The Opportunities

facilities. The “bottom of the pyramid” carries much of the burden of OOP payments, with the B40 group paying RM1 to RM5 to see a doctor at public hospitals, despite the coverage fromsocialinsuranceplans.

The Opportunities

As Malaysia embarks on a mission to create a completely cashless society, there are many opportunities for fintech and healthcare organizations to team up. 60% of Malaysians now own smartphones, providing an excellent foundation for creatingadigitalpaymentsecosysteminthecountry.107 Inthis ecosystem, there are many opportunities for innovative financing solutions – such as lending, crowdfunding, investments, and insurance models – that aim to address high OOPpaymentsinMalaysia.

Lending

Malaysians in the B40 and M40 groups experience barriers in seeking healthcare treatment in private centers because they lack the immediate financial resources needed to pay for the fees. Point-of-care lending solutions can provide immediate, affordable,andtargetedloanstothosestrugglingtopayup-front costs at private facilities. These loans would improve this population’s access to the private healthcare sector and outpatientclinics,avoidingthelongwaittimesanddiscontinuity in care experienced at public facilities. Opening up the private healthcare system to the wider population also lessens the burden on the public system. One opportunity for fintech companies includes the chance to build customer lending profiles using historical financial transactions to determine creditworthiness. This could then be used by patients or their

familymemberstoacquirefundstopayforotherOOPpayments ornecessities.

Crowdfunding

Crowdfunding is another innovative financing model that can addresshighOOPpayments.Typically,theP2Pmodelisusedas the crowdfunding source in Malaysia. This platform could be usedtohelpMalaysianspayhealthcareexpensesquicklyasthe funds come from multiple individuals at the same time.108 Raising the funds can be rapid or slow, allowing users the flexibility to use the funding according to the treatment they need.

Health Savings

Untilnow,manyMalaysianshavenothadmuchincentivetosave for their OOP or catastrophic healthcare costs. In the B40 and M40 groups, saving is even rarer and often not financially feasible.Simple digitalhealthsavingsaccounts(HSA),whether linkedtoone’sbankaccountorintheformofadigitalwalletfor theunderornon-banked,provideMalaysiansawaytosetaside money each month for their healthcare payments. These accounts allow Malaysians to put in small or varying sums of moneyeachmonthtosaveforhealthcarecosts. Future opportunities for fintech companies lie in the area of incentivizingsavingthroughproductsandservicesthatbolster the HSAs and through programs that make it easier for Malaysianstopullfromtheseaccountsforhealthcareservicesas soonasitisneeded.Inthefuture,FintechforHealthprojectsin Malaysiawilldelvemoreintoconversationsaboutwhatcanbe done to make these HSAs more attractive and saving for healthcareserviceseasierforB40andM40populations.

Insurance

Fintech companies could also play a role in creating curated insuranceproductsthatareaffordableforlargesegmentsofthe population.Affordabilityhasbeencitedby43%ofMalaysiansas the reason why they did not have healthcare insurance.109 Currently, only 22% of Malaysians are covered by personal healthinsurance.110 Throughdesigningandofferinginnovative insurancemodels,fintechcompaniescouldcustomizeinsurance products and packages for young married couples, women, recentgraduates,retiredelderly,orstudentsinhigherlearning institutions,amongothers. Currently, fintech companies are designing these insurance products from healthcare insurance companies without specificallytargetingpopulationsthatmightbenefitfromthem the most. For example, one-fifth of all birth deliveries in Malaysia, or about 100,000 deliveries take place in private healthcare facilities every year; however, there are no curated insurance products that target newly married couples or pregnant couples leading to Malaysians spending from RM300 million to RM600 million in OOP payments for birth deliveries.111 Additionally, the lack of affordable, customized healthcare insurance products for recent graduates means young graduates are dependent on poor-quality public health facilitiesorareforcedtopayOOPinprivatehealthcarefacilities. Thesecuratedinsuranceproductsmighthelptofurtherreduce the OPP payments, improve access to care for Malaysians and reducetheburdenonpublichealthfacilities. Theopportunitiesforfintechandhealthcaretocometogetherto createsolutionstothehighOOPpaymentsinMalaysiaarevast. With the market open and eager to find innovative solutions,