After the announcement of Budget 2019, we take a closer look at the healthcare allocation. Did it meet the stakeholders’ expectations and the wishes of the people?

Overall, healthcare received RM29 billion or two per cent of the GDP, an increase of 7.8 per cent from 2018's RM27 billion (1.87 per cent GDP).

1. Increased allocation

Deputy Health Minister Dr Lee Boon Chye said that the healthcare allocation is the highest in the country's budget history.

“We have altogether RM26.5 billion for operating expenses and RM2.2 billion for development expenses,” he added. “There are other expenses that are not included in the health budget, including RM100 million for PEKA40, RM50 million for rare diseases and RM20 million for health tourism. In total, it is actually close to RM30 billion.”

2. Upgrades and quality improvement

A third of the budget or RM10.8 billion goes to medicine, upgrades and improvements of quality of health services at clinics and hospitals. Dr Lee said that there was also a special allocation for manpower training and RM1 billion for emoluments for contract workers.

3. Rare diseases, Hep C, stunted growth, haemodialysis and Expanded Primary Healthcare (EPHC)

It is not clear yet how the RM50 million lump sum allocation will be distributed among the five. For 2018, rare diseases received an allocation of RM10 million. Meanwhile, the EPHC pilot project was introduced in July last year in 20 health clinics in Selangor and Johor, and Dr Lee reiterated that the government is committed to continuing and expanding it.

“We are trying to introduce the family doctor concept and also a system of referral with the surrounding hospital that they serve so that the patient care will be seamless. Hopefully, it can be expanded throughout the nation, but this is the long-term plan,” he said.

4. National B40 Health Protection Fund

The fund provides free protection against the top four critical illnesses for up to RM8,000 and up to 14 days of hospitalisation income cover at RM50 per day, equivalent to RM700 per year. This, however, is an initiative by the Finance Ministry, which is more of an income protection programme. There are no details yet as to what the four critical illnesses are.

More controversially, GE Life Insurance contributed the seed funding of RM2 billion, although the Central Bank is to manage the fund. Former MP from Parti Sosialis Malaysia, Dr Jeyakumar Devaraj, said he was troubled by the fact that the fund was set up without consulting key stakeholders. He said the move could potentially hurt the public healthcare system, which still looks after the majority of in-patients.

“I think it’s very arrogant. There’s been so many people, even former directors-general — none of these people was consulted,” he added. “If this system actually causes a further outflow of government specialists and runs down government hospitals further, then there’ll be a great pressure on those who can buy top-up insurance to top-up on the rm8,000 — the M40. And they’ve got to go to the same insurance company.”

5. Soda tax

A tax of 40 sen per litre for non-alcoholic beverages with added sugars of more than 5 g per 100 ml and fruit juices with added sugars of more than 12 g per 100 ml will be imposed starting April 2019. President of the Malaysian Medical Association Dr Mohamed Namazie Ibrahim said that while the move is in the right direction, it may not have much effect in reducing obesity.

“There are far too many solid foodstuffs with high sugar content that is being consumed by Malaysians,” he noted.

6. Screening and health promotion

For women's health, RM20 million is allocated for free mammograms, HPV vaccination and Pap smear tests, which is expected to benefit 70,000 women. Meanwhile, RM100 million is set aside for a pilot nationwide health screening programme, PEKA40, for 800,000 people aged above 50 years old from B40 households.

However, former Health Minister Datuk Seri Dr S Subramaniam wrote in his op-ed: “Medical screening in a blind fashion has not been proven to improve the quality of health and diagnosis. Medical screening has to be targeted and be guided by the age group and the patients' specific needs.”

He added it might be better for the money to be pumped into other structured programmes already within the ministry, such as the EPHC programme.

7. NO-mococcal vaccination?

Despite an election promise for free mandatory pneumococcal vaccination, there was no direct mention of it in the budget. Even Dr Lee was unsure of its status.

“The minister had requested for RM180 million for pneumococcal vaccination and I see there is an increase of about RM100 million under the public health division for drugs. We (still) need to verify, (we) cannot confirm whether it’s for pneumococcal,” said the deputy health minister.

What do you think of the healthcare allocation under Budget 2019? Listen to the podcast here 'What's In Store For Healthcare':

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