Kuala Lumpur, 20 September 2022 — For the upcoming Federal Budget 2023, the Galen Centre for Health & Social Policy calls upon the Malaysian Government to make tough decisions and boost efforts to build and future-proof the country’s healthcare infrastructure towards sustainability and resiliency. It calls for increases in commitment and investments in five key areas: healthcare financing; non-communicable diseases; public health emergency preparedness and response; reproductive health, and aged care.
“For too long, conversations concerning healthcare have been dependent on, hampered and restricted by issues of affordability, rather than centred around meeting the current needs and ongoing challenges of a growing population and economy of a country making the transition from a upper middle income to high income economy,” said Azrul Mohd Khalib, Chief Executive Officer of the Galen Centre for Health and Social Policy.
“Decisions are often based on what we can afford rather than finding out what we need, how much money is available, and finding solutions to bridge those funding gaps.This is also not just about having more funding, but also how that money is spent. We need to change the way we look at health. Investment not expenditure.”
“We recommend that the Government remove the RM 1 and RM 5 charges for outpatient and specialist care respectively in Ministry of Health (MOH) facilities. These charges sustain the misrepresentation that healthcare in Malaysia is somehow cheaper in government facilities. They are also inadequate for meaningful cost recovery, and misleads the public regarding the true cost of healthcare. We believe that these charges act as a barrier, and should be removed to facilitate future reforms in healthcare financing,” Azrul stated.
“Malaysia is in a non-communicable disease (NCD) crisis. One of these NCDs is diabetes. There are almost 4 million people living with diabetes in this country. A recent MOH – World Health Organisation report showed that annual direct healthcare spending for this disease is RM 4.38 billion, and is the highest compared to cardiovascular disease and cancer. For every ringgit spent on the three NCDs, 45 sen goes to diabetes, 41 sen goes to CVD, and 14 sen to cancer. We propose reducing subsidisation for diabetic treatments and introducing co-payments of up to 30 percent of actual cost. People must care and take charge of their own health. It will also help reduce wastage of subsidised medication,” he emphasised.
“COVID-19 has demonstrated the value and merit of investing in public health systems which are effectively able to respond to emerging diseases and outbreaks. We need to increase the capacity of the Disease Control Division of the Ministry of Health to prevent, detect and manage future epidemics. That means investing in training more epidemiologists, public health specialists, infectious disease experts, and increasing diagnostic laboratory capacity.”
“Unintended pregnancy is not just a problem of teenagers, unmarried women, or poor women from disadvantaged backgrounds. Being able to plan or decide one’s pregnancy enables women to take control of their futures, so that they can finish their education, get better jobs, and not be trapped in a cycle of grinding poverty and deprivation. It affects everyone,” Azrul emphasised.
“Unintended pregnancies are a national concern. This Budget should have an increased allocation to strengthen essential reproductive health services in the Ministry of Health and National Population and Family Development Board (LPPKN) which include providing contraceptives for both married and unmarried individuals.”
“Finally, Malaysia has been deemed as being ill-prepared to deal with the needs and consequences of a growing aging population. Aged and long-term care facilities and relevant essential services remain limited, mostly confined to urban centres, and concentrated to private providers,” Azrul pointed out. “There is a lack of clarity on which Ministry should be responsible. There is unsustainable dependence on informal care. As a result, this issue has suffered tremendous decline resulting in many older individuals vulnerable to neglect, substandard care, and even abuse.”
“The government needs to immediately make improving aged and long term care a priority to be addressed in the upcoming Budget 2023. Rather than depend on unfunded and unsustainable entitlements, it may be necessary to introduce a national insurance scheme for those above the age of 40 specifically to fund aged and long term care. Ad-hoc approaches will not be sufficient or sustainable,” he emphasised.
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