The health white paper advisory council’s co-chair acknowledged that government spending on public healthcare has increased over the years, and at RM41.2 billion takes up 10.5% of the 2024 budget, but said it still only makes up 2.1% of the national GDP.
“Even spending just 4% of GDP would mean doubling the budget,” he said, when speaking at a joint session between Academy of Medicine of Malaysia, the Faculty of Medicine, Universiti Malaya and the International Institute of Global Health, United Nations University.
The session, themed “National Health Service (NHS): Rise and decline – Lessons for Malaysia!” session, was held in Kuala Lumpur recently.
According to the white paper, Malaysia’s public sector share of current health expenditure is low compared to 6.4% and 4.4% of the GDP, which is the average spent by high- and upper middle-income countries, respectively.
Subramaniam said Malaysia is underinvesting and as a consequence the public health sector faces a myriad of problems, such as delays in service delivery, a lack of infrastructure and difficulty in retaining workers.
Subramaniam defended his introduction of a voluntary health insurance scheme, despite global economists favouring a tax-funded system.
He said general taxation would be ideal if the government gives enough funding.
“Our problem is, many times, the sum the health ministry receives is only 50% of that requested,” he said, adding that this was despite the fact that the request was based on evidence, with the ministry actually charting out its specific needs.
Hence, there is a concern that the general taxation method may not meet the ministry’s needs, he said.
Health policy analyst Dr Chan Chee Khoon said that a treasury official told him Malaysia engages in competitive lowering of income and corporate tax to compete against its Southeast Asian neighbours to attract foreign direct investment.
“It was partially true but he did not mention that there is a conscious policy decision to promote the expansion of the private medical sector.
“There was a conscious policy to restrict the further expansion of the public sector and allow space for the private sector to grow,” he said, adding that IHH Healthcare Berhad had become the second largest listed healthcare provider in the world.