Malaysia 2017 | HEALTH | REVIEW

The government has invested consistently and heavily in the public healthcare system and has implemented strict guidelines to make excellence not an option, but compulsory.

In Malaysia, the healthcare sector is generally characterized by a strong public sector, with government hospitals and clinics acting as the primary source of care, as well as a strong private sector that helps shoulder some of the burden and develop the sector's appeal to medical tourists. As it stands, the government heavily funds the public healthcare sector, and patients pay a nominal sum for treatment, while fees for private healthcare services are paid by the patients, their employers, or insurance companies.

This has been lauded as a model for developing countries, as it has succeeded in improving the health status of Malaysians over the last three decades. According to the Department of Statistics, the life expectancy at birth continues to rise, reaching 74.7 years, compared to 72.2 years in 2000. A baby born in 2016 could expect to live 72.6 years if he is a boy, and 77.2 years if she is a girl. Infant mortality is also one of the lowest in the world, standing at 16.3 per 1,000 live births in 2013.

Traditionally, Malaysia's national healthcare expenditure has been around 4 to 5% of GDP, but in 2014, the government set aside USD5.83 billion, 8.4% of the yearly national budget for public healthcare. When the 2017 budget was announced in October 2016, another MYR25 billion had been allocated to healthcare, representing 8.6% of the overall sum, just below the ratio spent by the UAE on its healthcare.

The public sector caters to the bulk of the population (around 65%), but is served by 45% of all registered doctors and even fewer specialists (25-30%). There are 143 public hospitals with 41,389 beds and 183 private hospitals with 12,963 beds. The private sector tends to be better equipped with more advanced medical equipment; for example, 75 out of the 105 magnetic resonance imaging machines and 91 out of 143 computerized tomography scanners were in private hospitals. All private medical facilities in Malaysia are required to be licensed under the private Healthcare Facilities and Services Act 1998, and work closely with the Ministry of Health, which monitors compliance and establishes benchmarks and regulations.
In total, according to the Ministry of Health's 2016 report, Malaysia has 46,491 doctors in both public and private hospitals, giving a ratio to population of 1:656. If the country intends to meet the goals laid out in the Eleventh Malaysia Plan (2016-2020), that figure will have to be improved to 1:400. There is an average of one dentist per 4,775 people and one pharmacist for 2,900 people.


One aspect of health coverage is access to consumer health products. In 2016, Malaysia saw a strong price competition in the fight for stronger market shares from various leading distributors. Slower economic performance has arguably made consumers more price sensitive, but come rain or shine, consumers in Malaysia tend to be consistent buyers of vitamins and dietary supplements as they have strong health awareness and engage proactively in preventing health problems by taking supplements.
Health and beauty specialist retailers like Watson's and AEON Wellness hold strong positions in the market. Although there are some online retailers, most Malaysians prefer over-the-counter service and access to in-store specialists. Inside stores, international players like Amway, Nu Skin, Cerebos, USANA Health Sciences, and GlaxoSmithKline dominate the consumer health market. Nonetheless, home-grown players such as HerbalCeutical, Cosway, Elken, and Total Image Regional did not fare badly against multinational players due to their strong brand reputations.


Despite awareness about the importance and value of supplements, the same health conscious mentality has not had such an impact on attitudes to food. Like in so much of the developed world, in Malaysia clothing stores are stocking more and more trousers with bigger waistbands. Twenty years ago 4.4% of Malaysians were considered obese; a decade later this was 14%, and today 18% of people can be classed as obese. E-Siong Tee, the resident of the Malaysia Nutrition Society, says the key to getting Malaysians to slim down is through education. “I believe the solution must be in educating the young people now, for example primary school children," he says.


Progress is being made in terms of attitudes to smoking. In a recent survey it was found that the prevalence of smokers over the age of 15 has reduced from 23.1% in 2011 to 22.8%, but the number of women who smoke has risen from 1% to 1.4% in the same time. However, one saving grace might be the smokeless tobacco product usage increasing sharply from 0.7% to 10.9% through e-cigarettes.


Malaysia's population is aging and although annual birth rates have been decreasing, its population is still increasing. By 2040, it is projected that Malaysia's proportion of population 65 years and above will rise to 11.4% of the total population. The government has traditionally held a deep-seated commitment to eradicate poverty and develop human capital, and has provided the means to achieve these aims. Nonetheless, there seems to be a shift toward the eventual corporatization of public-sector facilities, where market forces dictate the price, extent, and quality of the services offered. The ultimate aim would be for the government to play only a regulatory, monitoring, and facilitator role to safeguard the welfare of its citizens.


Malaysia is now home to six JCI-accredited hospitals, with aggressive plans for private facility expansion over the next five years, taking advantage of the strong position Malaysia holds and cementing its position as a medical tourism destination. Part of this is due to the stringent regulations and standards that have been set by the ministry over the years. All legislation has been benchmarked against the highest standards in the world. The most successful private sector operators have adopted this expectation of excellence with many holding accreditation from the Joint Commission International, the gold standard in global healthcare. It is therefore unsurprising that Malaysia was crowned the 'Medical Travel Destination of the Year' for the second year running at the International Medical Travel Journal's Medical Travel Awards in 2016. Malaysia is making its mark as the preferred medical travel destination of Southeast Asia.