On Sunday, health minister Dr Zaliha Mustafa said the government was struggling to maintain a free healthcare system, especially in view of rising costs and an ageing population.
She said Malaysia faced similar challenges to the UK’s National Health Service (NHS), as both provided free services with an emphasis on quality care in an equitable manner.
FMT takes a closer look at how the public healthcare system works, whether it is sustainable and what reforms can improve it.
Current public healthcare system
Malaysia inherited its healthcare system from the British upon independence in 1957, but services were mainly based in urban areas. Healthcare services were later expanded to cover rural areas.
Public healthcare services are organised under a civil service structure and centrally administered by the health ministry through its central, state and district offices.
Services range from preventive and primary healthcare to tertiary hospital care at public clinics, hospitals and health facilities.
The public healthcare system, which caters to about 65% of the population, is mainly financed by general revenue and taxes collected by the government.
As a result, Malaysian citizens only need to pay a nominal fee of RM1 for general outpatient consultation and RM5 for specialist consultation. Patients pay additional charges for medical prescriptions.
Concerns over sustainability
Galen Centre for Health and Social Policy CEO Azrul Khalib said the public healthcare system could soon buckle under the pressure of numerous issues.
“The overwhelming number of people suffering from non-communicable diseases, such as cardiovascular diseases and respiratory illnesses, has led to an increase in the demand for more effective treatment and care.
“Larger caseloads needing hospitalisation and complex care and people living longer, combined with more and more professionals leaving the public health service, mean the system cannot keep up,” he told FMT.
This, he said, put the people at risk of not getting the care they needed.
Azrul said with the growing volume of patients, the increasing complexity of diseases and the pressure on the healthcare system due to an ageing population, the current system of financing public healthcare was unsustainable.
No shortcuts to reform system
Calling for critical reforms in healthcare financing, Azrul proposed a social health insurance scheme, similar to the Employees Provident Fund (EPF), to which the majority of the population contributes.
“Social health insurance is not like private health insurance as there is no specific amount of coverage for critical illnesses and hospitalisation,” he said. “Patients pay nothing at the point of care because they are already subscribed to the scheme.”
In a statement on Sunday, the health ministry said Zaliha was committed to implementing changes in the country’s healthcare system through discussions with Malaysian medical experts currently serving in the UK, after she had taken part in a forum there.
The ministry said the forum, which discussed collaboration between UK and Malaysian clinical researchers, was useful as Malaysia was currently drafting a white paper on healthcare.
However, it remains to be seen what measures will be proposed in the white paper and if the healthcare system will be drastically reformed to ensure its sustainability.