Health care funding missing from 2023 budget: Galen

Health care funding missing from 2023 budget: Galen

KUALA LUMPUR, October 8 – The Galen Center for Health and Social Policy has expressed disappointment that the federal government’s 2023 budget did not provide long-term, sustainable health care financing solutions.

Galen Center Director General Azrul Mohd Khalib called on the government to summon the political will and commitment to invest now in a new and sustainable approach to health care financing, so that the health system Malaysian can continue to provide quality health services that are affordable and accessible to all. in the decades to come.

Azrul also cited the challenges of preventing and treating non-communicable diseases (NCDs), mental health and an aging population.

“More than ever, we must invest in the sustainability and increase the resilience and sustainability of the public health system. We cannot take it for granted,” Azrul said in his comments on the 2023 budget tabled yesterday.

Previously, Azrul called for the abolition of RM1 and RM5 tariffs for outpatient and specialist care respectively in Ministry of Health (MOH) facilities. These fees, he said, were insufficient for cost recovery and should be replaced by co-payments for certain treatments such as diabetes and by social health insurance.

Co-payments refer to payments for health care that are shared between the patient — either out of pocket or through health insurance — and the government.

In a recent interview with Astro Awani, Azrul explained that a social health insurance scheme in Malaysia could take inspiration from the UK, Taiwan, Singapore, Indonesia, South Korea, Australia or New Zealand. , where employees and employers would pay employee contributions – such as the Employees Provident Fund (EPF) or Social Security Organization (Socso) – into a certain fund for healthcare costs, such as salaries or infrastructure.

“When we have more people contributing to this pool, we would be able to raise this money to invest in health care development. This would not replace the current allocation that the government already provides through the federal budget; it would complete.

2023 MOH budget increased by 11.5%, or RM3.7 billion, to RM36.1 billion from RM32.4 billion in this year’s budget. The increase is the largest in both percentage increase and absolute numbers over the past five years.

“When the 2023 budget document is reviewed, the distribution of this allocation gives a mixed impression of being part of a responsive budget and operating as usual,” Azrul said, commenting on the Health Ministry allocation.

The Galen Center also criticized cuts to health education and the Peka B40 health screening program, pointing out that one in five Malaysian adults live with diabetes, three in 10 with hypertension and half of the adult population is overweight or obese.

“While the Minister of Finance acknowledges that Malaysia is still in pole position among countries in this region with a large population that is obese or living with non-communicable diseases, there seems to be little to remedy this. this situation.”

Azrul further criticized the government for its reluctance to fund a nutritious school feeding program for all children to address child malnutrition, despite allocating cash assistance of RM150 in the 2023 budget. for all children, regardless of household income, under the Bantuan Awal Persekolahan (BAP) programme.

“Stunting and obesity both affect a significant proportion of Malaysian children, regardless of their economic background. When are we going to invest in solving the problem of child malnutrition? »

code blue reported that based on the Ministry of Finance’s document on estimated federal expenditures for 2023, the government has made a 14.7% budget cut to health education under the Ministry of Health’s public health program Health for next year, which is a decrease of nearly RM9 million.

The Peka B40 Health Screening Scheme, which offers fully subsidized health screenings to the bottom 40% (B40) of low-income people, has lost RM5 million in funding for 2023, a reduction of around 6%.

Although Azrul welcomed the allocation of RM34 million to create a national center of excellence for mental health, he said the money would be better spent on increasing the number of psychiatrists, psychologists and others. mental health professionals.

“We need to increase the availability and coverage of mental health services, which are currently inadequate. We need more service providers, or at least ways for people to access public and private mental health services. This will require long-term investment and commitment.

According to the Estimated Federal Expenditure 2023 document, the Ministry of Health cut psychiatric and mental health services and supplies under the medical program by 2% (RM580,000).

Azrul criticized the lack of transparency in the Ministry of Health’s budget, noting that allocations for drugs and treatments in specific disease areas are unclear as they continue to be lumped together under general headings, “which prevents understanding and transparency of therapy funding priorities.

The Galen Centre, however, welcomed the allocation of RM1.8 billion for the construction of new hospitals, clinics and health care facilities, in addition to an allocation of RM420 million for repair. , maintenance and modernization of existing facilities.

“This is an important point because over the past five years there have been several fires in aging facilities, including one at Sultanah Aminah Hospital in Johor, which claimed six lives following a fire in 2016. of Malaysia’s 156 public hospitals, 45 are over 100 years old,” Azrul said.

“The government also wants to address the problem of contract doctors by increasing the position of contract recruitments, but does not appear to have increased permanent positions despite large increases in emoluments at all levels. This obviously aims to fund the promotion of existing staff and raise salaries to support the retention of skilled healthcare workers,” he added.

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