Germany’s Healthcare System: A Model for Malaysia?

The German healthcare system is a dual public-private system that dates back to the 1880s. Healthcare in Germany is funded by statutory contributions. Hence free healthcare for all.

All workers contribute about 7.5% of their salary into a public health insurance pool. Employers match that contribution. Those who earn less than Euro 57,600 a year take part in the government scheme – GKV. If you are earning above Euro 57,600 (2017), you can opt out and take out a private health cover – PKV. The difference between statutory and private health insurance is like economy and business class on a commercial airline.

Germany is one of the largest spenders on healthcare in Europe – 11.1% of GDP or Euro 4,000 per inhabitant. All German residents can access the healthcare system. Non-residents will use private insurance coverage.

In Malaysia, it is a dual-track system of public and private hospital care. Public healthcare is subsidised by Government and private healthcare covered generally by insurance. There is no fixed contribution by workers/employees, but employers provide the insurance cover under a benefits programme. Hence, many in private hospitals are from the private sector while the Government hospitals are patronised by Government employees and the poor. The service difference could be stark but there are pockets of excellence in public hospitals. If treatment cost exceeds the insurance cover, the patient has to move to a public hospital.

A free national health insurance scheme for low income individuals was announced by the Minister of Finance in December 2018. Initial cost was estimated at RM2 billion. This is targeted at B40 group and provides coverage for 36 critical illnesses. However, it is meant only for the age group 18-55 years.

The MMA proposed a compulsory social health insurance for all. This is in line with Universal Health Coverage endorsed by a “not-for-profit” National Health Financing Authority, a statutory agency answerable to Parliament. The MOH will then be a regulatory body rather than a healthcare provider. The case for a national health insurance is two fold – to protect employees if they lose their jobs and also provide for those retirees from the private sector. Health insurance cover for those above 65 is exorbitant.

We need to “tweak” our system and make healthcare available at affordable prices. Sick (or old) people should not be worried sick (pun not intended) with their hospital bills.

References:

1. The German healthcare system: A guide to healthcare in Germany (www.expatica.com)

2. Germany’s health care system a model for the U.S.? Erika Edwards and Lauren Dunn (www.nbcnews.com)

3. Government and private hospitals in Malaysia: How much do they really cost? The RinggitPlus Team, May 24, 2018

4. MMA: National health insurance scheme must be for all Malaysians, Ida Nadirah Ibrahim, Aug 6 2018 (www.malaymail.com)