Steps to a sustainable healthcare expenditure
KUCHING: With a heavily subsidised healthcare system in Malaysia, it is safe to say that the average Malaysian is greatly aided in their search for medical attention and medication.
However, this comes at a cost to our healthcare system, and that cost has to be borne by someone, in our case ourselves – through taxes, personal outofpocket expenses and our insurance companies.
Currently, our healthcare expenditures are consuming an ever increasing portion of our gross domestic product (GDP). Standing at 4.4 per cent of GDP or RM50.3 billion in most recent figures, 52.4 per cent of our current healthcare expenditure is being funded by the Ministry of Health (MoH), followed by private household out-of-pocket (OPP), private insurance, and all other federal agencies and ministries.
When compared to other universal healthcare nations like Japan and Canada, our expenditure of healthcare seems fairly moderate as they each spend 10.2 and 11.03 per cent of their GDPs respectively on healthcare, albeit at higher government funding rate of around 80 per cent.
However, in the longterm, analysts expect our healthcare expenditure to rise dramatically because of our aging population, higher life expectancy and rising lifestyle diseases, shifting a majority of the population to require more medical treatment than before.
During the 2010 to 2040 period, the Malaysian population aged over 65 and over will increase to more than three-fold its 2010 population. This increase will categorise Malaysia as an aging population society by 2021, when our aged 65 years and above population will reach 7.1 per cent of our entire population.
Lifestyle diseases are also on the rise as more Malaysians are dying prematurely due to increased incidents of noncommunicable disease (NCDs) arising from poor lifestyles. For example, of the 10 causes of premature death in Malaysia, a large majority are NCDs who have seen large increases of proportion in 2016 from 2005.
Diseases related to blocked arteries and mini strokes saw 36.4 and 20 per cent increase in changes from 2005 to 2016, while diseases known to have strong links to overconsumption of sugar like Diabetes, and chronic kidney disease saw a 37.1 and 28.0 per cent increase.
The predicted rise of healthcare expenditure is not new news as hospitals all around Malaysia have found themselves strained from a lack of resources in both labour and medicine as they try to serve the ever going number of patients.
This has caused much concern as it would be a daunting task for us to overcome if our healthcare expenditure exceeds sustainable levels.
In response to our rising medical expenditure, both the public and private sector have taken steps to curb unsustainable increases.
Public sector: More awareness needed
In the public sector, public health awareness campaigns are often the first sign of attack when tackling the issue of rising medical expenditure and rising number of diseases, and with good reason.
It is understood that public healthcare awareness is an effective tool in helping maintain the health in a population and is extremely applicable to us locally as statistics from Healthdata indicate found that are top risk factors in Malaysia that drive the most death and disability are dietary risks, high pressure, tobacco usage, high blood sugar, obesity, high cholesterol and alcohol and drug use.
Essentially, it seems that most of our problems stem from poor lifestyle choices such as diets rich in fat, sugar and salt; tobacco, alcohol and drug usage; and a sedentary lifestyle.
In response, the public sector has continually pushed for more publc health awareness initiatives in order curb these associated diseases and its related costs to medical spending.
In particular, its national community health empowerment programme (KOSPEN) is expected to see a further RM30 million budget allocation this year in order to help it achieve its goals.
Screening programs such as those for cancer can help catch the illness early and reduce the need for expensive and costly treatments for later stages.
For example, vaccines and screening programs for cervical cancer can easily reduce the amount of cases of cervical cancer drastically by 75 per cent – allowing hospitals to utilise the funds that would have been sued to treat cervical cancer to be placed in other areas such as research or facility improvement.