The privatization of public healthcare narrative took full swing after Mahathir lead BN won the April 1982 General Elections.
In 1983, an Health Service Financing Study was commission by the govt. It was concluded in 1985. Objective of the study is to look into financing methods & ways to "optimize utilization of health resources". Apparently, the study look into various factor such as rising public expectations & demand for high cost medicine & technology.
Its recommendation were as following:
1) Setting up of National Health Security Fund(NSHF) (which Msia got a ADB $450mil soft loan)
2) Establishing National Health Council for inter-agency cooperation btwn Public & Private
3) Development of group medical services & HMOs
4) Selective privatization of medical & non medical services.
5) Decentralization & leasing of some district & general hospitals
In 1981, there were 2021 private hospital beds. By 1984, there were 3750 private hospital beds. Private share of bed of total hospital beds went from 8.6% to 12.4%(approximate). Today, private sector account for 25% of bed.
Public hospital ratio for 1980 & 1985 account for 1.7 beds per 1000 population which is lot higher than now which is approx 1.5 bed per 1000 folks. (RMK5, EPU)
Govt allocation for new hospitals decrease from $471mil btwn 1980-85 to $378mil for 1986-1990 which was clearly inadequate by its own admission. Allocation for public clinics(family health was halved from $46.7mil to $12.5mil in the same period.
Healthcare spending over govt budget decreased from 7% in 1980s to 5.1% in 1986 to 5.5% in 1990
This is also how govt consciously choose to prop up private hospitals by under-investing in public healthcare.
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