The Rising Cost of Healthcare: Standards versus Cost

This is part of a series about the Rising Cost of Healthcare
Part 1 - Cost versus Standards
Part 2 - Measuring standards
Part 3 - Improving delivery
Part 4 - The PHFCS
Part 5 - Conclusion

This is an article written by Dr. Steven Chow and Dr. Ng Swee Choon of the Federation of Private Medical Practitioner’s Associations Malaysia.

It has often been said and much has been written about the high cost of healthcare in Malaysia. For a start, we are all very fortunate to be in Malaysia, where the healthcare standard is probably one of the best, if not “The Best” in the ASEAN region. If you take into account the amount of money spend on healthcare, Malaysia has indeed spent it wisely.

Thus on the macro level, there is thus little evidence to support those who call for a radically different healthcare system to replace the current one.

An overview

A quick look at the amount spend on health over the years (Tab. 1) will show that, over the last 5 years, our healthcare cost, as a proportion of GDP has risen from 3.2% in 1999 to 3.8% in 2003.

	1999	2000	2001	2002	2003
Indonesia	2.6	2.5	3.1	3.2	3.1
Malaysia	3.2	3.3	3.7	3.7	3.8
Philippines	3.5	3.4	3.2	3.0	3.2
Singapore	4.1	3.6	4.3	4.3	4.5
Thailand	3.5	3.4	3.3	3.4	3.4

Table 1 : Health expenditure as a % of GDP

Similarly, our healthcare cost as a proportion of total expenditure of public funds has risen from 6.6% to 6.9%.

Public expenditure on health care	1999	2000	2001	2002	2003
Indonesia	3.8	3.5	4.7	5.1	5.1
Malaysia	6.5	6.5	6.4	6.6	6.9
Philippines	6.5	7.1	5.9	4.9	5.9
Singapore	8.2	6.7	7.0	6.6	7.7
Thailand	10.5	10.8	10.3	11.8	13.6

It is clear from these figures that the healthcare cost in Malaysia has risen but in a reasonable, cost-effective manner. This rise is not unexpected based on the growth of the population and the inevitable introduction of more expensive new technology for disease diagnosis and management.

Scientifically speaking, just saying that healthcare cost has risen is only telling half the story. Perhaps what is more important is, how was the money spent? Did we spend our healthcare dollars wisely? Has the standard of health of the nation improved, and to what degree when compared to the other countries around us?

The next part of this series will be published tomorrow.