"The thing that happens to us isn't something out of the blue typically. The thing that happens is often quite boring, and it's just been gradually building while we watched it occur without the ability to act," said Dr. Stefan Hajkowicz, an author who specialises in the exploration of future trends, risks and scenarios in order to help the public, organisations and government plan better and make wiser choices.

"It is the translation from knowledge into action that is the bit we don't seem to get," the Commonwealth Scientific and Industrial Research Organisation (CSIRO) senior principal scientist on strategy and foresight added.

Key issues of future healthcare trends

Based on statistics from the United Nations, by 2030, 14.4% of Malaysia's population will be aged 60 and above and in 2035, Malaysia will be an aged population.

"The globe as a whole has a more aged profile. The median age is moving up for people," says Dr. Hajkowicz, "The rise in chronic illnesses, along with the ageing population, is what will push healthcare expenditure way up."

Taking countries with advanced economies such as US and Singapore, healthcare expenditure is rising more quickly than income growth in the economy generally and with unsustainable growth in healthcare costs, we are creating healthcare costs we can't afford, Dr. Hajkowicz explains.

The rise in chronic illnesses can be contributed to diet and lifestyle choices, including dietary issues such as the rapid increase in fast food and sugar consumption that is prominent in the US - which is slowly replicated in Asian countries.

"If you look at childhood obesity, it is continuing to rise at sharp rates right across the globe," he added.

Data on type 2 diabetes and cardiovascular diseases points towards a worrying increase amongst the population and the consequences of ignoring the problem are dangerous, due to an increase in the ageing population and higher costs on the healthcare system.

Apart from that, the recent megatrend of antimicrobial resistance has been a global wake-up call, leading to all UN member nations signing a declaration at the recent UN General Assembly in New York last month, to combat the proliferation of drug-resistant bacteria.

"It is a massive risk facing the human population, which is at the early stages," Dr. Hajkowicz said, "We need to manage the use of antibiotics and can no longer use antibiotics to the extent we currently do in the human population and livestock production."

But can Malaysia afford to tackle these problems financially?

Urging the government to take preventive measures

Malaysia is about to announce next year's budget allocations for each sector. Last year, the healthcare industry faced a cut in their budget and has seen the consequences this year. Yet, the budget is reported to focus more on the digital economy next year.

The Health director-general Datuk Dr. Noor Hisham Abdullah has recently reported a progressive rise of patients seeking services in the public health facilities. From January to May, an 8% increase was recorded, compared to the corresponding period of last year.

"This increase accounts for more than three million additional patients visiting the public health clinics. Similarly, nearly 45,000 additional hospital admissions were seen in hospitals from January to June this year as compared to the corresponding period in 2015.

In ensuring that crucial health services were not disrupted, the DG said his ministry evaluated the extent of its financial shortcomings and optimised and reallocated its limited resources to wherever it was needed the most - 'temporarily' suspending clinical laboratory tests and urging the public to reduce medicine wastage. Opposition Members of Parliament have highlighted the problem of these measures.

Sungai Siput MP Michael Jeyakumar stated that a few weeks ago, hospitals were under-equipped to the point that simple blood tests could not be carried out due to this year's cuts in the Health Ministry budget.

"They didn't have the chemicals needed, which I think is a poor show for a country heading for developed status," he added.

Klang MP Charles Santiago also highlighted that as a result of the Goods and Services Tax, the middle class who could previously afford private hospital visits have turned to government hospitals. In addition to the high cost of living, the low salaries of the workforce will cause the chronically ill to suffer if there is no increase in the health budget, he added.

For the treatment and care of cancer patients, MP Santiago has urged for a GST exemption and that 2017 budget allocations for the Defense Ministry and the Prime Minister's Department be decreased so that money could be made available for health and other important areas such as education and social welfare.

MMA: Increase spending on healthcare for the long run

The Malaysian Medical Association also hopes that the Government will increase spending on healthcare to meet the people's pressing needs in view of the long run.

Dr. John Chew, the president of MMA said that the country faced a triple burden of an ageing population, non-communicable diseases (NCDs) and newly emerging infections.

"As a nation, we need to spend more on health, aiming for 5% of gross domestic product (GDP) in the short term and up to 10% of the GDP by 2030," he added. Currently, only 4.3% of Malaysia's GDP is spent on health, of which the public-private share is 55:45.

The disparity between the different economical backgrounds that is attributed to maldistribution of facilities nationwide and uneven infrastructures in urban and rural areas is on the rise, according to Dr. Chew.

Dr. Chew also stressed that spending needs to be increased to meet the needs of the public and also to tackle issues such as high smoking rates, hypertension, obesity, diabetes and mental health.

"There should be higher taxes for cigarettes, sugar and alcohol," he added. MIMS

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