Extract from The Star



Healthcare cost is expected to escalate in line with the rising cost of living and the Health Ministry is taking steps to raise public awareness on non-communicable diseases.

OF late, the Health Ministry has been raising public awareness on non-communicable diseases (NCD) chronic respiratory diseases, heart diseases, cancer and diabetes.

According to Health Minister Datuk Seri Liow Tiong Lai, the recent United Nations’ high-level meeting on NCD in New York revealed that there would be a 17% rise in global prevalence of NCDs by 2025 if nothing is done to control it.

Recent statistics already show that 60% of premature deaths (below 60 years) in Malaysia were caused by NCD, he has said.

The focus is warranted not only because of the need to keep the population healthy and productive but also to keep healthcare cost, which is expected to escalate in line with the rising cost of living, manageable.

A World Economic Forum (WEF) study carried out with the Harvard School of Public Health shows that the cumulative costs of treating NCDs are expected to be US$7tril (RM21.9tril) from this year to 2025.

Mental health (which is not included in the list of NCDs but which the study found, along with heart diseases, to be responsible for nearly 70% of lost output) will account for US$16tril (RM50tril).

In Malaysia, the Government currently provides highly subsidised healthcare services to the general population while the poor are exempted from paying.

Liow says the current healthcare system offers a safety net from “catastrophic health expenditure” for those seeking treatment at government hospitals.

But Malaysia, like many other countries, is apprehensive that the present system of financing may not be sustainable in the long term due to rising health expenditure and the high out-of-pocket spending by the population, he reveals.

To ensure that people continue to get access and coverage to healthcare, the ministry is planning the 1Care programme, which seeks to address the issues and challenges of the current system.

“In 1Care, it is proposed that the health financing mechanism will keep healthcare inflation under control and reduce out-of-pocket expenditure at the point of seeking care,” Liow explains.

Under 1Care, it is envisaged that the population would have greater choice to seek care either at public or private health facilities. This could happen through mandatory contributions into a consolidated fund managed by the Government, Liow says.

“Healthcare providers will also be better motivated to practise in more rural areas, thus improving access and coverage of the population,” he adds.

“Primary healthcare providers will become family doctors responsible for providing long-term personalised services to their registered patients.”

1Care also envisages the use of a prepayment mechanism, implemented through enrolment in a Social Health Insurance (SHI) scheme, which will reduce high out-of-pocket payments at the point of seeking care when a person is already seriously ill.

SHI premiums, Liow explains, are community-rated and contributions will be based on a percentage of income. The Government will pay the premiums for the poor and vulnerable.

“SHI promotes equity in financing and access, where the amount contributed is based on the level of income and no one is denied access to healthcare due to their inability to pay. The scheme will deploy continuous monitoring and evaluation to ensure the goals of the health system transformation are achieved,” he says.

But there are challenges in implementing the scheme, he admits, citing as examples the recruitment of those in the informal job sector and determination of those eligible for government funding.