Budget 2022: MOH’s Allocation Should Form 5% Of GDP

Medical groups call for digitisation in health care, ring-fenced tax revenue for NCDs, tax incentives for GPs, effective tobacco harm reduction, and ageing care post-Covid.

KUALA LUMPUR, Oct 25 — The Malaysian Medical Association (MMA) has called on the government to allocate 5 per cent of the country’s gross domestic product (GDP) to the Ministry of Health (MOH) in Budget 2022.

MMA president Dr Koh Kar Chai said that the previous budget allocation for MOH is insufficient, especially when inflation is on the rise.

“Since 2006, the country’s health care budget has been below 4 per cent of our GDP. Currently, the health care budget is between 3.9 per cent to 4.1 per cent of GDP. Close to 50 per cent of that is from the private sector,” Dr Koh told CodeBlue.

“The government only spends approximately 2.2 per cent of GDP, therefore we are way below the health care budget recommended for a robust health care system.”

Dr Koh noted that advanced medical technology, an ageing population, disease burden, and increasing health care demands and costs in Malaysia are likely to outpace the national inflation rate.

“A minimum five per cent of GDP in health care spending is among several criteria that needs to be met towards achieving universal health coverage by year 2030.”

Dr Koh expressed his hope that the 2022 health care budget will reflect MOH’s commitment towards urgently needed reformation of the health care system.

Recently, Finance Minister Tengku Zafrul Aziz announced that Malaysia’s health spending is expected to reach 5 per cent of the GDP this year — comprising both public and private spending.

It is to be noted that Malaysia has been battling with the coronavirus pandemic for almost two years and is slowly transitioning into a Covid-19 endemic phase. During this pandemic, health care resources were extremely stretched and left many non-Covid patients, including cancer patients, without needed treatments.

Dr Koh highlighted the need to craft short- and long-term investments in human resources, as well infrastructure in the health care industry in Malaysia.

“Health care workers and the system had been stretched like we never imagined over the past two years largely due to insufficient manpower and resources. We hope to see meaningful allocations set aside to address these shortages in public health care.”

He said that the government should also focus on the digitisation process in healthcare.

“The use of artificial intelligence, Internet of Things, and electrical medical records systems will increase efficiency at public health care facilities, especially in the non-health care areas of work such as administrative duties which are time-consuming. With these conveniences, more time can be spent on improving patient care.”

Ring-Fence Tobacco, Alcohol, Sugar Taxes For NCDs

Sodas and soft drinks at a supermarket. By Marlith. https://creativecommons.org/licenses/by-sa/3.0/deed.en

At the same time, MMA supported the government’s initiative to impose heavier taxes for tobacco, alcohol and sugar, as Dr Koh mentioned that the tax revenue can be diverted to treat non-communicable diseases (NCDs).

“Manufacturers of soft drink beverages who reduce sugar in their drinks can also be incentivised.

“The public should also be incentivised for maintaining a healthy lifestyle. Tax incentives could be given to those who spend on health products, register or renew membership with a gym. Gymnasiums in return could be given incentives for promoting a healthy lifestyle.”

Furthermore, MMA noted the significance of the Peka B40 programme for low-income earners that was introduced by the Pakatan Harapan government in 2019.

“More households are expected to drop to the B40 group from the economic impact of the pandemic, hence the budget for this initiative should be increased. We also look forward to further enhancement of this programme.”

Boost Public-Private Partnership With GPs

Patients wait at a GP clinic in Kuala Lumpur in February 2020. Picture by Saw Siow Feng.

Dr Koh highlighted the inevitable role of private general practitioners (GP) in the health care industry throughout the early phases of the Covid-19 pandemic until now.

So he proposed that the government boost public-private partnership by working together with private GPs to handle NCD patients and to provide tax incentives to private physicians.

MMA further called for the RM1 encounter fee at public health care facilities to be increased to at least RM5 to assist the growing health care expenditure burden carried by the government.

“MMA had proposed that the encounter fee at public hospitals be increased by at least RM5. Those in the B40 group who find it a burden may have the fees subsidised or waived by the government.

“The government should also look into the formation of a health care commission, which is independent, towards health care reforms that are much needed. This will require legislative and regulatory frameworks.”

More Rural Health Care, Alternatives To Cigarettes

Dr Hew Kin Sun (right) examines a boy at the Orang Asli Medical Post’s first clinic at Kampung Dayok in Pos Lenjang, Kuala Lipis, Pahang, on September 29 2019. Picture by Boo Su-Lyn.

The Federation of Private Medical Practitioners Associations Malaysia (FPMPAM) highlighted three key aspects — building the resilience of the public health system, a focus on rural areas, as well as NCD and tobacco harm reduction strategies — to be incorporated in the upcoming health budget.

“The federal government needs to strengthen human capital in the public health care system by opening up more vacancies and incentivising public health care workers to remain in the system,” FPMPAM president Dr Steven Chow told CodeBlue.

“FPMPAM urges governments to build on the partnerships forged between the public and private sector health providers during the pandemic.”

Dr Chow said that MOH should work to deploy more mobile clinics to rural areas and educate these communities, particularly on vaccines.

“The government should provide administrative and logistic incentives for relevant medical NGOs for medical outreach to remote communities in keeping with the national goal of leaving no one behind as the nation recovers from the economic fallout of the pandemic.”

FPMPAM also suggested the government focus on effective tobacco harm reduction strategies, saying the decades-old practice of promoting abstinence failed to reduce tobacco consumption in the country.

“MOH, in particular, must start incorporating evidence-based tobacco harm reduction approaches as part of efforts to get smokers to kick the habit and opt for better alternatives to traditional cigarettes.”

Ageing Care In Post-Covid Era

Residents at an Agecare Sdn Bhd nursing home in Cheras, Selangor, for the elderly. Picture courtesy of Agecare.

The past president of the Malaysian Healthy Ageing Society (MHAS), Dr Wong Teck Wee, in his wishlist for Budget 2022, asked the government not to forget post Covid-19 care for elderly people.

He said that elderly people in an ageing society suffered the most during Covid-19, noting that the nation’s health care system was not ready to encounter a pandemic.

“There are many people who lost their jobs and income. This has directly or indirectly impacted the elderly,” Dr Wong told CodeBlue.

“The government should focus on their basic needs, especially health care needs during the post-Covid era.”

Dr Wong mentioned that the implementation of policies or programmes should be as effective as they have been announced, as he cited “gaps” in the budget allocation and its implementation particularly for the elderly population.

“We need a dedicated ministry of department focusing primarily on aging care needs like other countries. When a policy is announced, it is not always being implemented well as it has been stated.

“The process should not be cumbersome for stakeholders like us.”

Apart from highlighting the need to regulate unregistered nursing homes, Dr Wong said the government should also focus on creating quality public nursing homes for the elderly in Malaysia, as private centres may be unaffordable for the low-income and middle class.

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