MEDIA STATEMENT
Kuala Lumpur, 15 June 2023 — The Health White Paper tabled and debated in the Dewan Rakyat today contributes to ongoing decades-long difficult conversations surrounding healthcare reform. Frequently held among stakeholders in the health sector, these discussions have often not involved the public or even their elected representatives. The tabling of the document and subsequent debate by Members of Parliament are excellent developments.
“We welcome the inclusion of sustainable healthcare financing as one of the pillars of the White Paper. Combined with the two most recent reviews of the healthcare system commissioned by previous administrations, the Government already has the ingredients to make the necessary changes to ensure that the healthcare system is fit for the future,” said Azrul Mohd Khalib, Chief Executive Officer of the Galen Centre for Health and Social Policy.
“Ensuring sustainable healthcare for the future has been a consistent feature of these reviews. However, this White Paper will faces the same challenges which have stumped amd blocked previous attempts to reform the Malaysian healthcare system: gaining sufficient political commitment from the government of the day, ensuring significant resources (e.g. funding and manpower), and being able to tackle both the demands and crises of today, while keeping an eye towards ensuring successful implementation of promised reforms. The challenges are formidable,” Azrul emphasised.
“Healthcare does not cost RM1. It never has and never will. The current system of charges for RM1 (general outpatient) and RM5 (Specialist outpatient) per visit were introduced in the mid-80s and is still used today. Every single patient entering the public system has had more than 95% of their treatment cost subsidised by the public purse. As pointed out in the White Paper, it has long been unsustainable.”
“However, increasing these fees is not an option. For example, increasing these fees from RM 1 and RM 5 to RM 10 and RM 50 respectively would mean increases of 900%. This may be neither publicly or politically acceptable. It would also be pointless as the amount of funds raised would still be insufficient for cost recovery.”
“These fees are obsolete, inadequate for meaningful cost recovery, and mislead the public regarding the true cost of health care. Even the Government frequently describes their services as “free” or “cheap.” These charges now act as barriers to reform. Rather than increase the RM 1 and RM 5 charges, they should be removed altogether. People should not be required to pay anything initially at the point of care. A more sustainable and meaningful solution to healthcare financing should instead be proposed and supported such as National Health Insurance.”
“National Health Insurance involves almost everyone contributing to a common pool of funds which would then be used to fund healthcare. This has been described in the White Paper. Such a scheme would be applicable to all workers and be based on a sliding scale linked to monthly income and age. There would be collective pooling of both funding and risk. It would begin to address the issue by co-sharing the burden and responsibility of financing the health care system. It has the potential to stabilise public subsidisation, allow space for cost-containment, maintain access and quality to essential services, improve access to innovative treatment, and fund equitable access to services in the private health space.”
“Will this Government succeed where its predecessors have faltered? We need both strong, bold and fearless leadership in the health sector as well as a belief in working together in partnership between the public and private sectors. Many of these proposed reforms should have been implemented at least 10 years ago.”