1. HEALTHCARE REFORMS IN MALAYSIA*
07/16/96
HEALTHCARE REFORMS IN MALAYSIA
DR RIDZWAN BAKAR MBBS FRCP(LON)
President
Association of Private Hospitals, Malaysia *

2. 23 million people
Dual system of health delivery: public vs private
Public: 127 hospitals
32,000 beds
Private: 224 hospitals
9,547 beds
Doctors: public 8,723
private 6,780

3. *
07/16/96
STRENGTH OR WEAKNESS?
88.5% of the population is within 5km of a public health clinic or private practitioner
dual system of healthcare delivery (public/private)
almost total government subsidy for all services in public hospitals
infant mortality rate: 7.9 per 1,000 livebirths (1998)
maternal mortality rate:0.2 per 1,000 livebirths (1998)
healthcare expenses: 4% of G.D.P.
NOTES:
- Regulatory role
- PHFS Act *

4. FACTORS INFLUENCING GLOBAL TRENDS IN HEALTHCARE
Emphasis on patient empowerment & responsibility
shift to the wellness paradigm
redressing of social inequities
awareness of human rights
the consumerism movement
concern/awareness to the eco-systems & environs

5. *
07/16/96
Vision 2020
“By the year 2020, Malaysia is to be a united nation with a confident Malaysian Society infused by strong moral and ethical values, living in a society that is democratic, liberal and tolerant, caring, economically just and equitable, progressive and prosperous, and in full possession of an economy that is competitive dynamic, robust and resilient” *

6. *
07/16/96
Vision for Health
Malaysia is to be a nation of healthy individuals, families and communities, through a health system that is equitable, affordable, efficient, technologically appropriate, environmentally adaptable and consumer- friendly, with emphasis on quality, innovation, health promotion and respect for human dignity, and which promotes individual responsibility and community participation towards an enhanced quality of life. *

7. GOALS OF THE VISION FOR HEALTH*
07/16/96
GOALS OF THE VISION FOR HEALTH
focus on wellness
focus on the person
informed person
self-help
care provided at home or near to home
seamless care
tailored services
effective, efficient, affordable services *

8. Some major healthcare reforms….

9. *
07/16/96
SMART PARTNERSHIP
Necessary to maximise the utilisation of resources between private and public sectors
4 vital elements: shared vision
agreement and commitment
building on strengths
actions to overcome weaknesses
NOTES
Win-win approach *

10. SMART PARTNERSHIP Some examples:*
07/16/96
SMART PARTNERSHIP
Some examples:
annual dialogues, meetings and seminars
joint consultative panel meetings
patient referrals to private sector facilities/services
engagement of private specialists to public hospitals
establishment of accreditation standards *

11. TELEHEALTH IN MALAYSIA
"Malaysia's Telehealth initiative is not just about point-to-point teleconsultation. It incorporates the full spectrum of multimedia technologies to bring about benefits to all players in the health sector. It will transform the healthcare services and shape new relationships between people and their healthcare providers.”
-Minister of Health,Malaysia.

12. TELEHEALTH FLAGSHIP APPLICATIONS*
07/16/96
TELEHEALTH FLAGSHIP APPLICATIONS
the technology enabler to realise the Vision for Health
part of the government-funded Multimedia Super Corridor(MSC)
the integration of ICT and medical technology to deliver healthcare
empowering the individual, family and community to manage their health *

13. The Telemedicine Flagship Applications
The Mass Customised/Personalised Health
Information and Education Project
(MCPHIE)
Lifetime Health Plans Project
Continuing Medical Education
(CME) Project
Teleconsultation Project

14. Medical Records
LIFETIME HEALTH
RECORDS
Access
TELECONSULTATION
Consumer
Healthcare System
Provider
Consumer Health
Information
MCPHIE
Provider Health
Information
CME

15. HEALTHCARE FINANCING The universal issues:*
07/16/96
HEALTHCARE FINANCING
The universal issues:
How to mobilise sufficient funds
How to allocate
How to control costs
____________________________________________
2 possible Malaysian models:
medical savings account
social health insurance *

16. MEDICAL SAVINGS ACCOUNT*
07/16/96
HEALTHCARE FINANCING
MEDICAL SAVINGS ACCOUNT
2 essential components: -a compulsory personal fund with balances
-back-up insurance scheme
NOTES
i) remain the property of the individual
ii) contributed by employer/employee
iii) co-payment
iv) Govt. continues to fund marginalised groups *

17. HEALTHCARE FINANCING SOCIAL INSURANCE*
07/16/96
HEALTHCARE FINANCING
SOCIAL INSURANCE
- contribution to a centralised health fund by employers and employees
- government contributes on behalf of civil servants and marginalised groups
- community-rated
NOTES
- equitable access to basic services
- risk-pooling between sick & healthy, rich & poor
- creates moral hazards (rationing needed) *

18. except from a vending machine."
"Change is inevitable -
except from a vending machine."
-- Robert C. Gallagher

19. Thank You