With Dzulkefly Ahmad back at the helm of the health ministry (MOH), the time has come to address major concerns to help bring about a healthier Malaysia.
These are some of the immediate steps that can be taken.
Sweet solution to a bitter problem
The rise of non-communicable diseases (NCDs) is a ticking time bomb for Malaysia’s public health.
Data from the MOH and the World Health Organisation (WHO) shows that diabetes, cardiovascular disease and cancer now account for a whopping RM9.65 billion in Malaysia’s direct healthcare spending annually.
Combined with loss in productivity, the cost rises to RM22.5 billion annually.
One of the main causes of NCDs is an unhealthy lifestyle.
Take sugar intake, for instance. Each Malaysian consumes an average of 41.6kg of sugar each year, far exceeding the WHO recommendation of 18kg.
This excessive intake of sugar is a burden on our public health system. It costs the government RM4.4 billion annually just to treat diabetes.
Expanding the sugar tax is one way to deter this unhealthy lifestyle.
The newly revised sugar tax of 50 sen per litre covers only pre-packaged sugar-sweetened beverages.
While the revision is a step in the right direction, it not only falls short by excluding sugary foods but also lacks incentives for producers to reduce sugar content.
The sugar tax must cover all sugary foods. MOH must also introduce a tier-based sugar tax with a higher ceiling rate under the Strategic Plan for Reducing Sugar Among Malaysians (2023-2025).
In other words, higher taxes on foods and beverages with higher sugar content can promote reduced sugar intake and prevent producers from reformulating to offset the sugar tax.
The increased tax revenue can be used to strengthen our public health system against the looming threat of NCDs.
Bring back the GEG
The removal of the generational end game (GEG) component from the Control of Smoking Products for Public Health Bill 2023 has set us further back from achieving a smoke-free nation status.
MOH must recognise that reducing the prevalence of tobacco use to 5% by 2040 is impossible without GEG.
The potential revenue loss due to GEG pales in comparison with the enormous healthcare costs.
In 2020 alone, the government spent RM6.2 billion treating smoking-related diseases, dwarfing the RM3 billion in tax revenue from tobacco sales.
MOH should revise and re-table a stronger GEG framework to ensure a smoke-free nation.
We must be relentless in this pursuit.
Healthcare reforms to meet costly needs
With essential care workers burned out and the public healthcare system crippled, reforms have become essential.
The Health White Paper outlines MOH’s long-term transformation from a service provider to a regulator and policymaker, with a shift towards social health insurance.
At the heart of this transformation is a debate on healthcare financing methods between government revenue-funded healthcare and the proposed employment tax-based healthcare.
The status quo ensures near-universal access to healthcare but requires more public funding through taxes.
On the other hand, social health insurance pools funding from formal employees, their employers, and the government to provide healthcare for contributors.
However, it is costly to build, operate, and maintain. It may lead to over-treatment and cost escalation as unscrupulous service providers profit off the insurance claims.
Adopting a healthcare financing model is not an all-or-nothing decision. Given that a significant proportion of working adults are without formal employment, going full-on with social health insurance could exclude them from equitable access to quality healthcare.
A more feasible approach is to retain government-financed healthcare supplemented with social health insurance covering long-term care for old-age and NCDs.
This hybrid model will ensure equitable healthcare access for all Malaysians and alleviate the hefty costs of old-age care and NCDs.
With a new man at the helm, the path to a healthier Malaysia is full of possibilities.
If done right, expanding the sugar tax, reviving GEG and reforming healthcare will be a mark of success for the government.
The road ahead is challenging, but with determination, we can forge a future where public health is an unassailable pillar of Malaysia Madani. - FMT
The views expressed are those of the writer and do not necessarily reflect those of MMKtT.
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