IT has been dubbed the “silent epidemic”.
By 2035, Malaysia will turn into an ageing nation, where 14.5 per cent of its population will be aged 60 and above.
The rate of growth in the number of the aged in Malaysia is so alarming that policy measures must be put in place sooner rather than later to avoid a national crisis.
These include improving the pension system and putting more resources in healthcare, although the latter could pose a strain on public finances.
A lower fertility rate, longer life expectancy and relatively good public healthcare in Malaysia have all contributed to the rise of the aged population.
The rate of growth of our aged population, in fact, is faster than in many developed countries.
France took more than 100 years to double its population of those aged 65 and above.
In the case of Malaysia, it will take only 23 years to double the number of those aged 65 and above from seven per cent in 2020 to 14 per cent in 2035.
Healthcare spending will continue to rise, and economists say it will pose a bigger headache for the government as the population ages.
According to one regional study, the swelling ranks of the elderly will cost the Asian region some US$20 trillion (RM80 trillion) in healthcare by 2030.
Japan spends eight per cent of its gross domestic product (GDP) on healthcare; where 80 per cent of the expenses are met by the government.
But Malaysia’s health indicators compare well with countries such as Singapore, Indonesia, the Philippines, Thailand and Vietnam.
Malaysia spends 4.4 per cent of its GDP on healthcare, where 55.5 per cent is funded by the government. Our healthcare spending as a percentage of GDP is, however, lower than the Philippines (4.6 per cent) and Vietnam (7.2 per cent).
The majority of Malaysians go to public healthcare facilities: 75 per cent of Malaysians seek in-patient treatment and 90 per cent seek out-patient treatment.
This brings us to a bigger question. As Malaysians live longer, who should bear the growing medical costs?
Is it the sole responsibility of the government or on a cost-sharing basis with the users? Also, how can we offer more affordable medical services?
Today, hospitals that were once run by non-profit organisations or religious organisations, are increasingly being run by profit-oriented private hospitals.
The idea is simple: those who can afford will go to the private hospitals while government hospitals take in non-paying patients. But the cost of private healthcare is also soaring.
In fact, we should encourage social hospitals, or non-profit hospitals, as a way to ease the financial burden of the people.
Muhammadiyah, a major Indonesian NGO, runs not just schools, but also non-profit medical services. Today, it runs several hundred medical clinics and hospitals across Indonesia.
The Malaysian government must have a holistic approach in healthcare planning and management. There are structural changes that need to be taken into account in redrawing national healthcare policies.
FIRE PROBE MUST BE THROUGH
THE Sultanah Aminah Hospital fire that killed six ICU patients has shocked the nation and raised eyebrows on fire safety standards at government hospitals.
The Sultan of Johor, Sultan Ibrahim Sultan Iskandar, and Deputy Prime Minister Datuk Seri Dr Ahmad Zahid Hamidi both visited the scene and ordered a full investigation into the fire.
We hope the board of inquiry investigating the incident will share its findings on how and why it happened and how such incidents can be avoided in the future.
Hospital fires are usually deadly because of the presence of oxygen tanks and other flammable items. Furthermore, most of the patients are immobile.
In December last year, a fire at a hospital in southern Saudi Arabia killed at least 25 people and injured more than 100. The blaze broke out in the intensive care and maternity departments of the Jazan General Hospital.
In a pre-emptive measure, the Health Ministry has ordered nationwide checks on 48 hospital buildings that are more than 50 years old.
Health Minister Datuk Seri Dr S. Subramaniam has admitted that many of the old hospital buildings do not comply with safety standards as these were not a requirement then.
Among the oldest hospitals in the country is the Batu Gajah Hospital in Perak, which is 136 years old. Certain laws, such as the Uniform Building by-laws, did not come into force until 1984.
The MOH must ensure the safety audit, which must be independently carried out, includes checks on the fire protection system, though there had been no suggestion so far that faulty equipment is to blame for the JB incident.
But the incident could also throw the spotlight on the three companies (now extended to five) given long-term concessions by the government to undertake hospital support services.
Deputy Health Minister Datuk Seri Dr Hilmi Yahaya, however, said last week that the MOH would not suspend the services of the hospital’s support services concessionaire, Medivest Sdn Bhd, while the probe into the fire was underway.
Medivest’s concession, which runs until 2022 and is worth RM350 million a year, covers 22 government hospitals in Negri Sembilan, Malacca and Johor, he said.
“But, penalties and other actions can be taken if Medivest is found to have not fulfilled its contractual obligations in the lead-up to the incident,” Dr Hilmi said. There was no immediate comment from Medivest.
The ministry’s privatised support services — comprising over 35,000 beds — cover the following services: clinical waste management; cleansing; linen and laundry; facility and engineering maintenance and bio-medical engineering maintenance.
The two other companies serving hospitals in Peninsular Malaysia are UEM’s Edgenta Mediserve Sdn Bhd and Radicare (M) Sdn Bhd.
BRIGHT SMILE FROM GOVT CLINIC
I AM sharing this Facebook posting by Anwardi, my college mate.
“Went to a government dental clinic in Bangsar — one of my molars chipped and was scraping the inside of my cheek. I went in the afternoon. Registered, got a number. 1067. Currently, the dentists were servicing number 1063. Four numbers away not bad. True enough within half (an) hour my number was called. An Indian female dentist told me to sit down and she checked my molar and said that she will smoothen the sharp edges and refilled my lost filling with medicated filling (whatever that is). Within 10 minutes it was done. I walked out, gave my card to the counter. They charged me RM3. Thank you Kerajaan Malaysia. I love you.”
A Jalil Hamid is a veteran newsman, who believes that a good journalist should be curious and sceptical at the same time.