The Politics of Privatization in the Malaysian Health Care System

Abstract

Despite a strong commitment, for both ideological and pragmatic reasons, to of state enterprises and services, and pronouncements that public health care services would be privatized, Malaysian Government has introduced only a selective degree of in health Haemodialysis, pharmaceutical distribution and hospital support services have been transferred to private Several privatized entities have links with dominant party in ruling coalition government. Moves to privatize public hospitals have politicized health care policy in Malaysia and generated opposition from interest groups and demands for greater public consultation in policy-making. Both political and practical factors have restrained government from introducing wider policies within health Introduction Health encompasses high politics of very role of state in providing health care to its citizens: extent to which Malaysia's historical welfare model of public health care is to be replaced by one in which individuals and employers are responsible for health care costs and services provided by private, rather than public, Any radical change in role of state as a provider of public health care poses problems of political legitimacy for a ruling coalition which has historically projected itself as delivering socio-economic benefits to population and especially to its principal constituency, rural Malays. Organized opposition to health from medical, consumer and trade union interest groups and inclusion of health care in common manifesto of four major opposition political parties have demonstrated growing politicization of health care policy, which had previously escaped levels of political conflict which c haracterized such policy areas as education, culture and economics. Moreover, an investigation into how health policy has been made tells us much about political culture of Malaysia which, despite country's rapid industrialization and socio-economic development, is still characterized by reluctance of government decision-makers to consult with consumer interests and to open their decisions to a degree of public scrutiny. Finally, an exploration of ways in which has been carried out in health reveals close political linkages of many of successful tendering consortia with United Malays National Organization (UMNO), dominant party in Malaysia's ruling coalition government. It is important to explore some of meanings of term In its general application, Malaysian Ministry of Finance has defined in very broad terms as the transfer of public activities and functions to private sector. [1] More specifically, as Jomo has pointed out in his discussion of wider Malaysian experience, term privatization can be applied to a range of measures, including actual sale of state enterprises, leasing out assets, joint public--private ventures, private financing of projects, ending public monopolies, and contracting out to private of services previously provided by public [2] The concept of applied to health system has attracted a number of definitions. Scarpaci conceptualizes it in terms of a shift away from public sphere, defining it as reduced levels of public provision, subsidy or regulation of either preventative or curative health services. [3] Muschell points out that the encouragement of financing and provision of health services by private sector can also be regarded as a form of privatization. [4] In case of Malaysian health care system, a number of elements of can be identified in actions and articulated policy intentions of government. …