The Galen Centre for Health and Social Policy calls upon the government to make bold reforms and increased investments for three critical actions: financing health and aged care, removal of sugar subsidies, and increasing on-call allowances for doctors and dentists.
It is inadequate and unsustainable to expect or depend on increases in the yearly allocation for health under the government federal budget. It is tax funded.
At the current growth rate, assuming consistent political commitment, it would take at least 10 years to reach the desired 5 per cent of today’s GDP levels.
The question “How do we pay for it?” should rightly be on the minds of decision and policy makers whenever more funding is demanded. Future-proofing our health system must involve answering this question realistically.
Financing Health And Aged Care
We need to not only identify new, additional and sustainable funding for health, but also ensure that aged care will be properly supported.
A compulsory National Health and Social Insurance (NHSI) is needed to provide complementary funding to support both health and aged care.
Adopting a rate similar to SOCSO contributions (1.75 per cent of employer’s share and 0.5 per cent from employees), we can raise at least RM 6 billion annually to complement the annual health allocation under the Federal Budget. It will complement the existing annual budgetary allocation and not replace it.
It could provide a means to improve treatment and care options, expand human resource options (recruitment, retention, better pay), and a critical resource during times of crisis.
With more of the population becoming older and needing specialised services, a portion of the funds collected from NHSI could ensure that aged care is properly funded and sustained.
More than 11 per cent of Malaysia’s population is already above the age of 60. Simply hoping or assuming that families and private services will bear the burden and costs of aged care, will mean that many older people will be deprived of appropriate support, especially long-term care.”
The government should also remove the RM1 and RM5 charges for outpatient and specialist care respectively at Ministry of Health (MOH) facilities.
People should not need to pay anything at the point of accessing care. These charges also keep alive the fiction that the cost of healthcare in Malaysia is cheaper in government facilities and mislead the public.
Removal Of Sugar Subsidies
The government should remove all sugar subsidies and remove sugar from the schedule of controlled items under the Price Control and Anti-Profiteering Act 2011. These cost the taxpayer at least RM 500 million annually. Subsidising sugar is not necessary for living.
Sugar subsidies were supposed to have been abolished more than 10 years ago. However, due to the price of sugar continuing to be controlled rather than determined by the market, the government was forced to provide payments to sugar manufacturers from November 2023 as incentives or subsidies. The price of sugar should be floated and those subsidies used for other health priorities.
These subsidies funded by taxpayers amount to RM1.00 per kilogram of sugar for raw sugar and refined sugar which translates to around RM42 million monthly, and between RM500 million to RM600 million yearly.
RM 500 million in annual sugar subsidies wipe out any current and potential revenue gained from the increase in sugar-sweetened beverages (SSBs) taxes, which are around RM300 million. They also undermine the MOH’s “War on Sugar”.
Artificially cheap sugar is driving higher sugar uptake. The direct consequence of cheap sugar is the continued and uncontrolled spread of diabetes in this country, causing other non-communicable diseases such as chronic kidney disease and cardiovascular disease, which bring about premature death.
It is costing billions in funds, and thousands of lives each year.
Increase On-Call Allowances For Medical Officers, Dentists, And Specialists
By spending an additional RM 80 million annually, an increase of RM55 to RM65 per shift for medical or dental officers and specialist medical/ dental officers would help fulfil a key government’s promise to healthcare workers.
Medical or dental officers and specialist medical or dental officers are currently paid on-call allowance (ETAP) for 24-hour weekend shifts of RM220 and RM250 respectively. On weekdays, the rate is set at RM200 and RM230 per shift respectively.
Doctors’ groups believe that the existing RM220 weekend on-call claims rate to RM9.16 per hour for a 24-hour shift are unfair and exploitative. These are less than the hourly rate paid to restaurant workers and coffee baristas at retail shops.
This rate is contributing to reasons for the increasing dissatisfaction, frustration, and exodus of skilled health care workers from public health care. Our health care workers deserve better.
Azrul Mohd Khalib is the chief executive of the Galen Centre for Health and Social Policy.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
