Friday 29 Mar 2024
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KUALA LUMPUR (Dec 15): Malaysia must strengthen the public healthcare sector’s ability to continue providing health protection to the population through committing to public financing for the public healthcare system, implementing a comprehensive electronic health record system, and integrating health dimensions in all social policies, according to Khazanah Research Institute (KRI).

There is a need for health protection as part of a comprehensive social protection system as every individual faces potential unexpected loss of health such as illness, disability or death, according to KRI’s latest publication titled “Health and Social Protection: Continuing Universal Health Coverage” released on Wednesday (Dec 15). 

In 2019, on average, each person in Malaysia lost 2.8 months of the year to ill health, it noted. 

KRI said this loss of health could result in economic vulnerabilities for both individuals and their households due to high medical spending and/or loss of ability to earn income, leading to income insecurity.

“Through the public healthcare sector which is highly subsidised for Malaysians, we have been able to provide universal health coverage for the population, producing significant improvements in health outcomes, such as higher life expectancies and low child and maternal mortality rates. However, the chronic underinvestment in the public healthcare sector has left the overall healthcare system vulnerable and thus leaving the Malaysian population vulnerable,” it added.

KRI said the public healthcare delivery sector was under strain even before Covid-19 arrived in Malaysia. 

“For example, in 2019, 70.4% of total hospital admissions were in public hospitals compared to 29.6% in private hospitals. Similarly, 87.2% of total outpatient visits were in public hospitals compared to 12.8% in private hospitals. Thus, although the public healthcare sector may have higher numbers of hospitals beds, doctors and nurses, it also bears a higher burden of patient volumes compared to the private healthcare sector,” it added.

KRI noted that the country is also facing a steady increase in overall healthcare expenditure. Despite the public healthcare sector serving a higher volume of patients, the public sector has barely outspent the private sector, with its share of total health spending standing at 52.5% in 2019.

“Although total health expenditure has been increasing, it has been relatively low given our economic growth,” it said. 

In addition, KRI also touched on the insufficient investment in preventive health services compared to curative care services. 

“In 2019, only 6.8% of total health expenditure in Malaysia was spent on public health services including health promotion and prevention. Although historically, this has served Malaysia well in improving health outcomes, disease patterns have significantly changed as of late, with preventable non-communicable diseases making up 73.6% of total health loss in 2019. Public health interventions in Malaysia have also focused mainly on individual-level interventions, which failed to tackle health inequities between socio-economic groups,” it explained. 

Increase resilience of healthcare system with three proposed policy aspirations

Malaysia needs to increase the resilience of the health system to protect the population from health challenges, KRI said.

KRI proposed three policy aspirations and one of them is continued commitment to public funding for public health.

“Despite the government’s repeated claims that the current level of government spending on healthcare delivery is too high, there is room for increased government spending on health. Tax-based financing should remain as the dominant form of health financing to ensure the provision of universal health coverage through the public healthcare sector,” it said. 

The country also needs to focus on the implementation of a comprehensive national electric health record (EHR). 

“The government has already committed to realising an EHR system under the 12th Malaysia Plan, thus we recommend that this EHR system should be leveraged to facilitate person-centred continuity of care, promote preventive care services and create a comprehensive database on Malaysia’s public health,” KRI explained. 

Furthermore, KRI said it is important to integrate a health dimension in all social policies to address social determinants of health. 

“This will allow us to address the causes of disease in Malaysia. For example, obesity prevention requires approaches that ensure a built environment which facilitates easy uptake of healthier food options and participation in physical activity, and a living and work environment which positively reinforces healthy living and empowers all individuals to make healthy choices,” it added.

Edited ByJoyce Goh
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