KUALA LUMPUR, Sept 11 – Prime Minister Anwar Ibrahim’s administration is exploring a new health care financing model, but stopped short of specifying payroll-funded social health insurance.
According to the 12th Malaysia Plan (12MP) mid-term review tabled by the prime minister in the Dewan Rakyat today, the government is looking at revamping health care financing “to increase access to health care services in ensuring that no one is left behind”.
“Higher investments in developing and providing health care services will also be encouraged,” said the mid-term review report.
Bandar Kuching MP Dr Kelvin Yii, who is also Health Minister Dr Zaliha Mustafa’s advisor, told the Sarawak Health Summit 2023 in Kuching last Saturday that the Ministry of Health (MOH) was currently exploring various social health insurance models, such as in Singapore, South Korea, Taiwan, and Thailand.
The mid-term review report also cited the Madani Medical Scheme (SPM) as one of the ways to expand methods of health care financing.
“This Big Leap health care initiative will be able to fill the needs of patients with less affordability to obtain services in private health care facilities, thus reducing congestion in public health care facilities.”
SPM, allocated with RM100 million from the federal government, provides fully subsidised treatment to the low-income for acute conditions at private general practitioner (GP) clinics.
However, doctors’ groups have complained about the low reimbursable limits for consultation, medication, investigations, and therapeutic procedures that they say are way below market rates.
The Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM) said it had objected to the fee structure by ProtectHealth Corporation, which administers SPM, due to concerns that the SPM fee schedule would become a reference for future pricing if the government enacts a national health care financing or social health insurance model.
ProtectHealth recently told SPM panel GPs to “modify the treatment plan” for cost containment if treatment costs exceed patients’ benefit limits – and to subsequently refer patients to the public sector. The company fully owned by the MOH also prohibited co-payments for SPM, or balance billing, in which panel clinics charge patients on top of their benefit limits.
Anwar’s administration also plans to provide public health care facilities the option of renting medical equipment.
“This initiative, which is part of the Big Leap in health care, will be able to handle issues of high costs in procurement, maintenance, and replacement of medical equipment following rapid technological advancement,” said the mid-term review report.
“This new financing option will provide better financial flexibility in procuring the latest medical equipment for people’s benefit.”
Regional Blood Centre In Sabah, Public Health And Food Safety Labs In Kuching, Mental Health Institute, Geratric Centre, Haemodialysis Centres In Felda Areas
Anwar, in his speech when tabling the 12MP mid-term review, announced that a regional blood centre would be constructed in Sabah, as well as a Public Health Laboratory and Food Quality and Safety Laboratory in Kuching, Sarawak.
He added that the government has introduced an RM300 Sumbangan Kesihatan Rahmah (SKR) to Felda settlers aged 65 years and above, besides plans to construct a dozen hemodialysis centres in all Felda areas and Yayasan Felda premises in Kelana Jaya, Selangor.
The government also plans to set up a new Mental Health Institute to combine efforts by the public and private sectors, and civil society, in addressing mental health issues.
It’s unclear how this new Mental Health Institute differs from the National Centre of Excellence for Mental Health (NCEMH) that was launched in Cyberjaya less than a year ago in October 2022.
The public mental health facility under the MOH functions as a centre of control and coordination of mental health services and sharing of information across public and private agencies, as well as non-governmental organisations (NGOs), said then-Health Minister Khairy Jamaluddin.
Anwar said the government will also set up a new Geriatric Centre to provide quality health care services for senior citizens.
“The Private Aged Healthcare Facilities and Services Act 2018 is under review and is expected to be enforced in 2025.”
Despite acknowledging that Malaysia is an ageing nation, with 7 per cent of the population aged 65 years and above, and that the country will reach aged status in two decades, the prime minister did not elaborate on other plans to provide social care in the public sector, beyond just setting up one government facility.
EMR System, Invasive Heart Labs In Public Hospitals, School Dental Services, Upgrades Of 1,200 Dilapidated Clinics and HSA
The 12MP mid-term review document also announced the expansion of electronic medical records (EMR) in public hospitals and clinics across the country.
“An action plan to transfer data in the Malaysian Health Data Warehouse to MyGOVCloud will be developed to enable data sharing across government agencies.”
The government also plans to upgrade the MyCHAMPION registration system to improve content and activities of health volunteers on awareness about non-communicable diseases (NCDs).
According to the mid-term review report, cardiology services will be improved in the public sector, including providing invasive heart laboratories in public hospitals.
Besides that, 250 schools will be assisted to fulfil the criteria of School Dental Clinic Service Community Programme.
Anwar said in his speech that 1,200 dilapidated public health clinics nationwide would be upgraded from this year until 2025.
The government has also estimated RM500 million for the first phase of upgrades for Sultanah Aminah Hospital (HSA) in the Johor state capital of Johor Baru.