Lessons from Malaysia on how not to run a healthcare system

The following is the transcript of this video message that Dr Jeyakumar Devaraj, Parti Sosialis Malaysia chairperson sent in solidarity and support for the “G20 Sulla Salute Manifestazione Nazionale A Roma” (G20 on Health: National Event in Rome), a protest in Italy on May 22, 2021 demanding equitable access to healthcare.

Greetings of Solidarity from Malaysia.

Malaysia is a good example of how not to develop a health care system. Up until the 1980’s Malaysia had a strong public health care system. All the hospitals were run by the government except for a few run by religious charities.

But in the 1980’s, Dr Mahathir, our Prime Minister at that time, decided to allow private businesses to set up hospitals. His argument was that if the rich went off and got treatment in private hospitals, government funds could be used more for the have-nots who come to the government hospitals. The government should not waste its money on those who can afford.

As a result of his policy, private hospitals sprung up especially in the more affluent urban areas. And many specialists from the government sector left to join private hospitals as they could earn 5 to 10 times more in the private sector. This brain drain has created a 2-tier system of health care.

About 70% of the experienced specialists are now in the private sector catering for the richest 30% of population leaving only 30% of the specialists to look after 70% of the inpatients who get admitted to government hospitals. This has resulted in long queues and delays in treatment in the government hospitals such that even the poorer families are forced to borrow money to seek timely treatment in the private hospitals.

The exodus of senior specialists to the private sector also means that the training of the new generation of doctors has been adversely affected. The specialists in the private sector are in no position to pass on their experience and knowledge to the upcoming generation of doctors. This is a huge loss to the country.

This is why the PSM as well as the Peoples’ Health Forum has been advocating that there be a moratorium on new private hospitals. Every time a new private hospital is opened, more public sector specialists are enticed out to the private sector. We are also lobbying for a larger budgetary allocation for the public health sector. Currently the Ministry of Health only gets 2.1% of the GDP per year. We want that to be pushed up to 4% of GDP. We need extra funds to build more government hospitals as the existing ones are badly over-crowded. We also need more health care staff – doctors, nurses, community health workers, etc.

But this is going to be a tough fight. Like many other governments, the Malaysian government has budgetary constraints. It is scared of raising taxes on the super-rich and the large corporations as the government fears that these large corporations will shift their headquarters to Singapore or Bangkok and shift their profits there as the tax rates there are lower. The liberalized financial system makes that very easy to do.

This is why the Peoples’ Health Movements across the world have to link up with the Fair Taxation initiatives. Ultimately its all to do with how the wealth that we collectively create is being apportioned. Right now too much of it is going to the top 1% and too little is being used to create social protection for the 99%. This is not acceptable! A better, fairer world is possible.

We are happy that you are organizing this rally to put forward the need for a good public healthcare system that puts people before profits.

Together we shall build a better future for the 99%.

Dr. Jeyakumar Devaraj
Parti Sosialis Malaysia

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