TWO DOCTORS AND A COUNTRY
Increasing healthcare costs and sustainability issues call for accurate diagnosis and treatment
MALAYSIA has come a long way in terms of healthcare development. We have successfully navigated the public health challenges faced by developing countries but like most countries across the globe, we are stuck in a quagmire of increasing healthcare costs and issues of sustainability.
With two doctors at the helm, it is hoped that the issues ailing Malaysia will be both diagnosed accurately and treated effectively. Many things can be looked into, but a specific number of issues should be looked into during the early half of the current administration.
FIRST, Pakatan Harapan (PH) has promised to introduce the “Peduli Sihat” scheme within the first 100 days of administration. The scheme allocates RM500 annually to individuals from the B40 group, allowing them to access privately-run primary care services.
The element of choice and greater autonomy is very much welcomed. Besides empowering the patient, it also allows patients to choose the investigations and treatment that is relevant to them. However, before rushing into implementation it is essential to introduce a mechanism that ensures patients are protected from unnecessary investigations driven by profit-making.
SECOND, this focus on primary care is very welcome and should be continued. PH has pledged to increase the Health Ministry’s allocation to the equivalent of four per cent of GDP within the first term. The bulk of this should go into the development and maintenance of primary care and public health efforts including increasing health literacy amongst the public. The budget for specific sectors should be ring-fenced and funded from sin taxes.
THIRD, increasing the money spent per se is no guarantee of good outcome. Each ringgit spent must be accounted for. Even before increasing allocation, a comprehensive audit should be conducted looking into the awarding of contracts for construction and ICT projects. The presence of monopolies, which are likely to inflate costs, should be addressed. Most importantly, overhauling the manner in which government procurement for medication and medical equipment is conducted will generate sufficient cost savings — savings that can be put into use elsewhere.
FOURTH, with the increase in non-communicable diseases (i.e. non-infectious or “lifestyle” diseases), modifiable risk factors should be addressed in order to prevent development of diseases. These include campaigns to promote good health and combat online misinformation. Most importantly, the implementation of a new Tobacco Act, covering all unhealthy substances including tobacco and electronic cigarettes, should not be delayed. Addressing the root causes of diseases that cost the country billions of ringgit annually will benefit us not only financially, but in the number of lives saved.
FIFTH, healthcare financing is the elephant in the room that no political coalition touched during the recent campaigning. There is no denying the fact that an ageing population and increasing costs of medication will lead to increasing costs for both the government and public. Out of pocket expenditure is increasing, just as there is a lack of efficiency in utilising available resources — there is definitely huge potential for greater public-private collaboration. It is essential that options such as the Voluntary Health Insurance scheme are discussed in an open and transparent manner as implementation, no matter how well intentioned, will be fraught with political challenges.
SIXTH, the potential of revolutionising healthcare with digital technology should not be underestimated. If done correctly, there is potential to address many number of issues — from establishing disease databases to ensuring that services to rural areas are not substandard. However, it is easy to get lost and be misdirected with the latest trends. While Artificial Intelligence may sound sexy and convincing, we need to ensure that we have good solid data in the first place. The government should continue the current work done between the Health Ministry and Malaysian Communications and Multimedia Commission whereby specific aspects are looked into in order to obtain greater efficiency of services.
SEVENTH, last but certainly not least — human resources. Investment in training and hardware for specialists as well as increasing the number of auxiliary care staff such as physiotherapists and the paramedics is critical. Our paramedic service should be given priority — both in terms of hardware and skills development in order to be able to provide the minimum standards of emergency care services.
Despite the many successes of our healthcare system, it is important that we do not rest on our laurels. Many of the issues that need addressing will require cross-ministerial cooperation. It is hoped that the new Health Minister will help break these silos in order to address the issues outlined above with the ultimate aim of better healthcare for the rakyat.
With two doctors at the helm, it is hoped that the issues ailing Malaysia will be both diagnosed accurately and treated effectively. Many things can be looked into, but a specific number of issues should be looked into during the early half of the current administration.