Kuala Lumpur, November 5 – The Women’s Health Summit has always been one of the highlights of the year ever since its conception in 2013. Organised by Pantai Hospital Kuala Lumpur, the summit brings together over 300 participants from diverse backgrounds, and enjoys the participation and support from the Ministry of Women, Family and Community Development (LPPKN), Ministry of Health, NGOs, various medical associations and civil societies.
The high point of the day is the Consensus Roundtable, which sees various key opinion leaders, experts and advocates coming together to deliberate on important issues in women’s healthcare, as well as to recommend policy innovations that will enhance healthcare coverage for women in this country.
This year, the 3rd Women’s Health Summit Consensus Roundtable is chaired by YBhg Tan Sri Rafidah Aziz, Patron of the 3rd Women’s Health Summit. Dr Azlina Firzah, consultant breast surgeon, serves as co-chair while Dr Patricia Gomez, also a consultant breast surgeon, acts as moderator.
Breast reconstruction should be seen as a medical right for breast cancer patients.
Ms Ranjit Kaur, Chairman of Together against Cancer Malaysia and Non-Communicable Disease (NCD) Alliance Malaysia explains that treatment of breast cancer is holistic in nature. It is not solely about surgeries or chemotherapy; the patient needs to receive care for her psychological and emotional well-being too. Breast reconstruction plays a significant role in the healing process, as it allows her to regain her self-esteem and confidence, leading to better adherence to treatment and improved chances of survival.
However, breast reconstruction is currently considered a cosmetic procedure by nearly all Malaysian insurance companies and the Employee Providence Fund (EPF). As a result, breast cancer patients who undergo mastectomy do not have the ability to withdraw funds from their EPF account to cover the costs of breast reconstruction, and only three out of 60 insurance companies in Malaysia provide coverage for this medical procedure.
The Consensus Roundtable brings up the fact that there are already precedents such as in the United States, where the Women’s Health and Cancer Rights Act (also known as Janet’s Law) made it compulsory by law for all sponsored group health plans, insurance companies, individual policies and health maintenance organisations offering medical and surgical benefits with respect to a mastectomy to also offer coverage for reconstructive surgery (including costs of implants and treatment for physical complications at all stages of the mastectomy).
Breast cancer survivors or women carrying breast cancer genes are discriminated by insurance companies as well as employers.
Professor Dr Teo Soo Hwang, Chief Executive of the Cancer Research Malaysia, brings up the Genetic Information Nondiscrimination Act of 2008 (GINA), implemented in the United States to prohibit the use of genetic information by employers and insurance companies to deny a woman her right to employment and insurance coverage, respectively.
In Malaysia, however, there is no similar law, and consequently, she points out that there are many instances when breast cancer survivors find themselves denied further insurance coverage and employment. Those with breast cancer genes are either denied insurance or they have to pay very high insurance premiums.
The call for action
It is time for the government to act. Tan Sri Rafidah Aziz calls for the Malaysian government to make the right provisions for the women in this country. Dr Patricia adds that the government needs to look at Janet’s Law and GINA to see how countries such as the United States handle this matter.
The Consensus Roundtable also urges the Ministry of Health to consider abolishing the need for ex-government servants and pensioners to pay upfront for the prosthetics (implants) needed for breast reconstruction in government hospitals.
The insurance companies can play a role. Dr Myralini S Thesan (Chairman of the Joint Technical Medical Committee of LIAM and Medical Advisor and Head of Care Management of AHS, AIA Berhad) says that she will send a representative to talk to Prof Dr Teo and other parties on the types of changes that we need to see in local insurance policies, as well as to clear the air on any wrong perceptions or misunderstanding on how the local insurance companies operate.
EPF can step up. Mr Azrulzimar Aminuddin, the Deputy Manager of the Withdrawal Operations Department of EPF, states that he will propose allowing women to withdraw from their EPF accounts for breast reconstruction in an upcoming meeting, and Tan Sri states that she will personally write to the EPF to support Mr Azrulzimar.