THE “Malaysia’s population in 2050: What Does This Mean Socio-Economically?” forum held recently left me feeling dejected with the prospect of growing old in Malaysia. An ageing population is a common trend seen in countries heading towards high-income, developed status. While there is currently no comprehensive policy to tackle this issue, there is no better time to start than now to guard ourselves against the prospect of being old, poor, and sick by 2050.

Ageing healthily

Acccording to the National Health and Morbidity Survey 2015 by the Ministry of Health, current data shows that nearly half (47.7%) of the Malaysian population aged 18 and above are overweight or obese. Obesity is linked to a myriad of other diseases, where 30.3% of Malaysians aged 18 and above suffer from high blood pressure, 47.7% have high cholesterol levels and 17.5% have diabetes. Tackling obesity should be high on the national health policy agenda.

A strong policy focus on promoting increased uptake of vegetables, fruit, whole grains, nuts and seeds, and seafood omega-3 should be implemented. A diet policy could benefit overall national health, with a policy focused on advocating increased uptake for the above mentioned food groups yielding better impact versus one that is focused solely on reducing sodium, sugar, and fats .

Further, a national diet policy should consider the following aspects: cost-effectiveness, political feasibility, intensity of implementation, reactions of various stakeholders towards policy implementation (including consumers and the food industry) and environmental effects including climate change. Malaysians’ intensely emotional connection with good food adds to the challenges faced by Malaysian policymakers intending to tackle this issue.

Nonetheless, there are current efforts by various parties that currently promote nutritious, “clean eating”. Such efforts could potentially steer the Malaysian national diet towards a lower risk threshold.

The Ministry of Health estimated that 73% deaths in Malaysia is caused by hypertension, diabetes, and heart problems that resulted from unhealthy lifestyle including bad smoking habit . In addition to a balanced diet, health policies should prioritise overcoming smoking addiction and promoting an active lifestyle that incorporates daily exercise.

The FIT Malaysia programme provides a solid platform for this intention. Improvements could come through concerted efforts between ministries and local councils to provide recreational facilities such as exercise parks and cyclists or runners lanes along roads.

The current lifestyle tax relief should be increased, and to include purchase of running shoes as an incentive for Malaysians to lead a healthier lifestyle. Further, plain-packaging for cigarettes has been shown to increase negative perceptions towards smoking, subsequently leading to lesser uptake of smoking among youths. If past methods fail to deliver the desired results, perhaps our policy makers can consider ‘nudging’ different segments of the population by providing them with incentives towards living a healthier lifestyle.

Affordable healthcare

According to the 2017 annual budget, it is plain to see that Malaysia’s public healthcare is highly-subsidised. Expectedly, a bulk of this goes towards operations of 1Malaysia clinics, and other public health clinics, as well as for the supply of drugs, consumables, vaccines and reagents to all government hospitals and health facilities.

As we prepare to face the onset of an ageing population in 2050, the cost for healthcare should be retained or kept at an affordable increase in accordance with living wages. This should not be at the expense of maintaining quality of healthcare provided through both the public and private healthcare systems. Annual budget allocations should shift towards programmes for cancer prevention and prevention of other chronic diseases through early detection, as well as advocating for and subsidizing annual health screenings (including pap smear and mammogram).

The proposed voluntary health insurance scheme could provide an avenue to buffer the increasing cost of healthcare borne by government subsidies and increased accessibility of private healthcare for Malaysians. This could also be an avenue to assist people living with HIV (PLHIV), for whom stigma is a barrier to purchasing private health insurance. The public must be convinced that this is not an insurance scheme which will be run by political cronies who will pocket the profits and leave the costs with the consumer and / or the government. The implementation of this scheme must be transparent in order for health policy advocates to analyse its impact and benefit to the general public.

Overall, there must be more concerted, meaningful efforts from the government, policymakers, economists and health advocates to ensure that, come 2050, the ageing population would continue to enjoy robust health and a good quality of life despite the odds. – May 7, 2017.

* Lyana Khairuddin is currently reading for a Master of Public Policy at The Blavatnik School of Government, University of Oxford; funded by Chevening-Khazanah Scholarship. Lyana was formerly a researcher at Penang Institute.The opinion here is her own and does not represent the views of her funders, the School or university.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.