Budget Must Focus On 5 Key Health Areas Says Think Tank

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Budget 2023 must aim for sustainability and resilience in healthcare, says the Galen Centre for Health and Social Policy. (Bernama pic)PETALING JAYA: The government has some “tough decisions” to make on Budget 2023 as it pushes for sustainability and resilience in healthcare, says a health think tank.
The Galen Centre for Health and Social Policy called for increases in commitment and investments in five key areas: healthcare financing; non-communicable diseases; public health emergency preparedness and response; reproductive health; and aged care.
“For too long, conversations concerning healthcare have been dependent on, and hampered and restricted by, issues of affordability, rather than centred around meeting the current needs and ongoing challenges of a growing population and economy of a country making the transition from an upper middle-income to high-income economy,” the centre’s CEO, Azrul Mohd Khalib, said in a statement.
“Decisions are often based on what we can afford rather than finding out what we need, how much money is available, and finding solutions to bridge those funding gaps.
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Azrul Mohd Khalib.“This is also not just about having more funding, but also how that money is spent. We need to change the way we look at health. Investment, not expenditure.”
Azrul also called on the government to remove the RM1 and RM5 charges for outpatient and specialist care in health ministry facilities as he said they sustain the misrepresentation that healthcare in Malaysia is cheaper in government facilities.
He said such fees are also inadequate for meaningful cost recovery, and mislead the public regarding the true cost of healthcare.
“We believe that these charges act as a barrier, and should be removed to facilitate future reforms in healthcare financing,” he said.
Highlighting a recent report by the World Health Organization and the health ministry which showed that the country spends RM4.38 billion to treat diabetes annually, Azrul also proposed reducing subsidisation for diabetic treatment and introducing co-payments of up to 30% of actual cost.
“It will also help reduce wastage of subsidised medication,” he said, adding that there are almost four million people living with diabetes in Malaysia.
He also called for increased capacity at the health ministry’s disease control division to prevent, detect and manage future epidemics.
“That means investing in training more epidemiologists, public health specialists, infectious disease experts, and increasing diagnostic laboratory capacity,” he said.
This was especially crucial as the Covid-19 pandemic has demonstrated the value and merit of investing in public health systems which are effectively able to respond to emerging diseases and outbreaks.
Azrul also said the government needs to make aged and long-term care a priority to be addressed in Budget 2023, adding that Malaysia is “ill-prepared” to deal with the needs and consequences of a growing aging population.
He pointed out that aged and long-term care facilities and relevant essential services remain limited, are mostly confined to urban centres, and run by private providers.
He said there is a lack of clarity about which ministry should be responsible, and there is also an unsustainable dependence on informal care.
“As a result, this issue has suffered tremendous decline resulting in many older individuals vulnerable to neglect, substandard care, and even abuse,” he said.
He noted that it may be necessary to introduce a national insurance scheme for those above the age of 40 specifically to fund aged and long-term care, rather than depending on unfunded and unsustainable entitlements.
“Ad hoc approaches will not be sufficient or sustainable,” he said.
He also said Budget 2023 should have an increased allocation to strengthen essential reproductive health services in the health ministry and National Population and Family Development Board (LPPKN), which includes providing contraceptives for both married and unmarried individuals.
The government allocated RM32.4 billion to the health ministry last year, the second largest allocation in Budget 2022 after that for the education ministry, which received RM52.6 billion.
Budget 2023 will be tabled on Oct 7, three weeks earlier than initially scheduled. - FMT

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