KUALA LUMPUR (September 20): The government must make tough decisions and increase efforts to build and future-proof the country’s healthcare infrastructure for sustainability and resilience, the Galen Center for Health and Social Policy said.
In a statement Tuesday (September 20), Azrul Mohd Khalib, the Galen Center’s chief executive officer, called for increased commitment and investment in five key areas: healthcare financing; non-communicable diseases; Public Health Emergency Preparedness and Response; reproductive health; and elderly care.
He said that for too long, talks about health care have been constrained, hampered and constrained by issues of affordability, rather than focusing on meeting the current needs and ongoing challenges of a growing population and economy of a country making the transition from a top Center completes -income for high-income economy.
“Decisions are often based on what we can afford, rather than figuring out what we need, how much money is available, and finding solutions to fill those funding gaps.
“This isn’t just about having more funds, it’s also about how that money is spent. We need to change the way we look at health as an investment and not an expense,” he said.
Azrul recommended that the government remove the RM1 fee for outpatient care and RM5 for specialist care at Ministry of Health (MOH) facilities.
He said these allegations reinforced the misrepresentation that health care in Malaysia was somehow cheaper in state-run institutions.
“They are also insufficient for meaningful cost recovery and mislead the public as to the true cost of healthcare.
“We believe these fees are a barrier and should be removed to facilitate future health-finance reforms,” he said.
Azrul said Malaysia is in a non-communicable disease (NCD) crisis.
“One of these NCDs is diabetes. There are nearly four million people living with diabetes in this country,” he said.
Azrul said a recent report by the MOH and the World Health Organization showed that the annual direct healthcare expenditure for this disease is RM 4.38 billion, highest when compared to cardiovascular disease (CVD) and cancer.
“For every ringgit spent on the three NCDs, 45 sen goes to diabetes, 41 sen to CVD and 14 sen to cancer.
“We propose cutting subsidies for diabetes treatments and introducing co-payments of up to 30% of actual costs.
“People have to take care of their own health and take responsibility. It will also help reduce the waste of subsidized medicines,” he said.
Azrul said Malaysia is ill-prepared to deal with the needs and consequences of a growing aging population.
He said elderly and long-term care facilities and relevant basic services remain limited, mostly confined to urban centers and concentrated in private providers.
“There is a lack of clarity as to which ministry should be responsible. There is an unsustainable dependency on informal care.
“As a result, this problem has suffered a tremendous decline, leaving many older people vulnerable to neglect, substandard care and even abuse,” he said.
Azrul added that the government must immediately make improving elderly and long-term care a priority to be addressed in the upcoming 2023 budget.
“Instead of being dependent on unfunded and unsustainable entitlements, there may be a need to introduce a national insurance scheme for those over 40 that specifically supports the funding of old-age and long-term care.
“Ad hoc approaches will not be sufficient or sustainable,” he said.