Is Malaysia’s Healthcare System Failing?

World healthcare expenditure was at about 9.8% of GDP in 2018. Japan spends about 9 percent of its GDP on healthcare, where 80 percent of the expenses is funded by the government. Malaysia, on the other hand spends only about 4 percent of GDP on healthcare, and where government funds only 50 percent of it. (Data source: countryeconomy.com).

Anas Alam Faizli pointed out in 2016 that the GDP percentage spent on healthcare ranks Malaysia at number 156 in the world. Majority of Malaysians go to public healthcare facilities. 75 percent of Malaysians seek in-patient treatment and 90 percent of Malaysians seek out-patient treatment at public facilities. Despite that, the government spends only slightly higher than 50 percent for total healthcare expenses.

The Malaysian government in 1983 under then-prime minister Dr Mahathir Mohamad introduced privatisation policies which allow the private sector to play a greater role in taking away the government’s responsibilities in both healthcare and education. Healthcare has exhibited ever increasing costs since then.

As a result of privatisation, highly qualified and experienced doctors flocked to the private sector. Within twenty years, according to Anas (2016), the private sector held two-thirds of the total number of medical, surgical consultants, and specialists. Brain-drain by default? Eventually the waiting time and quality of service in government hospitals deteriorated significantly. Some have experienced tragedies where relatives met their death due to late diagnosis or late treatment.

We need to find the real cost of healthcare. Why are there Approved Permits for medicines?  And large health conglomerates, government-linked companies (GLC) like Sime Darby, Pantai, Khazanah, KPJ and others account for more than 40 percent of private hospital beds. These are not cheap. And if there is an insurance cover then procedures not really required are put through—why? For profit of course!

The government is wearing three hats, as the public healthcare provider, regulator, and as an investor in profit- oriented healthcare facilities. Isn’t there a conflict of interest? Perhaps during this Covid pandemic we should re-examine our healthcare sector and determine how low- and middle- income folks could avail of the facilities.

Reference:

1.     Aas Alam Faizli, A barometer on Malaysia’s healthcare system - are we doomed to fail? 23 Sep 2016, Malaysia Kini

2.     JD Lovrenciear, Private healthcare in Malaysia: Millstone or milestone? 19 May 2021, Aliran