The Ministry of Health (MOH) is currently working to optimise the current healthcare delivery system and reduce healthcare cost through a module that will promote a better partnership between the private and public healthcare sectors.

This was due to an increase in Malaysia's total health expenditure in the recent years. Health Minister Dr S Subramaniam revealed that health spending per capita in Malaysia increased two and a half times in 17 years, from RM641 in 1997 to RM1,626 in 2014.

Currently the total healthcare expenditure in Malaysia is RM52 billion, with the public health sector accounting for 52% and the private health sector for 48% of the amount.

Private healthcare can cause financial difficulties for citizens

"The amount of money given to the public sector is insufficient but 10% of the annual budget is given to the health ministry, second only to the education ministry," he said, adding that the challenge was to optimise spending.

"Optimising the expertise that both the public and private healthcare system have, would help in ensuring patients receive medical services in primary care," he added.

Subramaniam also raised the issue that 39% of private medical healthcare expenditure was "out of pocket" spending and many citizens who opt for private healthcare risk running into financial difficulty.

"As politicians, we see it every day - letters on the table from people who landed in private hospitals with bills of over RM60,000 but who are unable to pay," he explained, "So 'out of pocket' expenditure is not the best solution."

Private healthcare sector accused of profiteering

This has triggered a widely held notion that the private healthcare is raking in high profits. The Association of Private Hospitals Malaysia (APHM) was quick to denounce that notion. The association's president, Jacob Thomas, said it was wrong to think of private healthcare in the country as a gold mine.

"People think we are here to make pots of money because our charges are higher compared to public hospitals," he said, adding that there was little difference in "actual costs" between public and private healthcare.

"The difference is that public healthcare is heavily subsidised. So an individual may think it's cheap, but it does come at a cost to taxpayers," he explained.

Thomas said that private hospitals were still a necessity in the nation's healthcare system, noting that the country's 230 private hospitals accounted for 30% of the country's healthcare needs.

Malaysia's ageing population needs to be addressed

A possible solution that could be better than private schemes to ease the pressure the public health sector has placed on the private health sector, is a voluntary health insurance scheme the government was considering, , Subramaniam said.

"We have a very resilient private sector which responds to demand and if we create demand, we are confident the private sector will respond by investing in and creating infrastructure and facilities," he said.

He also said that that Malaysia's ageing population is a challenge for the healthcare system in the future as people were living at least a decade longer than they did 40 years ago.

The elderly need more medical care but many lack sufficient savings for their retirement.

"Hospital admission for the elderly is 157 per 1,000 compared with 86 per 1,000 for the general population," Subramaniam said, "This means the elderly are twice as likely to be admitted."

In addition, the elderly are prone to have multiple ailments and are more likely to seek outpatient treatments, posing a big challenge to the government and healthcare system.

"The answer to this is to keep the elderly functional, healthy, and if possible, make them economically active," he said, citing Singapore, which implements a quota for hiring of employees over the age of 60, as an example.

The concept involves the employer paying a sub-amount to the employee, while the other part is supplemented by the government. However, the Malaysian government will need to revamp its welfare programmes first, said Subramaniam. MIMS

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