Malaysia is "seriously considering" introducing a national government-run healthcare insurance scheme to compensate for weaknesses in the country's private healthcare system, according to New Straits Times.
Implications | Out-of-pocket (OOP) healthcare spending in Malaysia accounts for approximately one-third of the country's total annual healthcare spending – a level that the World Health Organization (WHO) has recommended reducing by 15–20%. |
Outlook | Although still in the planning stages, Malaysia's voluntary public healthcare scheme is expected to enlist private healthcare resources, given an overstretched public health sector – a situation that has itself led to high OOP spending on private healthcare. |
According to the source, Malaysian health minister Datuk Seri Dr S. Subramaniam is considering the establishment of a voluntary public scheme to provide an alternative to the current private system, which is used by more than half of the country's population.
However, few details were released, with Subramaniam quoted as stating that plans were still at an early stage, and that the shape of the scheme would evolve over time, adding that "there will be no private player and no profit motive… once we are confident, we will offer it to the public". Nonetheless, Subramaniam added that the introduction of a public health-insurance programme did not mean that the government planned to put an end to the current public healthcare-delivery system.
Malaysia's health ministry conceived the idea of a national public health-insurance scheme in response to its concerns over the risk of catastrophic healthcare spending, according to the source.
Currently, approximately half of Malaysians seek treatment at private healthcare institutions. Earlier this month, Subramaniam said that more than one-third of Malaysians are paying healthcare costs out of pocket (OOP) despite universal healthcare, which could lead to catastrophic healthcare spending. According to a report in MalayMail Online, OOP healthcare spending made up approximately 35% of Malaysia's overall health spending of MYR44–45 billion (USD10.8 billion–11 billion) every year; this compares with the World Health Organization (WHO)'s recommendation that the country's expenditure be reduced by 15–20%, according to the source.
Outlook and implications
Although the idea of a voluntary public health-insurance scheme is still in its infancy, there are indications that the ministry of health would seek the involvement of the private sector, given the over-stretched state of public healthcare resources (see Malaysia: 5 June 2015: Malaysia's out-of-pocket healthcare spending rises 11.9% annually due to public healthcare shortages). Overcrowding at Malaysia's public healthcare institutions has in fact led to the high OOP healthcare spending, as many patients prefer to opt for faster access to treatment by seeking private services.
The proposed public health-insurance scheme will potentially provide a welcome buffer between patients and high OOP healthcare spending, particularly given the expected wider eligibility criteria compared with private health insurance, which tends to operate with selective criteria and adds to patients' financial burden.
The proposal is especially timely given the relatively high cost of pharmaceuticals in Malaysia – particularly after the introduction of the Goods and Services Tax (GST), the lack of a formal drug-price control system, and stalled negotiations over the proposed Pharmacy Bill. However, it remains to be seen whether the plans for the new public health-insurance scheme will meet resistance within the government, considering its aim to cut healthcare spending due to the economic climate (see Malaysia: 14 January 2016: Malaysia's health ministry to cut spending by 10% in FY2016 due to economic climate).