HEALTH associations are hoping the underfunded healthcare sector will get a much needed funding boost in Budget 2022.

Malaysian Medical Association (MMA) president Dr Koh Kar Chai said healthcare expenditure must be equal to a minimum of 5% of the gross domestic product (GDP) to achieve universal health coverage by 2030.

“Since 2006, the country’s healthcare budget has been below 4% of our GDP. Currently, the healthcare budget is between 3.9 and 4.1% of the GDP.

“Close to 50% of that is from the private sector. The government only spends approximately 2.2% of the GDP; therefore, we are way below the healthcare budget recommended for a robust healthcare system,” Koh told The Malaysian Insight.

He said due to advances in medical technology, an ageing population, disease burden and increasing healthcare demand, healthcare costs in Malaysia are likely to outpace the national inflation rate.

According to the Malaysia National Health Accounts: Health Expenditure Report 1997-2019, the total nominal health expenditure for the public and private sectors in 2006 was RM 22.08 billion, or 3.7% of the GDP.

Finance Minister Tengku Zafrul Tengku Abdul Aziz recently said healthcare expenditure in 2020 was RM63.8 billion, or at 4.7% of the GDP. He said this could increase to 5% in 2021.

Koh hoped that the 2022 healthcare budget would reflect the Health Ministry’s commitment to implement urgently needed reforms for the healthcare system.  

“The pandemic has exposed many gaps in our healthcare system which will need to be addressed with both short- and long-term investments in healthcare human resources and infrastructure,” he said.

“Healthcare workers and the system were stretched like we never could imagine over the past two years largely due to insufficient manpower and resources. We hope to see meaningful allocations set aside to address these shortages in public healthcare.”

Koh said the government should also set aside funds for the digitalisation of healthcare with artificial intelligence, internet of things and other technology to increase efficiency.

“For many years, Malaysians have enjoyed healthcare services at RM1 per visit at public healthcare facilities. While most other items have increased in price over this period, healthcare charges for public healthcare have remained unchanged.

“Revenue from hospital visits in the public sector have not been revised since 1982. This is less than 3% of healthcare expenditure.  While this may not be a major revenue increase, it will still contribute to the revenue,” he said.

He said that the increase in the encounter fee at public healthcare facilities has been long overdue, but there has been a lack of political will in the past to make the decision.

“MMA has proposed that the encounter fee at public hospitals be increased by at least RM5. Those in the B40 group who find it a burden may have the fees subsidised or waived by the government.”

He also called for transparency in the management of healthcare spending. He said the government should look into the formation of an independent healthcare commission which looks into healthcare reforms.

The MMA will also support heavier sin taxes for cigarettes and other substances and ingredients which could “cause harm to humans in the long run” like vape pods and sugar, Dr Koh added.

“Tax revenue from this move can help finance healthcare while at the same time prevent or reduce cases of non-communicable diseases (NCD) – associated with the consumption of these products. Manufacturers of soft drink beverages who reduce sugar in their drinks can also be incentivised,” he said.

Koh also hoped for bigger allocations to the Peka B40 programme which incentivises or funds those in the income group to get health screenings, purchase medical equipment and complete cancer treatments.

More households are expected to fall into the B40 group due to the economic impact of Covid-19.

Putrajaya should also ensure equitable distribution of healthcare services throughout the country, along with adequate manpower to manage the infrastructure, he said.

Meanwhile, Malaysian Public Health Physicians’ Association president Dr Zainal Ariffin Omar said the government should also increase the budget for district health offices to manage Covid-19, including for staff,  equipment and  allowances.

More money should also be allocated towards training of specialists and contract healthcare workers.

Zainal agreed with Koh’s proposal for revenue from cigarette and sugar taxes to be ploughed into healthcare.

He also proposed tax incentives for healthy living including the purchase of sports equipment, while civil society groups in the medical field should also be given funding similar to the now defunct Health Promotion Board.

About RM31.9 billion was allocated to the Health Ministry under Budget 2021, up from RM30.6 billion the year before. – October 1, 2021.