hospitals or across the Causeway.

Yeah, yeah, sounds great. More money, still under MOH, which means win-win la kan? But squint a little more and you start seeing why some doctors are so totally not on board with the concept. So before we dive into whether Rakan KKM is the hero our doctors deserve or just another half-baked idea, let’s get the obvious out of the way first.

What the heck even is Rakan KKM?

Okay. So Rakan KKM is NOT a privatisation plot to turn your next hospital visit into a Gleneagles bill. That’s the first thing MOH wants you to know. In fact, Health Minister Dr Dzulkefly himself reassured everyone that Rakan KKM is 100% government-owned through the Minister of Finance Incorporated (aka not some shady private venture). Even if GLCs or GLICs buy in later, it’ll still be under the government.

So what is it then?

First off, do you guys know what locum is? It’s when doctors do extra shifts at private clinics or hospitals after their regular hours to earn some extra moolah. It’s not so much a thing in public hospitals since, duh, doctors can earn way more if they do their locum privately. Well, Rakan KKM is about to make this locum-in-public-hospitals thing official.

That said, there are some conditions lah. This program is for specialist doctors at a few selected hospitals and they’ll just handle elective stuff only meaning no emergency cases. And yes, patients have to pay for it. But it’s supposed to be less than private prices, with the bonus of picking your specialist and getting shorter wait times.

MOH is calling it “premium economy” healthcare which to our understanding, means not quite private service lux, but definitely a notch above your standard public healthcare. The idea is to generate revenue from patients who can afford it, and then use that money to cross-subsidise the rest of the system.

So now that we know what Rakan KKM is, let’s talk about why MOH seems to think it’s the next best thing since antibiotics.

MOH thinks the cure is more hours, more pay and less waiting

At the heart of it, Rakan KKM is MOH’s way of doing damage control before the whole system flatlines.

Oh, doctors are leaving? No worries, Rakan KKM gives them a way to earn more while staying put.

Are there long wait times for elective surgeries? All good, Rakan KKM slots those into evenings and weekends, using the same facilities and doctors.

Goddamn, private healthcare getting stupid expensive? Rakan KKM becomes the price benchmark to hopefully stop those hospitals from charging your kidneys to treat your kidneys.

And just so you know, this isn’t any random side project. The government has already poured RM25 million into it through the federal budget with more funding expected to come from GLICs later. If you’re concerned that this is just another money pit, the idea is that Rakan KKM will be financially self-sustaining and thus repay those funds with revenue from its services and eventually even turn a profit that flows back to public coffers.

On paper, it’s a neat lil ecosystem. Patients who can pay, pay a bit more and doctors who want extra cash, can earn a bit more. And in doing so, the public system gets to breathe again. MOH insists it’s all value-based, which is just a corporate way of saying they have everyone’s best interest at heart. Or in other words, they aren’t the money minded vultures you think they are, rather all they want is to make the system work better.

But ofc, not everyone is buying it…

Doctors, the MMA and everyone with opinions aren’t exactly throwing confetti

First of all, naur, we don’t mean that MMA. Although the way things are going, we wouldn’t be surprised if overworked doctors start kapowing the system out of pure stress. Cos seriously, which genius thought it was a good idea to add even more work to a healthcare system that’s already bursting at the seams?

Take away all the fancy talk around Rakan KKM, and it’s just burnt out staff and crowded wards having to layan those who can afford to skip the queue. So now wealthier patients get the express lane while everyone else is stuck waiting in a queue they already paid to be in as taxpayers. Which brings us to the million-ringgit question: why blur the line at all? For a government that’s all about the B40 and Rahmah everything, it kinda just feels weirdly out of touch.

And it’s not just us taking issue with this, okay? Even the people at the Malaysian Medical Association (MMA) are waving red flags.

“Such an outcome would undermine the principles of Universal Health Coverage, which are built on fairness and equal access to care for all, regardless of socioeconomic status,” – Dr Kalwinder Singh Khaira, MMA President via NST

And when we move past that glaring blackhole, the remaining complaints cover a wide range.

Rakan KKM reportedly applied for licensing under the Private Healthcare Facilities and Services Act, meaning this public hospital initiative is being treated more like a private venture. According to Dr Kalwinder, it’s worrying cos the government is basically regulating its own programme, which raises questions about how transparent or fair it really is.

And let’s not even start on staffing. We barely have enough doctors and nurses for one system, let alone two. Then when you take into account the salaries they’re offering Rakan KKM staff when our doctors are deep in the trenches counting their sens…

All of it adds up to the same concern, and by that we mean…

Rakan KKM is well-meaning but kinda messy

At the end of the day, Rakan KKM isn’t the worst idea to come out of MOH. (That would be the 45 hours work week thing that was rescinded, whoops). As a whole, and if you stand pretty far back, the idea kinda makes sense since it keeps doctors from jumping ship, eases the backlog and gives the public system some room to recover. Even MMA has acknowledged that it’s a good thing that the government is looking to ease the burden on the public system.

The only issue is rn, too many parts feel rushed, vague and a bit too prickly for comfort. The public is confused, doctors are divided, and the details keep raising more questions than answers. And when you have a system already bleeding out, the last thing it needs is a fancy new bandaid that camouflages the problems instead of fixing it.