Former Health Minister Tan Sri Dr S. Subramaniam’s advice to MPs to “stop promoting free health care for political support, amid difficulties in pursuing health financing reforms” is disappointing but not surprising. It is a view that is shared by the political elite whether BN, PN or PH and it needs to be refuted as it is insensitive to the problems faced by the working people. It also fails to take a holistic view of income generation, and distribution, in our country.
The sweat and sacrifice of our working people has led, over the past 50 years, to a 24 fold increase in the Malaysian GDP in real terms (ie after taking into consideration inflation). However, this increase in the wealth of our nation hasn’t trickled down to the workers, farmers and small business people in the country. Government policy has kept salaries low. For example, the median wage of factory workers in Malaysia has only increased 1.4 fold in real terms over the past 50 years.
Wage suppression is just like a tax – a tax on the labour of workers. But unlike most taxes, the proceeds do not fund public services or redistributive programs that benefit the vulnerable. Instead, wage suppression contributes to handsome corporate profits and causes the share of income accruing to workers to fall. Salaries are low in Malaysia, and it all boils down to a model of economic growth that suppresses wage increases. The longstanding pursuit of a wage-suppressing model of economic growth to attract foreign direct investment (FDI) has been the country’s policy for the past 40 years. The steps to de-unionise the labour force, reduce the collective bargaining coverage rate and allow the use of migrant labour to shrink the payroll are the other features of this economic model.
A living wage is defined as the minimum income necessary for a worker to meet the basic needs of his or her family. The goal of a living wage is to allow a worker a basic but decent standard of living through employment without requiring government subsidies. The minimum wage of RM1500 is far from a living wage, given the current cost of living.
The term ‘social wage’ is used frequently in a journalistic sense, to mean the provision of a set of public services which invariably includes education and health care. As we are unable to pay fair monetary wages to our workers, the least we can do is to provide healthcare to them at subsidized rates. The government of the day should bring public healthcare like England (NHS) and the Nordic nations. It’s the moral obligation of the government to provide quality health service as part of the social wage. Healthcare is a right, not a privilege.
Unfortunately, “learned men” from the Bretton Wood institutions – the World Bank, the International Monetary Fund and the World Trade Organisation – have poisoned the minds of Malaysian policymakers who now tend to view health care as a commodity to be sold and to generate profit. Health spending is often wrongly seen as a form of subsidy and as an unacceptable drain on national revenue. The PSM disagrees with this paradigm. We advocate a human rights approach where the government provides health care for the people. The health system should be government-led, government-funded, and rights-based.
Quality health services should be seen as part of the “social wage” that has been “pre-paid” by our workers and farmers (by quietly accepting lousy wages). Public health service budgets should be funded by taxes on the richest and biggest corporations. The government should not impose new taxes on the B40 and M40 groups or require the payment of health insurance premiums. These are the options being considered by our policy makers at present!
It is high time our policy makers start taking steps to ensure that a larger portion of the immense wealth generated by the labour of our working people is used to improve the quality of life for our population – and funding an efficient public health care system that is free at the point of receiving care, should be one of their main goals.
Robert Devaraju
Parti Sosialis Malaysia (Buntong Branch)
26/2/2024