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. 2008 Jun 9:7:15.
doi: 10.1186/1475-9276-7-15.

Equity in health care financing: The case of Malaysia

Chai Ping Yu  1 , David K Whynes, Tracey H Sach
Affiliations

Equity in health care financing: The case of Malaysia

Chai Ping Yu et al. Int J Equity Health. .

Abstract

Background: Equitable financing is a key objective of health care systems. Its importance is evidenced in policy documents, policy statements, the work of health economists and policy analysts. The conventional categorisations of finance sources for health care are taxation, social health insurance, private health insurance and out-of-pocket payments. There are nonetheless increasing variations in the finance sources used to fund health care. An understanding of the equity implications would help policy makers in achieving equitable financing.

Objective: The primary purpose of this paper was to comprehensively assess the equity of health care financing in Malaysia, which represents a new country context for the quantitative techniques used. The paper evaluated each of the five financing sources (direct taxes, indirect taxes, contributions to Employee Provident Fund and Social Security Organization, private insurance and out-of-pocket payments) independently, and subsequently by combined the financing sources to evaluate the whole financing system.

Methods: Cross-sectional analyses were performed on the Household Expenditure Survey Malaysia 1998/99, using Stata statistical software package. In order to assess inequality, progressivity of each finance sources and the whole financing system was measured by Kakwani's progressivity index.

Results: Results showed that Malaysia's predominantly tax-financed system was slightly progressive with a Kakwani's progressivity index of 0.186. The net progressive effect was produced by four progressive finance sources (in the decreasing order of direct taxes, private insurance premiums, out-of-pocket payments, contributions to EPF and SOCSO) and a regressive finance source (indirect taxes).

Conclusion: Malaysia's two tier health system, of a heavily subsidised public sector and a user charged private sector, has produced a progressive health financing system. The case of Malaysia exemplifies that policy makers can gain an in depth understanding of the equity impact, in order to help shape health financing strategies for the nation.

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Figures

Figure 1
Figure 1
Households' Financial Contributions to Health Care System in Malaysia.
See this image and copyright information in PMC

References

    1. Hurley J, Feeny D, et al. Introduction to the concepts and analytical tools of health sector reform and sustainable financing, Centre for Health Economics and Policy Analysis, McMaster University. 1998.
    1. Van Doorslaer E, Wagstaff A, et al. Equity in the finance and delivery of health care: An international perspective. New York: Oxford University Press; 1993.
    1. Hurst JW. The reform of health care: A comprehensive analysis of seven OECD countries. OECD Paris. 1991.
    1. Hurst JW. Reforming health care in seven European nations. Health Affairs. 1991;10:7–21. doi: 10.1377/hlthaff.10.3.7. - DOI - PubMed
    1. Ministry of Health . National Healthcare Financing Conference 2002. Financing healthcare in Malaysia: The way forward. Pulau Pinang, Malaysia; 2002. 19–22 June 2002.

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