Govt should consider a new open system to address healthcare inequity and accessibility
by ANIS HAZIM / Pic by MUHD AMIN NAHARUL
THE healthcare sector without a doubt remains one of the most important sectors in Malaysia with the government’s latest allocation of RM36.14 billion for the Health Ministry (MoH), among the highest in Budget 2023.
The higher allocation, compared to RM32.41 billion in Budget 2022, looks promising in the government’s efforts to strengthen the country’s health services. In fact, Malaysia is in need of better accessibility and affordability for its healthcare system in general.
Osel Group medical director and chief clinical and innovative scientist Datuk Seri Dr Kris See viewed healthcare equity and accessibility among the remaining issues plaguing Malaysian healthcare in the past decade.
He said Malaysia recorded yearon-year (YoY) improvements in ensuring every Malaysian is able to receive primary healthcare, from improved accessibility to increased outreach to rural areas, based on MoH’s annual report.
“However, data shows that only 65% of Malaysian citizens are being served by the public healthcare sector, and the lower-income bracket being in much poorer physical and mental health,” Dr See told The Malaysian Reserve (TMR).
Moreover, he noted that medical inflation is also rising in double digits YoY.
“According to Aon’s 2022 Global Medical Trend Rates report, the current medical inflation rate in Malaysia is 12%, which is six times higher than the annual general inflation rate,” he said.
Dr See recommends that the government provides stimulus and, importantly, fosters cooperations across many fields such as through a “public-private-people” approach, which is the best-suited method.
“The government could provide the initial leadership, but it boils down to the private sector and individuals’ willingness and mindsets to bring about change,” he added.
Meanwhile, public health medicine specialist Datuk Dr Zainal Ariffin Omar said both the government and private hospitals in Malaysia are doing well in providing basic quality services.
“We do not have any real problems in terms of accessibility and access. The only difference is in the settings, whereby urban areas have more options and advanced services, but there are crowds and long queues in government facilities, while private centres are imposing higher fees,” Dr Zainal told TMR.
Therefore, he said, people with no extra money or insurance, especially in the lower income groups, can only go to the crowded government hospitals since private hospitals and specialist clinics are expensive.
To address the income inequity in healthcare, he suggested for the government to plan and implement a new open health system.
“The system should allow people to go to either government or private facilities with a universal payment scheme — maybe through a national health insurance scheme or the government could pay to outsource services for some of the patients from government facilities who need faster services,” he added.
Private Hospitals Feel the Pinch
The Willis Towers Watson’s 2023 Medical Trends survey projects healthcare costs around the world to rise next year. Hence, it is no surprise if the doctors, especially in private facilities, are demanding higher fees for their services in order to stay in business.
To allow healthcare industry players to be competitive, Dr See said costs must be managed and adjusted. However, he noted that higher increments will give rise to equity and affordability issues.
On inter-hospital arrangements where patients get transferred from a public hospital to a private one, Dr See believed that this will help to cater to patients’ welfare.
“Public hospitals, as we know, are often overwhelmed with patients and scarce resources, so private hospitals can help to reduce the burden,” he said.
However, some patients have brought up the issue of fees with the inter-hospitals arrangement, where there’s a significant gap.
“I believe communication is key to ironing out any issues, including modalities of payments. This would not be a hindrance towards affecting healthcare equity and accessibility,” he added.
Dr Zainal said the inter-hospitals system is fair as some specific treatments and procedures are not available in government hospitals.
“Usually, the government will pay for that (inter-hospitals system) or patients will pay through their insurance or other means,” he noted.
Additionally, he opined that the current economic slowdown, high inflation rate and high cost of medicines will definitely increase private doctors’ operating costs.
“Naturally, they need to ask for higher fees and we only hope it is reasonable, so as not to burden the patients.”
Public Displeased with Long Wait at Govt Hospitals
Schizophrenia survivor Hanisah Mashkuri shared her experience in public hospitals where she had to bear the long waiting times to get her treatment.
“It always felt like I had to wait forever for my turn through the numbering system, even though I already had an appointment for a follow-up. For example, I came at 8am, but only got to see the doctor at 11am,” Hanisah told TMR.
Moreover, she said it takes over six months to set an appointment at public hospitals.
“That is why I gave up going to public hospitals. I have overcomed schizophrenia, so now I know how to handle anything that triggers my anxiety or depression.”
Public relations executive Sherlyn Kang said she always opted for private hospitals due to the long waiting time at government hospitals.
“Even if I wanted to go for a non-urgent treatment, it will take me maybe three to six months just to get the appointment.”
Kang shared her tooth-extraction experience, whereby the wait for her treatment took more than three months as the government clinic she went to had a shortage of dentists.
Meanwhile, insurance agent Azizah Hassan shared her client’s costly experience of being in a motorbike accident and admitted to a private hospital for treatment.
“This particular private hospital, which was listed in the insurance policy, charged everything inside and out, from charging separately for the cervical collar to the pillowcase, which should be included in the hospital equipment fees. So, to me, I think this is daylight robbery,” she told TMR.
Nonetheless, she admitted to preferring private hospitals over government hospitals, despite having to pay more, due to the quality of health facilities, shorter waiting time and less crowded.
- This article first appeared in The Malaysian Reserve weekly print edition