July-August . 2024 | The HEALTH |
Hot Topic 19 |
|||||||
|
sibility of a NHIS , mainly regarding financial sustainability and practical implementation .
“ For a NHIS to work , it must make participation mandatory . It will then need to create a payment system catering to public and private hospitals .
“ That would require the corporatisation of public hospitals so they can “ compete ” with private hospitals for funds . And that means switching to a kind of fee-for-service system for both private and public hospitals . These massive changes will be resisted by many factions , including the Peoples Health Forum ( PHF ) and PSM .”
He advocated for a phased approach to reform , suggesting that incremental changes may be more palatable and effective than a wholesale overhaul of the healthcare system .
IMPLEMENTATION OF A NHIS
As for the potential costs and fiscal implications of implementing a NHIS , Dr Jeyakumar said : “ The proponents of the NHIS are proposing it as a way to mobilise funds from the population to reduce government fiscal expenditure .”
|
He called for a significant increase in the health budget and proposed longterm plans to bolster corporate taxes to finance healthcare initiatives .
“ The PHF and the PSM are asking the Government to increase the MoH ’ s budget from 2.2 per cent of the GDP to four per cent within four years .
“ The Government must develop long-term plans to increase the rate of corporate taxes in conjunction with other countries . Our corporate tax rate has dropped from 40 per cent in the 1980s to 24 per cent . Because South East Asian countries are in a race-to-thebottom in their competition for Foreign Direct Investment ( FDI ), this has to be addressed .”
Reflecting on international examples , Dr Jeyakumar cited countries such as Indonesia , Taiwan , and Korea as successful implementers of NHISs . However , he noted that these countries adopted different initial models than Malaysia ’ s tax-funded National Health Service ( NHS ) type system , highlighting the importance of tailoring healthcare interventions to suit the local context .
|
Datuk Dr Kuljit Singh
Fabrice Benard
|
Association of Private Hospitals Malaysia ( APHM ) President Datuk Dr Kuljit Singh emphasised the pivotal role of government leadership in designing and implementing a NHIS . He underscored the challenges of the inherent variability in healthcare delivery and urged policymakers to establish a robust framework that addresses payment mechanisms , subsidy considerations , and quality assurance standards .
“ The complexity of healthcare necessitates a structured approach led by the Government .
“ We must address fundamental questions regarding citizen contributions , taxation , and equitable access to care .”
He proposed the possibility of government subsidies to support the insurance scheme , suggesting a model where insurers manage funds and reimburse healthcare providers , whether public or private . However , he acknowledged that while similar approaches have been adopted in other countries , none have achieved an ideal solution .
“ Private hospitals are willing to support the public sector , but the impetus must come from the Government . We need a structured approach that ensures sustainability and equity in healthcare provision ,” said Dr Kuljit .
Dr Jeyakumar said there was also the need to sort out the private health insurance packages in force now . “ Both the insured and insurers will object so it ’ s not a practical solution .
“ Step by step is more likely to succeed than a massive revamp .”
Generali Insurance Malaysia Berhad Chief Executive Officer Fabrice Benard said : “ The impact of a NHIS is farreaching , and it would depend on its scope , design and implementation .
“ There is no one-size-fits-all scheme . However , it will likely lead to significant changes in the healthcare and insurance industry landscape .”
He emphasised the need for strategic collaboration between the Government , insurers , and healthcare providers in navigating the potential impact of an NHIS on the healthcare and insurance industry .
He also stressed the need for a tailored approach considering Malaysia ’ s unique healthcare landscape and demographic profile .
However , Federation of Malaysian Consumers Associations ( FOMCA ) President Datuk Dr Marimuthu Nadason opposed a NHIS , citing concerns about its potential impact on consumer affordability .
“ It is the responsibility of the Government to increase public health investment to ensure universal health coverage .
Studies provide evidence that public health investment has better outcomes at lower costs than a NHIS ,” he said , highlighting the need to safeguard the interests of vulnerable populations . – The HEALTH
|