HEALTHCARE REFORMS IN
MALAYSIA
DR RIDZWAN BAKAR MBBS FRCP(LON)
President
Association of Private Hospitals, Malaysia
e-mail: aphm@po.jaring.my
http://www.hospitals-malaysia.org
23 million people
 Dual system of health
delivery: public vs
private
 Public: 127 hospitals
32,000 beds
 Private: 224 hospitals
9,547 beds
 Doctors: public 8,723
private 6,780

STRENGTH OR WEAKNESS?






88.5% of the population is within 5km of a public
health clinic or private practitioner
dual system of healthcare delivery (public/private)
almost total government subsidy for all services in
public hospitals
infant mortality rate: 7.9 per 1,000 livebirths (1998)
maternal mortality rate:0.2 per 1,000 livebirths (1998)
healthcare expenses: 4% of G.D.P.
FACTORS INFLUENCING GLOBAL
TRENDS IN HEALTHCARE






Emphasis on patient
empowerment & responsibility
shift to the wellness paradigm
redressing of social inequities
awareness of human rights
the consumerism movement
concern/awareness to the ecosystems & environs
Vision 2020
“By the year 2020, Malaysia is to be a united
nation with a confident Malaysian Society
infused by strong moral and ethical values,
living in a society that is democratic, liberal
and tolerant, caring, economically just and
equitable, progressive and prosperous, and in
full possession of an economy that is
competitive dynamic, robust and resilient”
Vision for Health
Malaysia is to be a nation of healthy
individuals, families and communities,
through a health system that is equitable,
affordable,
efficient,
technologically
appropriate, environmentally adaptable
and consumer- friendly, with emphasis on
quality, innovation, health promotion and
respect for human dignity, and which
promotes individual responsibility and
community participation towards an
enhanced quality of life.
GOALS OF THE VISION FOR HEALTH








focus on wellness
focus on the person
informed person
self-help
care provided at home or near to home
seamless care
tailored services
effective, efficient, affordable services
Some major healthcare reforms….
SMART PARTNERSHIP

Necessary to maximise the utilisation of resources
between private and public sectors

4 vital elements: shared vision
agreement and commitment
building on strengths
actions to overcome weaknesses
SMART PARTNERSHIP
Some examples:





annual dialogues, meetings and seminars
joint consultative panel meetings
patient referrals to private sector facilities/services
engagement of private specialists to public hospitals
establishment of accreditation standards
TELEHEALTH IN MALAYSIA
"Malaysia's Telehealth initiative
is not just about
point-to-point teleconsultation.
It incorporates the full
spectrum of multimedia
technologies to bring about
benefits to all players in the
health sector. It will transform
the healthcare services and
shape new relationships
between people and their
healthcare providers.”
-Minister of Health,Malaysia.
TELEHEALTH FLAGSHIP APPLICATIONS




the technology enabler to realise the Vision for Health
part of the government-funded Multimedia Super
Corridor(MSC)
the integration of ICT and medical technology to
deliver healthcare
empowering the individual, family and community to
manage their health
The Telemedicine Flagship Applications




The Mass Customised/Personalised Health
Information and Education Project
(MCPHIE)
Lifetime Health Plans Project
Continuing Medical Education
(CME) Project
Teleconsultation Project
Access
TELECONSULTATION
Consumer
Consumer Health
Information
MCPHIE
Medical Records
LIFETIME HEALTH
RECORDS
Healthcare System
Provider
Provider Health
Information
CME
HEALTHCARE FINANCING
The universal issues:
• How to mobilise sufficient funds
• How to allocate
• How to control costs
____________________________________________
2 possible Malaysian models:


medical savings account
social health insurance
HEALTHCARE FINANCING
MEDICAL SAVINGS ACCOUNT
2 essential components: -a compulsory personal fund
with balances
-back-up insurance scheme
HEALTHCARE FINANCING
SOCIAL INSURANCE
- contribution to a centralised health fund by employers
and employees
- government contributes on behalf of civil servants and
marginalised groups
- community-rated
"Change is inevitable except from a vending machine."
-- Robert C. Gallagher