From Medical Tribune
Excerpted from the opening address by Dato’ Sri Liow Tiong Lai, the then Health Minister of
Malaysia, at the Healthcare in Asia 2013 Summit, Kuala Lumpur, 21 March.
The Ministry of Health considers health a basic human right. The WHO Constitution of 1946, which is adhered to by physicians in the Ministry of Health, states that health is a major resource; it is critical to the success of the nation’s socioeconomic [wellbeing] and sustenance. Health and healthcare are viewed as investments and not as costs in this country. With this in mind, we have put in a lot of investment in healthcare.
It is now well recognized that knowledge development can lead to better access to health services and, therefore, improving the health of the population contributes directly to increased productivity and earnings of the country.Malaysia’s socioeconomic development policies have made equitable access to the health services a key concern, especially for the rural population and the poor.
Having a comprehensive health system is important to Malaysia; a social right and to eliminate the health risks to the poor and increase survival. At the same time, ground
works have addressed the key health factors and contributed to improved health status –
they include education, affordable housing, sanitation and clean water supply. Thus, the
success of Malaysian healthcare system did not occur by chance, but through careful and
systematic planning by the government.
The government designs the country’s development through long-term planning programs such as Vision 2020. The MOH has built a lot of infrastructure as well as increased human resource in providing a wide network of primary healthcare facilities throughout the country.
Malaysia healthcare system is very extensive. We have an extensive primary healthcare network supported by a referral system, and secondary and tertiary care provided by hospitals. The public healthcare system is supplemented by a growing, largely urban-based private healthcare sector that serves mainly those with the means to pay. With this dual system, Malaysia has been relatively successful in providing equitable and efficient healthcare for the rakyat. This is evident through our improving health status, which is comparable to countries of a similar level of development.
While spending 4.4 percent of GDP [gross domestic product] on health, Malaysia has
achieved a universal health solution for the whole population. We have done well in improving access to healthcare for both urban and rural populations. About 90 percent of the population now lives within a 5-km radius of a static health facility. They can access the highly subsidized healthcare services in the public sector with a nominal fee
Since 2005, MOH has established a medical assistance fund to finance the cost of medical prostheses and medicines not already covered by MOH services for those who cannot afford. As a result, Malaysia’s healthcare system is acknowledged internationally as a successful and modern health system that provides effective, efficient and equitable health services.
Health services modify the economy – they are also an effective means of reviving the most vulnerable and poor population who suffer from more ill health. In Malaysia, inpatient and outpatient services funded through general government revenue are highly subsidized. Patients are charged only US$0.30 for primary care treatment and US$1.60 for specialist outpatient care. Moreover, services at rural health centers are free. Charges for inpatient care are capped at about US$160 per admission for all kinds of treatment when admitted to the
third class ward in public hospitals.
In 2012, upon understanding the economic burden of ill health, the government abolished fees at primary care and reduced specialist fees as well as third class ward charges for those aged 60 and above.
The prime minister has identified healthcare as a priority sector, viewing it as a net contributor to society. The government has designed an Economic Transformation Programme to achieve high income status by 2020. This is by leveraging the private sector and opening up to foreign investment.
Relying on the private sector alone is not enough. The free market cannot provide equity of access. Sustaining a dual public-private system would be the priority, and challenge, of future governments.
The major focus in coming years would be the burden of non-communicable diseases. Currently, the diabetes population in Malaysia stands at 2.6 million, those with hypertension number 5.8 million, high cholesterol level, 6.2 million, and the obese, 2.5 million. These diseases will remain a focus of government spending.
With per capita income levels having increased 49 percent in 3 years, demands on the government in terms of healthcare provision will soar. The government will have to meet this demand by delivering increased access to care as well as better equipment and hospitals.