By James Jeremiah
This article is written taking into account the Ministry of Health’s current carrion call for transparency and competency in the private healthcare ecosystem.
This urgent carrion call should also apply to the public healthcare ecosystem, which is propped up by taxpayers’ money.
In a time when the MoH is striving towards transparency, competition and economic efficiency, monopolies – especially in critical sectors like healthcare – must be abolished.
One such monopoly is Fomema Sdn Bhd, the sole entity authorised to manage mandatory medical check-ups for foreign workers in Malaysia for almost 30 years.
What started as a well-intentioned system in 1997 has now evolved into a bureaucratic monopoly, creating ethical concerns, economic inefficiencies and a single entity reaping a huge ugly profit at the expense of the people.
Let me explain why Fomema should not retain monopoly status over this crucial process:
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Monopolies kill innovation
- No competition means no urgency to improve.
- Clinics and labs are forced to follow rigid protocols that may be outdated or impractical on the ground. (Clinics and labs are held at ‘gunpoint’ to accept whatever prices Fomema dictates.)_
High costs, no transparency
- Employers face unclear billing structures and hidden administrative fees.
- With no pricing competition, costs can continue to rise without justification.
Conflict of interest
- Fomema profits from every screening it processes.
- Fomema is the executor and gatekeeper of this system – is this acceptable?
Doctors are treated like vendors
- Clinics are made to upgrade systems and follow strict standard operating procedures, often at their own cost.
- A single dispute with Fomema can result in blacklisting.
Data privacy risks
- Fomema controls millions of personal medical records with limited transparency on data protection.
- Centralised systems are highly vulnerable to data breach and abuses.
- Is there a third-party audit in place?
According to Fomema records, it collects an average of RM200 from employers per foreign worker.
The cost breakdown is allegedly as follows:
- Doctors – RM80 (medical check-up RM45 + X-ray RM35)
- Labs – RM45 (according to labs interviewed)
- Fomema – RM75
According to sources, Fomema conservatively does two million-plus foreign workers’ check-ups per year.
Estimated revenue generated by Fomema, a monopolistic entity
Fomema generates a revenue of multi-million ringgit yearly, unfairly at the expense of GPs’ clinics and labs.
Wouldn’t the MoH consider monopolies as one of the causes for inflation in our medical landscape?
MoH must move on
After close to 30 years on a single monopoly entity, its high time the MoH rethinks its policy and bring in multiple players into this arena.
This is to ensure a more level playing field, which will eventually benefit the people.
This is not about attacking any single entity. It is about ensuring our system works fairly, ethically and efficiently for everyone to assist in bringing down inflation in our current medical ecosystem.
Let’s work together to build a better Malaysia.
Fun fact: Fomema Sdn Bhd, the entity responsible for managing medical examinations of foreign workers in Malaysia, reported a significant financial performance in 2023. According to data from EMIS, the company experienced a 63.4% increase in net sales revenue and a 57.8% rise in net profit for that year. While the exact revenue figures are not publicly disclosed, these substantial growth percentages indicate a robust financial position. (Citation: EMIS NEXT)
Datuk Dr James Jeremiah is a past president and founding president of the Association of Private Practitioners Sabah (APPS).
- Tegakkan maruah serta kualiti kehidupan rakyat
- Galakkan pembangunan saksama, lestari serta tangani krisis alam sekitar
- Raikan kerencaman dan keterangkuman
- Selamatkan demokrasi dan angkatkan keluhuran undang-undang
- Lawan rasuah dan kronisme
Who are the staff. Can’t get to see or communicate with the Drs there. For minor results the workers are asked to repeat their tests, thus incurring costs for employers.