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Malaysians fear 2-tier hospitals as government pushes paid-for services: ‘change is coming’

While the government argues it needs to generate income to meet future needs, critics warn of compromised care and a widening gap in service quality

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A male patient with heart pain speaks to a specialist in hospital. Malaysia’s proposal to expand paid services in public hospitals has sparked fears of a two-tier system. Photo: Shutterstock

A government proposal to expand full-paying services at Malaysia’s public hospitals has raised concerns about diverting resources from an already struggling service and the potential entrenchment of a two-tier healthcare system.

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Health Minister Dzulkefly Ahmad told the World Cancer Congress in Geneva on September 17 that Malaysia needs a paid-for service to ensure the country’s tax-funded health system “actually generates income” and can meet future needs.

Currently, patients pay a token fee of 1 ringgit (US$0.25) for a hospital visit or 5 ringgit to see a specialist at government facilities.

The government has repeatedly stated that it is struggling to maintain this status quo, citing rising costs and the medical needs of an ageing population as factors stretching resources thin and leading to deteriorating services.

But senior medical workers have warned about the inherent risks in damaging service delivery by bolstering the two-tier system.

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“If specialists used their time for the full-paying patients, it would mean that other patients would not be cared for and younger colleagues would have to shoulder that burden,” consultant paediatrician Amar Singh HSS told This Week in Asia.

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