The government must live up to its responsibility of ensuring that all citizens and other residents of Malaysia have equitable access to safe, adequate and quality health care, said participants at a forum on the proposed national health financing scheme. No one must be denied proper care because of lack of means.
We, the participants of the Forum on the proposed National Health Financing Scheme, held in University Malaya on 25 March 2007, call on the Government of Malaysia to adhere to the principles enunciated below in any future reform of the nation’s health care system.
Any future reform of the public health care system must only be undertaken after informing and getting the feed-back of the Malaysian public. All reports should be made publicly available and consultation must be held with the public.
We, as the participants of the forum, strongly state call for:
1. the government to live up to its responsibility of ensuring that all citizens and other residents of Malaysia have equitable access to safe, adequate and quality health care. No one must be denied proper care because of lack of means.
2. the government health budget to be increased to 4 per cent of GDP. Currently, it is at a mere 2.8 per cent. This increase should come from general taxation as well as from Petronas revenue. There should not be any GST or special payroll taxes to supplement the health care budget as such taxes are not appropriate given the deterioration in the Malaysian Gini Coefficient.
3. The public health care system must be strengthened as it is both cost-effective and equitably distributed. The measures that the Government should implement to achieve this are
a) Set up a separate Service Commission for Health Care Personnel so that their remuneration can be improved.
b) Allocate a larger budget to offset co-payments that are now being borne by patients, the degree of subsidy depending on the economic status of the patient.
c) Freeze the development of private hospitals – Do not permit the setting up of any more new private hospitals and control the expansion of the existing hospitals.
d) Do not promote health tourism at the cost of public health care. The main focus of our health care sector should be to cater to the health care needs of our population, and not to bring in foreign exchange.
e) Implement schemes whereby the expertise in the private sector is drawn to teach young doctors and other paramedical staff.
4. The Essential Health Benefits Package must be comprehensive and include all the modalities of treatment that are currently available at our public hospitals.
5. A team of independent stakeholders should be set up to evaluate the cost effectiveness of the existing privatisation exercises involving the public health care sector. The findings of this team should be made available to the Malaysian public so that we can make an informed decision whether we wish to have any further privatisation of the health care services in this country.
6. Until such time the above study is released to the public, there must be a strict moratorium on all further privatiaation and/or “outsourcing” of components of the public health care sector.
7. A national health care financing oversight committee must be set up to ensure that the funds allocated to health care are properly utilised. Adequate funds should be made available for this committee to perform its watchdog function effectively. The Suhakam model of staffing and funding can be considered, but at least 50 per cent of the members of this committee should be elected by the public. It should be mandatory that Parliament allocates time to debate the annual report of this committee.
8. The health status of the 2 million foreign workers in Malaysia should be of concern to us all. The government must reverse the current policy of charging these patients higher rates when they come to government health care facilities, as this will lead to delays in diagnosis and treatment. A portion of the RM2 billion levy collected from foreign workers should be channelled to the public health care sector, and foreign workers should be charged no more than our citizens.
Resolution on the US-Malaysia FTA
We, the participants of the Forum on the proposed National Health Care Financing Scheme in University Malaya on 25 March 2007 are disturbed to hear that the Health Minister has informed the Cabinet that he does not have any objection to the US-Malaysia FTA Agreement. We would urge the Honourable Minister to reconsider his position as it is clear that a US– Malaysian FTA would adversely affect the health status of the Malaysian public by raising the prices of medicines and through weakening the public health care system.
The prices of medicines will go up because the US–Malaysia FTA will:
a. extend patent durations;
b. tighten regulations pertaining to the registration of generic medications (e.g. the data exclusivity clause)
c. restrict the existing right of the government to bring in generic drugs even if it is in national interest.
The US–Malaysia FTA would also open the door for US hospital chains to enter the Malaysian market – either alone or in joint ventures with existing Malaysian private hospitals. Such a development would lead to the further erosion of public hospitals by aggravating the brain drain.
The US–Malaysia FTA would also curtail the power of government to regulate the potential toxicity of US products and the environmental pollution arising from US production processes. The FTA-given right for corporations to sue host governments under the “expropriation” clause would deter government agencies from acting on suspected product toxicity and environmental pollution.
For these and other reasons, we would like to urge caution. The Malaysian government should not rush into an FTA agreement with the United States. The terms of the proposed FTA should be made known to Malaysian civil society before a final decision is inked, so that meaningful feedback can be obtained from the public.
We also call upon the US not to pressure the Malaysian government into signing the FTA but to respect the democratic right of the people of Malaysia to have a say in a matter that is going to affect many aspects of our lives!