Parti Sosialis Malaysia (PSM) Petaling Jaya vehemently opposes the recent statement by Bukit Gasing state assemblyman Rajiv Rishyakaran, whose support for the public health care reforms dangerously flirts with the logic of privatisation.
While we welcome Rajiv’s political ideology as being anchored in the centre left; however, his argument, in favour of introducing market-driven ‘solutions’, contradicts that political stance.
Echoing neoliberal narratives, camouflaged under polished terms like ‘premium services’, ‘value-based care’, and ‘co-pay models’, only serves to erode the very foundation of a universal public health care system. These arguments do not address the root cause of the crisis in health care, which is chronic underfunding by the state.
This creates a narrative of helplessness, as if the only path to reviving the deteriorating public health care system is to gradually arrive, if not dive right into, privatisation. This is untrue, deceiving and manipulative.
Warnings and repercussions raised over the years of not attending to the chronically ill-funded public health care have not fallen on the right ears. As a result, overworked staff have resigned or migrated to local private hospitals or taken up international opportunities, hence widening the gap between the number of health care workers and the patients.
Amidst the backdrop of an ageing society, a growing population, and an existing landscape with numerous private hospitals, how will the Malaysian Madani government and future administrations address the risk of a looming health care collapse without resorting to a neoliberal approach?
It is estimated that by 2030, Malaysia will require 114,187 doctors to serve a projected population of 38 million. Are we on the right track?
Those who once stood on the frontline against privatisation efforts when power was beyond their reach have now convinced themselves to drive the privatisation agenda. What our system suffers from is years of neglect and political disinterest. There are several points of disagreement we would like to assert.
Public Services Must Be Protected From Market Logic
Health care is not a business. Like education, public safety, and basic infrastructure, it is a social right, not a commercial service.
Applying business principles to health care such as profitability, customer segmentation, and service tiers will inevitably exclude the very people the system was built to serve: the poor, the elderly, the disabled, and the working class. Universal access is what we are proposing.
The introduction of ‘premium economy’ or ‘fee-for-service’ care in public hospitals sets a dangerous precedent. It legitimises a two-tier system where access to quality health care depends on income level.
Those who cannot afford treatment are delayed for a timely intervention. This is not reform. It is abandonment and punishment.
Privatisation Won’t Fix Burned Out Health Care Workers
Another major fallacy in this push towards privatisation is the claim that it would alleviate the burden on overworked health care professionals. Can it be true?
There is no clear mechanism that shows how fee-paying systems or insurance models would reduce burnout or improve staffing. If anything, such models encourage patient discrimination based on payment capacity, and fail to address the root issue: inadequate staffing, under-resourced facilities, and insufficient government funding.
There are two additional concerns that have germinated as a result of the implementation of a monetary-oriented mechanism.
Firstly, PSM chairman Dr Jeyakumar has argued that the Full Paying Patient (FPP) scheme created a conflict of interest by allowing senior government doctors and specialists to treat private patients in public hospitals for higher fees (private sector rates).
While some specialists used the scheme moderately, others prioritised private patients, earning double their salaries and neglecting public duties. This undermined morale among colleagues, strained public services, and hindered the training of junior doctors.
Public hospitals, which are responsible for the majority of inpatient care, are currently experiencing staff shortages, extended waiting periods, misdiagnoses, and increased pressure on their less experienced physicians.
The reason for this is that private institutions now employ 75 per cent of specialists with 10 years of post-specialisation experience. Consequently, a mere 25 per cent of the senior specialists in public health care are responsible for the care of 75 per cent of the patients.
The labour force’s participation in public health care system is the second fundamental concern. In an article published on CodeBlue, a senior consultant surgeon expressed the likelihood that the overworked specialists and younger physicians would hesitate to participate in schemes such as Rakan KKM, which necessitates additional working hours in exchange for additional compensation.
The disparity between wage and labour is further reflected in this structure. In addition to burnout, what are the collateral consequences for these professionals if they opt to participate? Compromise of well-being, lack of social life, and family life?
Do Not Touch The EPF
The proposal to allow deductions from Account 2 of the Employees Provident Fund (EPF) to pay for medical insurance is utterly reckless. It is presented as a universal remedy, but in reality, it is a financial burden disguised as empowerment.
What’s alarming is that proponents of such mechanisms, including the state assemblyman, appear to be indifferent to the fact that a large segment of the population lacks the financial means to secure a safe, stable, and dignified retirement.
Research by Khazanah Research Institute (KRI) has confirmed that over 90 per cent of EPF members aged 30 and below do not have sufficient savings to retire by age 55 since the pandemic.
The same study reveals even more troubling statistics: 52 per cent of members under 55 have less than RM10,000 in their accounts, and 25 per cent have less than RM1,000.
This dire situation is largely driven by suppressed wages that fail to keep pace with the cost of living. In times of crisis, families in such vulnerable financial positions are pushed into further instability.
EPF is meant to safeguard people’s retirement, not subsidise an inefficient or underfunded health care system. For a rapidly ageing population, this move could prove devastating.
Once again, the cost is quietly being passed to the rakyat while the government absolves itself of responsibility.
What’s Missing: The Political Will To Tax The Rich
Amid all the talk of co-payments, insurance schemes, and public-private collaboration, one solution remains curiously absent: progressive taxation of the ultra-rich.
Malaysia is not a poor country. The problem is not a lack of resources, but it is the lack of political courage to tax accumulated wealth and the ultra-rich.
A central-left representative should be the first to champion tax justice and wealth redistribution. Yet, instead of advocating for such structural change, we are presented with neoliberal policies that favour the market over the people.
We must be clear: a just, universal, and effective public health care system can and must be funded directly from the country’s GDP, not from the overworked hands and shrinking pockets of ordinary Malaysians.
Privatising health care, either openly or covertly is a betrayal of the public’s trust. It deepens inequality, undermines public institutions, and abandons dignity and care for all, regardless of income.
We call on all Malaysians to firmly reject this quiet transition toward a market-based health care system. We demand that the government increase public health expenditure, staff hospitals adequately, and make the rich pay their fair share.
The public health care system is not a playground to test out privatisation efforts, at the expense of the many for the benefits of the few.
Barathi Selvam is a member of Parti Sosialis Malaysia (PSM) Petaling Jaya.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
