january, 2019 | The Health
2019 budget
“The government
will allocate
RM29 billion
towards the
healthcare sector,
which is an
increase of 7.8%
compared to
2018.”
– Lim Guan Eng,
Minister of Finance
“The focus for the
B40 healthcare
screening program
is to identify
and control non-
communicable
diseases among B40
households, and
the program will be
different than the
other healthcare
protection schemes
under the Ministry of
Finance.”
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“The National
B40 Healthcare
Protection Fund
can elevate the
well-being needs
of Malaysians
while also
improve existing
healthcare
services.”
– Datuk Dr Noor Hisham
Abdullah, Director-
General of Health
– Datuk Seri Dr Dzulkefly
Ahmad, Minister of Health
7 healthcare
service
initiatives
for 2019
Allocation of RM29 billion, of
which RM10.8 billion going to
hospitals and clinics upgrades,
medications, and equipment
Health Services Scheme for
B40 households aged 50 and
above which includes 800,000
individuals with allocation of
RM100 million
Free breast cancer
screening (mammogram),
HPV vaccination program, and
pap smear screening in public
hospitals and clinics which
benefits more than 70,000
women with allocation of RM20
million
Starting January 1st 2019,
the Ministry of Health will
widen the non-smoking zones
including all restaurants and
eateries, strengthening the
‘Malaysia Bebas Asap Rokok
Tahun 2045’ mission
RM50 million allocated to
rare diseases treatment,
Hepatitis C treatment, program
to manage stunted growth issues
among children, screening, and
the widening of hemodialysis
treatment as well as Enhanced
Primary Healthcare (EnPHC).
Widening the partnership
programs between public and
private healthcare whereby the
government provide healthcare
infrastructure while private
healthcare organizations to add
funding
April 1st 2019 is when
the excised duty will be
implemented to two categories
of sugary beverages which is
manufactured in ready-to-drink
packaging
Beverages containing more
than 5g of added sugar or
other sweeteners per 100ml as
well as fruit and vegetable juices
containing more than 12g per
100ml.
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Concerns regarding
B40 healthcare fund
C
hief Executive Azrul Mohd Khalib
was frank in his opinion about the
potential longevity of the newly
proposed National B40 Healthcare
Protection Fund. It is said that the latest
initiative’s practicality will the biggest
challenge in making it as effective as it is
attended to be.
“We are concerned about the intro-
duction of the proposed National B40
Health Protection Fund. Coverage of
up to RM 8,000 per annum for the top
four critical illnesses is considered by
healthcare experts to be inadequate to
provide the intended protection under
private healthcare, especially applied to
a household.”
The protection fund essentially is
meant to help people from B40 house-
hold to get treatment from private
healthcare, instead of going to public
healthcare. Though most of the time
they will inevitably be referred to public
healthcare for further treatment.
“It is at best a stop-gap measure at the
primary care level. Once they are referred
to a public healthcare facility, these
patients will be unfairly imposed with
First Class treatment charges as required
under the Fees (Medical) (Amendment)
Order 2017. These rates are significantly
higher than for patients referred from the
public sector, as it is heavily subsidized.”
“Unless the legislation is amended,
this scheme could end up victimizing
enrollees. It might actually be more
advantageous for B40 households to not
enroll, and to access primary care services
through public facilities as they do now,”
Azrul cautioned.
“It is also unfortunate that there was
no announcement of the development
Azrul Mohd Khalib
of a long-term solution to healthcare
financing such as a social health insur-
ance scheme for all.”
“In order to ensure that Malaysia’s
healthcare system is able to continue to
provide quality, affordable and accessible
health services in the decades to come,
the government must summon the will
and commitment to invest now in a new
sustainable approach to funding health.”
That was absent during the recent 2019
Budget announcement.
Sugar tax,
innovative
yet flawed
The general consensus on the sugar
tax is this; it is indeed an innovative
way to get manufacturers to lessen the
sugar content in their products, leading
to lesser sugar consumption. Yet the
strategy has a more short-term effect
rather than long-term.
The Galen Center for Health and
Social Policy again, was one of the first
to be forward in analyzing the recently
proposed initiative as part of the 2019
Budget.
Chief Executive Azrul Mohd Khalib
commented, “The effectiveness of this
tax in actually reducing obesity is a
mixed bag. Studies from the United
Kingdon, Chile, and Mexico which have
implemented this measure shows that in
the short term, young consumers (13 to
30 years old) who are price-sensitive will
very likely reduce their sugar consump-
tion by up to 80 percent.”
“Older individuals and those who
already have a high-sugar diets for
decades are unlikely to change habits
and are relatively insensitive to a price
increase. In the long-term, consumers
will very likely be desensitized to the
price difference, requiring additional
tax increases in the future.”
The recommended method of excis-
ing duty on sugary products is not at
the point of retail, rather applied to
the manufacturers. This would make
manufacturers bear the tax and increase
the products’ prices, or find other ways
to lessen the sugar content altogether.
“The truth is that we cannot depend
on Malaysian consumers to change and
adopt healthy chpices and habits,’ said
Azrul.
Another matter that could render the
tax ineffective is the abundance of other
sugary beverages and food available in
Malaysia that will not be taxed. “The
beverages being taxed are but a small
proportion of food and drink which are
of poor nutrition and high in fat, sugar
and salt.”
“Consumers will switch or increase
preference to familiar alternatives such
as ‘teh tarik’ and ‘milo ais’,” he added.
This type of beverages proved to be
more problematic as it is consumed by
the majority of consumers, and will
unfortunately escape taxation.