#VPN What's the problem with the Malaysian healthcare industry?

Last Tuesday, the private clinics held a demonstration outside the PM Office against the new regulation to display price list of drugs for consumers. Prime Minister Anwar Ibrahim responded to request MOH to justify the rule. Doctors did not take well of Domestic Trade Ministry to enter the frame.  

Yesterday, the Star came out with another two features, namely: 'Specialists needed in all areas' and Increase training capacity to resolve shortage, say experts. It was highlighted that more cardiothoracic and emergency medicine specialists needed. 

Well, its not a new problem. "They" wanted a less stringent standards to allow for not as credible FRCS certification to practise cardiothoracic and its for a socio-political agenda. 

And "they" refused to allow  local Universities to develop own Master in Surgery programs with as credible in-house training as credible as the original FRCS and serve as a long term solution. 

Why still the complain? 

The present problem need to research, but the possible problem arising may have been known and mentioned in past postings during the fight against the "fake" FRCS run for money churning by the Edinburgh institution. Its a surprise they are still complaining of shortage. 

Anyway the bigger issue is the structural problem of health industry that need major fixing. Its too big a task for Minister Dr Dzulkifli Ahmad to do without the cooperation of a group of vocal self serving medical practitioners.

A question was posed to Chat GPT below:

Once the Malaysian healthcare was highly rated. It has since been on a declining and pubic hospotal facing bottleneck. What are the problems with Malaysian healthcare industry; public and private? What is the root cause? What are available options to address it? 

Their response:

You're absolutely right—Malaysia's healthcare system was once praised internationally, especially for its relatively low-cost, high-quality services in the public sector. However, in recent years, the system—especially public healthcare—has faced mounting challenges. Here's a breakdown of the current problems, root causes, and potential solutions:

🇲🇾 Problems in Malaysian Healthcare

Public Sector

1. Overcrowding & Long Wait Times:

Emergency departments and outpatient clinics in government hospitals are often overwhelmed.

Elective surgeries and specialist appointments can be delayed for months.

2. Staff Shortages & Burnout:

Severe lack of doctors, nurses, and specialists, especially in rural areas.

Many public healthcare workers migrate to the private sector or overseas for better pay and working conditions.

3. Underfunding:

Malaysia spends around 4-5% of GDP on healthcare—low compared to other upper-middle-income countries.

Public hospitals are often under-resourced and rely on outdated equipment.

4. Infrastructure Gaps:

Rural and East Malaysian areas (Sabah & Sarawak) face poor access to quality care.

Many clinics are understaffed or operate without full-time doctors.

5. Medical Brain Drain:

Doctors often leave the public sector for better-paying jobs in private hospitals or abroad.

Private Sector

1. Expensive Services:

Private care is unaffordable for the majority, especially without insurance.

Prices are unregulated and vary widely.

2. Urban-Centric Distribution:

Most private hospitals are concentrated in urban areas, exacerbating inequalities.

3. Profit-Oriented:

Focus is often on profitable procedures, not primary or preventive care.

Low public trust in private healthcare pricing transparency.

4. Dependence on Foreign Patients:

Medical tourism has skewed priorities in some hospitals, further diverting resources from locals.

🧩 Root Causes

• Chronic Underinvestment: Despite ambitious blueprints, public healthcare has not kept up with population growth and rising disease burdens.
• Human Capital Mismanagement: Oversupply of medical graduates without adequate housemanship slots, paired with underutilized allied health professionals.
• Policy Fragmentation: Lack of integration between public and private systems—inefficiencies, duplication of services, and policy inconsistency.
• Inequitable Access: East Malaysia and B40 groups have poor healthcare access compared to urban elites.
• Aging Population: Rising demand for chronic disease management and geriatric care.

🛠️ Options to Address the Crisis

Short-Term Measures

• Increase Healthcare Budget: Raise spending to at least 6-7% of GDP, in line with regional peers.
• Expand Contract Hiring & Housemanship Slots: Prevent brain drain and reduce waiting lists.
• Public-Private Partnerships (PPPs): Use private facilities to help clear public hospital backlogs (e.g., elective surgeries).
• Digital Health & Telemedicine: Expand access in rural areas and ease hospital burden.

Medium-Term Strategies

• National Health Insurance: Implement universal health financing model (like Singapore’s Medisave or Thailand’s UCS) to ensure equity.
• Restructure MOH Roles: Separate regulatory, purchaser, and provider functions to reduce conflict of interest.
• Boost Rural Healthcare Infrastructure: Invest in logistics, mobile clinics, and better pay for rural postings.

Long-Term Vision

• Healthcare Workforce Reform: More balanced production and deployment of doctors, specialists, and allied health workers.
• Focus on Preventive Health: Shift from curative care to community and wellness-centered models.
• Transparent Healthcare Governance: Combat corruption, and ensure accountability in healthcare spending and hospital procurement.

A tall order to correct in the shortest of time with the present challenging fiscal situation.