Cure Is An Absolute, But Prevention Is The Ideal – Vasanthi Ramachandran

This is the right time for health care reform to fix what is broken and build on what works.

Preventive health care is not a magic bullet that is the responsibility of the Health Ministry alone. The paradigm shift from a ‘sick’ to a ‘sick free’ society needs all stakeholders to be persuasive advocates to elevate Malaysia’s status to a healthy nation. 

For decades, health care support was about curing an ailing society and not about effectively keeping people out of hospitals. This is the right time for health care reform to fix what is broken and build on what works. 

The health of a nation is measured through three key components — mental and physical health, health infrastructure and the availability of preventative care.

The management costs of cancer, cardiovascular disease, and diabetes exceeds RM9.65 billion yearly. Some of these disease can be prevented with successful intervention in early detection, as well as with investments in prevention and wellness programmes.

The ‘institutionalisation’ in health care reform is an ongoing process, where programmes and policies become an ongoing routine. It will only become sustainable with the  coordination and cooperation of all stakeholders, and with integration prevention modules in long term policies. 

“The White Paper on Health will be an exercise for our own existential reform with a fundamental shift from a curative model to a preventive one. We will focus on public health surveillance, policy development, research,  regulation, monitoring, and evaluation,” said Health Minister Khairy Jamaluddin at the recent Health Policy Summit 2022. 

Better integration between the public and private health care sectors would reduce pressure on public facilities to seamlessly endorse prevention  whether in the public, private, or non-profit sector.

It is indeed going to be a long road when you consider that even hospitals have fast food outlets as cheaper and easier options, indicating what fuels a ballooning epidemic of obesity, diabetes, and various other health issues.

According to the National Health and Morbidity Survey (2019), one in two Malaysian adults are overweight or obese, three in 10 adults have hypertension, while in four in 10 adults have  elevated cholesterol levels. 

In 2020. the World Health Organization (WHO) reported that coronary heart deaths in Malaysia reached 36,729 or 21.86 per cent of total deaths. Heart diseases kill about 17.9 million people in the world annually, and Malaysia ranks 61st

For starters, food quality regulators, advertisers, and schools should be mindful of the pervasive marketing schemes of school sport events that are sponsored by companies that manufacture junk food, fizzy drinks, and sweets. 

Exercise as a medicine or as therapy has been prescribed both in mental and chronic diseases. 

Town planners should designate parks for children within every housing estate. The present trend of cutting down trees to approve high rise condominiums should be monitored.

In place, there ought be well-designed and equipped playgrounds, football fields, and safe cycling lanes. Such facilities should be attractive enough to draw children away from their smartphones. 

Schools should delegate more hours for sports and physical activities to diffuse the stressful environment of examinations and grades. 

Essentially, it will be the efforts of the Ministries of Sports, Education, and Housing and Development, and the institutionalisation of all agencies to push the prevention agenda. 

For workers, there should be schemes to appraise the health risk through the Employment Provident Fund, social security, and the Employment Insurance System.  

Getting an annual health check-up is the most reliable test of our health. 

“The Health Ministry will screen about 1.5 million people who had never undergone health screening, including tests for colorectal cancer and breast cancer at public and private clinics,” said Khairy.

The National Health Service in the United Kingdom offers free testing once every five years for the 40 to 74 age group without a pre-existing condition, and a discussion with a health care professional. Health risk assessments can help people get care they need before problems escalate. 

A hallmark of Malaysia’s health care system should be subsidised and affordable check-ups for preventable ailments for the poor. No one should be denied a medical test or examination that can prevent or detect disease at an early stage. 

As it is, our limited national expenditure on health infrastructure means that many cannot receive intensive care in public hospitals, unless they can afford exorbitant private hospital fees.

This will also have a tremendous impact on congested hospital services to be freed up to focus on complex curative cases. 

 It is more effective to have a preventive model than injecting money to maintain curing the sick. The curative model is becoming increasingly expensive for the majority of the population. It is not financially viable, and is never-ending. 

“I want to increase the annual budgetary allocation for public health care to 5 per cent of gross domestic product (GDP) over the next few years. And that increase must be ring-fenced in every subsequent budget,” Khairy affirmed. 

However, health care allocation as a percentage of GDP has not moved much over the last decade. In 2011, the health care allocation, which comprised both development and operating expenditures, worked out to 2.4 per cent of GDP.

By 2022, health care made up only 2.59 per cent of GDP.

The White Paper on Healthcare Reform will be tabled in November, covering wide-ranging proposed changes to health care financing, among other issues, spanning a 15-year period. It is recommended that a Health Reform Commission supervises the reform.

“The government is considering gradually increasing the health care budget up to targeted levels over a number of years while working out funding structures to make the system more sustainable and progressive.,” said Khairy.

Khairy advocated using science, data, and technology to identify and intervene proactively and help people sustain their health and wellbeing.

“Part of this work requires the sharing of patient records across facilities and providers, and initiatives to pilot and scale up electronic medical records will be critical,” he explained.

Finally, it is about the people. We cannot reimagine a world of good health unless we play a major role in the prevention process.  

As consumers, it is important for us to get to know the different types of products that are available in the market, whatever the marketing might tell us. Market logic cannot be all legitimate when profit is the bottom line. 

A simple measure for us is to read labels on how much fat, salt, or sugar each food product contains, and how do we process this information. 

Most importantly, getting an annual health check-up for everyone above 40 is the most reliable test of our health.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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