Kuala Lumpur, 2 November 2018 – The Galen Centre for Health and Social Policy congratulates the government for ensuring that the commitment to healthcare is not only maintained but further enhanced to help ensure preparedness and resilience, especially of B40 households, in responding to ongoing and future health challenges, particularly non-communicable diseases (NCDs). However, there are a number of concerns specifically linked to the proposed B40 health protection fund and the lack of a proposed healthcare financing mechanism.

Commenting on today’s tabling of the 2019 Budget, Chief Executive Azrul Mohd Khalib said, “It is welcome news that in their very first budget, the Pakatan Harapan government has continued the previous government’s commitment of incrementally increasing the allocation for health. This is the highest ever allocation for health. It is almost RM 29 billion, an increase of 7.8% compared to this year and making up almost 10% of the overall budget. The government took a first step today investing in interventions aimed at transforming Malaysian healthcare from a sickness service to a health and well-being service.”

“We honestly did not expect some of the initiatives announced today. It is heartening to note that the government has taken up our recommendation to impose a sugar tax or excise duties on sugar sweetened beverages at the manufacturing stage and not at the point of retail. This will have the intended result of manufacturers taking the initiative and being incentivised to reduce the sugar content in their products to avoid being taxed.”

“However, a tax alone is not going to solve the obesity crisis. The revenue collected should go directly to funding public health programmes designed to deal with NCDs such as diabetes and cancer. Earmarking this revenue for this purpose would help strengthen the effectiveness and sustainability of current health literacy and NCD prevention programmes, particularly as there has been a reduction in the allocation for health education.”

“The increase in the allocation for the supply of drugs, consumables, vaccines and reagents is certainly good news for patients. In the past, insufficient funds have resulted in shortages of essential drugs needed to treat diseases, particularly NCDs such as hypertension, heart disease and diabetes. These shortages affected those most vulnerable such as senior citizens, pensioners and those in the B40 and even M40 households who can afford no other choice and depend solely on public healthcare for treatment.

“The announcement of a nationwide health screening pilot programme aimed at almost a million individuals aged 50 and above in B40 households, as well as the different screening initiatives for women, are certainly welcome but will face significant known challenges, particularly linking individuals to diagnosis and treatment. There must be investment in interventions which address this problem.”

“However, we are concerned about the introduction of the proposed national B40 Health Protection Fund. Coverage of up to RM 8,000 per annum for the top four critical illnesses is considered by healthcare experts to be inadequate to provide the intended protection under private healthcare, especially applied to a household. It is at best a stop-gap measure at the primary care level as patients will be inevitably forced to move to public healthcare for further treatment.”

“Once they are referred to a public healthcare facility, these patients will be unfairly imposed with First Class treatment charges as required under the Fees (Medical) (Amendment) Order 2017. These rates are significantly higher than for patients referred from the public sector, as it is heavily subsidised. Unless this legislation is amended, this scheme could end up victimising enrollees. It might actually be more advantageous for B40 households to not enroll, to access primary care services through public facilities as they do now,” cautioned Azrul.

“It is also unfortunate that there was no announcement of the development of a long-term solution to healthcare financing such as a social health insurance scheme for all. In order to ensure that Malaysia’s healthcare system is able to continue to provide quality, affordable and accessible health services in the decades to come and tackle the challenges of preventing and treating NCDs, the government must summon the will and commitment to invest now in a new sustainable approach to funding health. We did not hear that today.”

 

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