Issue of the Week: Should Malaysia adopt a decentralised healthcare system?

Analysts have strong points against the idea.

While a more decentralised Malaysian healthcare system may close the current gap in service delivery between wealthy and poor Malaysians by freeing the government from some conflicts of interest, decentralisation brings its own set of headaches.

Here are some healthcare analysts’ views on Malaysian decentralisation:

Ashwin Moduga, research manager, IDC

One of the major issues with decentralized health delivery systems based on experience in other countries is that of the lack of an integrated health system.

Especially in managing chronic conditions like diabetes, cardiovascular disorders and respiratory disease, all of which are severe burdens on health finances of a country.

All such chronic disease management need to be monitored at a central level to assess population health. Decentralized health systems have had a problem with communicating disease statistics, disparate population level disease management programs and have often led to huge pockets of underserved populations.

Dr Yong Chern Chet, healthcare sector leader, Deloitte Southeast Asia

Perhaps the more urgent issue is the ongoing stagnation (both from an overall capacity and capability perspective) of the Malaysian public healthcare sector in the recent past.

The Malaysian population’s healthcare demand is rapidly shifting as with the rest of developing nations in the region. Issues of an ageing population, earlier onset of lifestyle and chronic diseases including cancer are real on the ground issues which are currently partly addressed by the private healthcare sector picking up on the spill over. That said, there is risk that even with the rapid growth seen in the private sector, it will not be enough to keep up with the demand. Malaysia might risk in the future of becoming a medical tourist source besides being a destination.