Healthcare reforms will take time, but cannot lose momentum, say experts

 Sunway University’s Dr June Choon says the RESET strategy and MediAsas insurance plan must withstand political scrutiny, legislative argument and budget haggling.

The health ministry’s RESET reform agenda seeks to strengthen the private healthcare ecosystem while modernising the public healthcare system as the cornerstone of universal health coverage. (Bernama pic)

PETALING JAYA:

The public should not expect recently introduced healthcare cost‑cutting initiatives to deliver results overnight, an expert says, stressing that structural and institutional reforms often take years before their benefits are felt.

Sunway University’s Dr June Choon said long term initiatives like the RESET strategy and the MediAsas insurance plan “must survive political scrutiny, legislative argument, budget haggling and a great deal of unglamorous implementation planning before any of it reaches a patient.”

“But ‘careful’ must never become a polite word for needlessly slow,” Choon, who heads the school of pharmacy at the university’s faculty of medical and life sciences, told FMT.

“The real test of a reform is whether it moves the system measurably closer to better, and fairer access for patients.”

The RESET framework covers five strategic thrusts to systematically curb medical inflation: revamping medical and health insurance/takaful; enhancing price transparency; strengthening the digital health ecosystem; expanding cost effective options; and transforming provider payments.

MediAsas, meanwhile, is not a national or social health insurance scheme. It is a voluntary private medical insurance and takaful initiative intended to make private healthcare coverage more accessible, affordable and sustainable, while complementing Malaysia’s tax-funded public healthcare system.

At the recent Sasana Symposium, the health ministry’s Healthcare Transformation Office head Dr Yap Wei Aun similarly stressed that MediAsas should not be viewed in isolation.

He said it formed part of the broader RESET reform agenda to strengthen the private healthcare ecosystem, alongside continuing efforts to modernise the public healthcare system as the cornerstone of universal health coverage.

Choon went on to cite Malaysia’s harm reduction programmes, piloted in 2005 and 2006, to highlight the point about the “delayed visibility” of reforms.

A 2013 World Bank-funded study estimated that these pilot programmes had prevented roughly 12,650 HIV infections and saved RM47 million in healthcare costs between 2006 and 2013.

New HIV cases fell from 6,978 in 2002 to 3,393 in 2013, and the share driven by injecting drug use, about 74% back in 2002, dropped sharply in the years that followed, she said.

“Reform is patient work. Its rewards come slowly, and you often only appreciate them years later, which is exactly why we have to give reform the time it needs.”

Choon however stressed that political continuity is vital in ensuring policies bear fruit, noting that the constant reshuffling of health ministers in recent years risked reforms “being paused, rebranded or restarted”.

She said responsibility for the RESET strategy and the MediAsas insurance plan could not rest on any single minister.

“It needs sustained, cross-party commitment and protected funding.”
Separately, Choon noted that current reform efforts are directly confronting long-standing structural bottlenecks, particularly the fragmented financing inherited from past policy frameworks.

Malaysia funds public healthcare largely from general taxation, she said, meaning the health ministry must compete annually with every other ministry for its allocation.

“When funding for a reform is not ring-fenced and no single actor owns the outcome, implementation slows down,” she said, endorsing the focus on building a dedicated and sustainable health-financing mechanism, calling it “the pivotal reform pillar”.

She also highlighted incomplete digital infrastructure, noting public and private health data still sit in separate systems. “Without that visibility, course-correction is slow, and we risk measuring success years too late,” she said.

Chua Hong Teck, an independent health analyst agreed, describing the ministry’s long-term strategy as a necessary shift. “Healthcare reform is a marathon, not a sprint,” he said.

“People shouldn’t expect reforms to work overnight, it will take a long time, a generation for formative shifts.”

Chua, who previously served as director of the Healthcare National Key Economic Area under the Prime Minister’s Department, also said the health ministry’s dual role of setting policy while also running day-to-day services leaves it consumed by “operational firefighting” rather than delivering reform.

He said MediAsas should not be mistaken for a complete solution on its own.

Chua said the plan must work hand‑in‑hand with RESET’s other components—such as price transparency and a shift to diagnosis‑related group payments—if it is to meaningfully tackle medical inflation. - FMT