Social health insurance ensures sustainable healthcare, say experts

The government is proposing a social health insurance scheme financed by contributions from the government, employers and working adults.

PETALING JAYA: Health experts have given a proposed social health insurance scheme their backing, saying it is a more sustainable approach to healthcare funding.

The scheme, which health minister Dr Zaliha Mustafa previously said would be developed under the health white paper, would require premium contributions from the government, employers and working adults, and is typically mandatory.

Galen Centre for Health and Social Policy CEO Azrul Khalib said it would aid in resolving the issue of insufficient funding for the healthcare system by “co-sharing the burden and responsibility”.

“It also has the potential to stabilise public subsidisation and allow space for cost-containment, while maintaining access and quality to essential services,” Azrul told FMT.

As examples, he pointed to South Korea and Taiwan, two countries that have implemented social health insurance, funded by contributions from the public to a common pool. The funds are used to finance their respective healthcare systems.

Azrul proposed that the amount of each individual’s contribution be based on a sliding scale linked to their age and monthly income.

Malaysian Medical Association (MMA) president Dr Azizan Abdul Aziz also supported the idea of a social health insurance scheme, but urged that more studies be conducted first.

“We need to take into consideration all income groups as well as those who are unemployed. If we decide to take this route, it needs to be fair to all,” she maintained.

She also said poor policies in the past and a lack of political will have contributed to the current underspending on healthcare, which has led to issues like maldistribution of healthcare workers, shortages in specialists, lack of permanent positions and burnout among public healthcare workers.

“An increase in healthcare spending would address most of these issues but more than that, what we need is leadership to drive these changes,” she said.

Last month, Bandar Kuching MP Dr Kelvin Yii repeated his call for Putrajaya to introduce the scheme to boost public healthcare funding.

He reportedly said social health insurance should be implemented in stages and without having to make big deductions from workers.

However, former deputy health minister Dr Lee Boon Chye said a social health insurance should only be considered when the country’s economy improves.

“I don’t think contributing to health insurance at this stage is a good idea. The whole country needs to have a better economic status, where the income level of the lower and middle income groups are at a comfortable level, before we can even think about making employees contribute to such a scheme.”

Lee said the government must set its sights on increasing the allocation of funds for health in future budgets to at least 4% of Malaysia’s gross domestic product (GDP).

According to the Malaysia National Health Account for 2021, the total expenditure for healthcare was about RM78.2 billion in that year, equivalent to about 5.1% of the country’s GDP. Of the amount, the private sector contributed 2.1% while the remaining 3% came from the public sector.

Under the 2024 budget, some RM41.2 billion has been set aside for the health ministry.