Monday, July 12, 2010


I read in New Straits Times, 11th July 2010, an announcement by the Minister of Health that Malaysia is looking towards a socialised healthcare system. You may remember that in Feb 2010, I had written about a seminar that I was invited to attend, organised by the Ministry of Health. A seminar for the trasnsformation and restructuring of the Malaysian Healthcare system.
Well, Dato Liow has just made the announcement to the public. According to him, there will be increase taxation through the employer ( almost like EPF ), so that those who earn more, pay more into the fund, and those who earn less pay less. He calls it a contribution by those 18years and above who is working. He has also announce the setting up of the National Health Financing Authority, to administer the funds. He declared that the restructuring will come in 4 phases, namely, i) strengthening the healthcare system like governance and standards of care. ii) to grant more autonomy to primary healthcare providers in areas like human resource and management, iii) to integrate all public and private clinics so that they are all linked under a common network so that people can access either one, iv) introduction of the national health insurance under the national health financing scheme.
The justification for all these is that healthcare cost is too high, RM 13.5B in 2009. I have always reasoned at all the healthcare seminars, that for a public expenditure of RM 13.5B ( which is about 4% of GDP ), the healthcare outcomes are very good, making us one of the more cost effective healthcare systems in the world. It is tu that healthcare cost is rising, because medical science has improved and patients are living longer and better.
It is true that most of the specialist are in the private sector that looks after the minority of patients. This may not be entirely by design. It may be by default, because of the push to leave public service. It is always made out to seem like everyone leave public service for greener pastures ( more money ). But that is not entirely true. The push to leave public service is also significant.
Whatever it is, look like the Minister is testing the waters. Increasing taxes and increasing EPF contribution is not going to go down well with the rakyat, especially when we are being asked to tigthen our belts, with removal of subsidy and whatnot. I suspect that this will become a " hot topic " in the coming GE 13. I am sure that the government of the day knows that the opposition will make an issue of this given that our " wastage " and " leakages" is more then our healthcare expenditure. Would stopping, or reducing the leakages not be a better choice than increasing EPF contribution for all workers 18 years and above, especially in times of economic slowdown and removal of subsidies?

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