At the 10th National Health Seminar organised by the Faculty of Medicine and Health Sciences on September 25, 2025, under the direction of Dr Mohamed Fakhri Abu Baharin, the discussions on ageing and health care struck a deep chord.
The keynote address, delivered by Dr Norsiah Ali, director of the Family Health Development Division at the Ministry of Health (MOH), reminded us that the country is on course to become a super-aged nation by 2050, when 22 per cent of the population will be over 60 years old.
Life expectancy has improved, but the real challenge is how we can ensure Malaysians age healthily and sustainably.
Adding weight to the debate, Prof Dr Syed Mohamed Al-Junid Syed Junid from International Medical University (IMU) presented the sobering economics of dementia and elderly care. A single hospital episode for mild dementia already costs an average of RM8,182, while severe dementia can reach RM14,036, consuming nearly 39 per cent of our per capita GDP.
Beyond dementia, projections show that by 2040, the health care costs for older Malaysians will exceed RM21 billion annually, or more than 1 per cent of GDP. Families are already struggling with out-of-pocket payments, long-term care, and the risk of catastrophic expenditure.
At present, Malaysians depend largely on either public subsidies or private insurance. But private insurance is proving unsustainable for retirees.
Premium hikes of up to 275 per cent have forced many elderly to abandon their coverage, leaving them to return to already overstretched public hospitals. This is the inherent flaw of risk-rated insurance: the older and sicker you are, the more you pay.
Malaysia must urgently pivot to a community-rated national health insurance scheme. Unlike risk-rating, which penalises the elderly and ill, community rating spreads risk across the entire population.
The young subsidise the old, the healthy support the sick, and society as a whole bears the shared responsibility of protecting its most vulnerable. This is not just about cost management — it is about social solidarity, justice, and dignity in ageing.
Such a system will protect families from financial ruin, guarantee access to long-term care, and strengthen confidence in the nation’s health system. More importantly, it would ensure that our elderly receive the care they deserve without pushing their children into poverty.
The debate over health financing has lingered for decades. But as dementia cases rise and health care costs escalate, the figures speak for themselves.
What Malaysia needs now is not another round of debate, but the political will to implement a fair, sustainable, and community-rated national health insurance policy.
Our ageing parents deserve nothing less. And one day, so will we.
Prof Dr Rafidah Hanim Mokhtar is professor in gender and cardiovascular physiology, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), and president of the International Women’s Alliance for Family Institution and Quality Education (Wafiq).
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