Towards a Sustainable Healthcare System: A Concept Paper for a National Hybrid Financing Model for Malaysia

Moideen, Mohd Arshil; Wan Mohd Abdullah Yaakob, Wan Nadiah; Malek, Khasnur Abd

doi:10.34172/ijhpm.9223

Towards a Sustainable Healthcare System: A Concept Paper for a National Hybrid Financing Model for Malaysia

Document Type : Viewpoint

Authors

Mohd Arshil Moideen ¹

Wan Nadiah Wan Mohd Abdullah Yaakob ²

Khasnur Abd Malek ³

¹ Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia

² Independent Researcher, Kuala Lumpur, Malaysia

³ Primary Care Medicine Department, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia

10.34172/ijhpm.9223

Keywords

Hybrid Healthcare System

National Social Health Scheme

Public-Private Partnership

Hybrid Healthcare Financing

Introduction

This concept paper for a hybrid healthcare financing system directly responds to the Malaysia Madani Government’s call for comprehensive, conceptual frameworks to diversify funding for public healthcare services.¹ While the government has made serious attempts at reform, including the proposed National Health Insurance under the broader National Health Financing Scheme,² no concrete steps have followed. ...(Read more...)

Tee K. Ministry proposes national health insurance to help pay Malaysia’s medical bills. Malay Mail. June 13, 2023. https://www.malaymail.com/news/malaysia/2023/06/13/ministry-proposes-national-health-insurance-to-help-pay-malaysias-medical-bills/74088. Accessed April 17, 2025.
Rahman MRKA. Why Malaysia needs a national health care financing scheme. CodeBlue. December 13, 2024. https://codeblue.galencentre.org/2024/12/why-malaysia-needs-a-national-health-care-financing-scheme-dr-mohamed-rafick-khan-abdul-rahman/?utm_source=chatgpt.com. Accessed April 17, 2025.
Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J. Malaysia Health System Review. Geneva: World Health Organization Press; 2013.
Isamail N, Said R. Health insurance effects on out-of-pocket health expenditure among the low-income groups in Malaysia. Malays J Med Health Sci. 2025;21(1):103. doi:47836/mjmhs.21.1.14
Mohd Nordin M. 2023 health budget remains stagnant against GDP. CodeBlue. October 10, 2022. https://codeblue.galencentre.org/2022/10/2023-health-budget-remains-stagnant-against-gdp-dr-musa-mohd-nordin/. Accessed April 17, 2024.
Mukhriz IS. Rising medical premiums: can it be cured? Khazanah Research Institute Views. 2024; 55/24. Kuala Lumpur: Khazanah Research Institute. Published December 21, 2024.
Investor updates. 2025 analyst briefing. AMB 2024 Q4 analyst briefing website. https://www.allianz.com.my/personal/allianz-at-a-glance/investor-relations/investor-updates.html. Accessed May 1, 2025.
IHH Healthcare. Reports: Results briefing presentation – 2023 full year financial results of IHH Healthcare Berhad. https://www.ihhhealthcare.com/investors/reports-presentation/reports-and-presentations. Accessed May 1, 2025.
Ministry of Health Malaysia. Malaysia National Health Accounts: Health Expenditure Report 2011–2022. 2024. https://www.moh.gov.my/moh/resources/Penerbitan/Penerbitan%20Utama/MNHA/MNHA_2011-2022.pdf. Accessed July 26, 2025.
ReportLinker. Forecast: out-of-pocket health expenditure in Malaysia. https://www.reportlinker.com/dataset/3a39175be070baf179afa01876d7524e8b0fc2ff#:~:text=%5BXLS%20+%20PDF%5D%20Forecast:,Health%20Insurance%20Industry%202025%2D2029. Accessed August 10, 2025.
Jamal MH, Abdul Aziz AF, Aizuddin AN, Aljunid SM. Gatekeepers in the health financing scheme: assessment of knowledge, attitude, practices, and participation of Malaysian private general practitioners in the PeKa B40 scheme. PLoS One. 2023;18(10):e0292516. doi:1371/journal.pone.0292516
Economic Planning Unit Malaysia. Rancangan Malaysia Kesebelas Bab 3: Memperkukuh inklusiviti ke arah masyarakat yang saksama. Putrajaya: Economic Planning Unit Malaysia; 2016. https://www.epu.gov.my. Accessed July 22, 2025.
Bedi RS. A shortage of surgeons in Malaysia’s public hospitals may further impact patients’ quality of care, say experts. Channel News Asia. July 17, 2024. https://www.channelnewsasia.com/asia/malaysia-doctors-specialists-shortage-surgeons-healthcare-parallel-pathway-4482481. Accessed April 19, 2025.
Radhi NAM. 1:400 doctor-to-population ratio target reachable, says former deputy health minister. New Straits Times. July 2, 2024. https://www.nst.com.my/news/nation/2024/07/1071340/1400-doctor-population-ratio-target-reachable-says-former-deputy-health. Accessed April 19, 2025.
Mukhriz IS, Gong R. Putting patients first: principles for electronic health records in Malaysia. Kuala Lumpur: Khazanah Research Institute; 2023. https://www.krinstitute.org/assets/contentMS/img/template/editor/20231201%20Principles%20for%20EHR%20in%20Malaysia.pdf.
Patcharanarumol W, Panichkriangkrai W, Sommanuttaweechai A, Hanson K, Wanwong Y, Tangcharoensathien V. Strategic purchasing and health system efficiency: a comparison of two financing schemes in Thailand. PLoS One. 2018;13(4):e0195179. doi:1371/journal.pone.0195179
World Health Organization Western Pacific Region. Health financing country profiles in the Western Pacific Region 1995–2011. 2014. https://iris.who.int/bitstream/handle/10665/208114/9789290616740_eng.pdf. Accessed July 26, 2025.
Social Security Organization (SOCSO) Malaysia. Organisation profile. https://www.asean-ssa.org/files/Organisation%20Profiles/SOCSO%20Malaysia.pdf. Accessed July 19, 2025.
Laws of Malaysia. Act 586 Private Healthcare Facilities and Services Act 1998. 1998. https://i-lib.imu.edu.my/mod/page/view.php?id=458#:~:text=The%20Private%20Healthcare%20Facilities%20and,that%20patients%20receive%20appropriate%20care. Accessed July 26, 2025.
Mehmood A, Ahmed Z, Ghailan K, Dohare S, Varghese J, Azeez FK. Implementation of healthcare financing based on diagnosis-related group in three WHO regions; Western Pacific, Southeast Asia, and Eastern Mediterranean: a systematic review. J Health Manag. 2023;25(3):404-413. doi:1177/09720634231168250
Chua HT, Tan CC. The Malaysian DRG casemix system: financial implications of inaccurate coding. Med J Malaysia. 2007;62(Suppl A):59-65.
Ghahramani A, de Courten M, Prokofieva M. The potential of social media in health promotion beyond creating awareness: an integrative review. BMC Public Health. 2022;22:2402. doi:1186/s12889-022-14885-0
Hang CC. [Columnist] The WBB system: a symptom of deeper failures in public healthcare policymaking. Awani International. January 25, 2025. https://international.astroawani.com/malaysia-news/columnist-wbb-system-symptom-deeper-failures-public-healthcare-policymaking-505916. Accessed April 20, 2025.