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Healthcare is getting more expensive, while public hospitals struggle with overworked staff 

WE’VE all heard it before: Health is wealth. And honestly, right now, in Malaysia, it couldn’t ring truer. Think about it — without good health, everything else in life takes a back seat. Your career ambitions, financial stability, family life, even the simple peace of mind we all crave, can quickly crumble if your health falters. But when we zoom out from individual lives to the national scale, the question becomes bigger: How do we ensure everyone in the country can stay healthy without going broke? 

This is the challenge Malaysia is facing today. Across the board, our healthcare system is being tested. Private healthcare costs keep climbing, insurance and takaful premiums are rising and our public hospitals are stretched so thin that doctors, nurses, and allied health staff are constantly overworked. This isn’t just a policy issue — it’s a reality that touches every Malaysian household, and it’s changing how we define “wealth” in terms of health. 

Protection That’s Getting Harder to Afford

Most of us rely on some form of health coverage, whether it’s private insurance or takaful. Ideally, these are supposed to offer a safety net, spreading risk so that no single family is crushed by medical bills. But over the past few years, premiums have been rising at a pace that feels almost relentless. 

Medical inflation — essentially the rate at which healthcare costs rise — has been averaging around 15% in 2023 and 2024, which is higher than general inflation and faster than the Asia-Pacific regional average. That means that every time we think we’re covered, our coverage costs more, and in some cases, offers less than before. 

Take the example of a young professional in Kuala Lumpur who has a standard medical insurance policy. Two years ago, their monthly premium might have been RM300. Now, it could be RM420 or even RM450, depending on the plan. For a single person, that’s a significant increase, but for a young family, the numbers start to add up quickly. 

It’s not surprising, then, that policy cancellations are rising. Between January 2024 and June 2025, more than 340,000 Malaysian insurance and takaful policies were surrendered because premiums became unaffordable. Many middle-income households find themselves caught in a difficult middle ground: They don’t qualify for government subsidies, but paying for private healthcare or insurance is a stretch. Even families in the top 20% of income group (T20) earners are sometimes opting back into public hospitals because private care has become prohibitively expensive, placing further strain on an already overburdened system. 

The takaful sector has also been sounding alarms. When medical costs rise faster than contributions, the pooled funds that support takaful plans face significant strain. Companies are left with no choice but to raise premiums or tighten coverage. 

There are attempts to address this problem. For instance, the Malaysian government has proposed the Medical and Health Insurance/Takaful (MHIT) base plan, which aims to create more affordable benchmark products and even allows Malaysians to use Employee Provident Fund (EPF) savings to pay premiums. While this is a step in the right direction, critics argue that it doesn’t tackle the root causes of rising costs — the structural issues in healthcare pricing and delivery that continue to push premiums upward. 

Health Costs Keep Outpacing Coverage

The problem isn’t just about rising premiums. The very structure of insurance and takaful can be vulnerable in times of rapid cost increases. 

Here’s why: When healthy people drop coverage because premiums are too high, the pool of insured becomes riskier. The remaining insured population tends to have higher healthcare needs, which drives premiums even higher — a classic case of “adverse selection.” On top of that, many 

private hospital services operate on fee-for-service pricing. As treatment costs rise, insurance payouts rise with them, and any reform that doesn’t address the underlying cost of care itself is unlikely to succeed. 

For example, consider the cost of a common procedure like an appendectomy in a private hospital. Five years ago, the surgery might have cost RM8,000. Today, with advanced equipment, hospital fees and post-operation care included, the same procedure can easily exceed RM15,000. If insurance premiums rise in response, many families will either pay more out-of-pocket or delay coverage altogether. 

And this isn’t just a financial problem; it’s a matter of equity. When insurance is out of reach for a growing portion of society, access to timely care becomes stratified by wealth. People delay treatment, conditions worsen and eventually, the public system bears the extra burden. 

Public Healthcare — A Lifeline Stretched Thin

Malaysia’s public hospitals and clinics have long been the backbone of equitable healthcare access, providing subsidised care to anyone who needs it. But these lifelines are under significant strain. Programmes like Rakan KKM, designed to link private and public capacity, have highlighted just how limited resources are. 

Staff shortages are a major part of the problem. Many hospitals are short of doctors, nurses and allied health professionals. Some regions report nurse-to-patient ratios far below the optimal standard, leaving hospitals struggling to meet demand. 

The consequences are all too visible. Patients face long waits for consultations, delayed elective surgeries and crowded emergency rooms. Staff burnout is increasingly common, with clinicians juggling heavy caseloads that compromise both care quality and their own well-being. 

Even though Malaysia produces many healthcare graduates every year, the public sector struggles to retain them. Contract work, limited career progression and modest salaries push many into private practice or overseas opportunities, leaving public hospitals further understaffed. This internal “brain drain” directly impacts service quality and access for everyday Malaysians. 

For example, in states like Selangor and Johor, patients sometimes wait weeks — even months — for non-emergency procedures like cataract surgery or joint replacements. Meanwhile, emergency rooms see overcrowding because primary care clinics can’t handle the patient volume. 

The Ripple Effect 

Staff shortages and stretched public hospitals don’t just affect queues; they have ripple effects throughout life and the economy. Delayed care can turn manageable health issues into chronic problems, lowering quality of life and productivity. 

Families without insurance face high out-of-pocket expenses that eat into savings, sometimes forcing them to take loans or cut back on other essentials. In many ways, rising healthcare costs act like an invisible tax on households, draining both financial and health “wealth.” 

Consider the case of a middle-income family whose teenage child develops asthma. Without timely treatment, the condition worsens, leading to hospitalisations that can cost thousands of ringgit. If insurance coverage isn’t comprehensive or affordable, this family may face debt, missed workdays and long-term health consequences — a situation all too common in Malaysia today. 

Moving Beyond Quick Fixes

If health is truly wealth, Malaysia needs more than band-aid solutions. Capping premiums or offering base plans are useful stopgaps, but they won’t solve the structural challenges. 

First, private healthcare pricing needs transparency and regulation. Unchecked fees fuel both rising insurance premiums and public dissatisfaction. Without controlling the cost of treatment itself, coverage reforms alone can’t keep healthcare affordable. 

Second, the public healthcare workforce must be strengthened. This means better pay, clear career paths, improved working conditions, and incentives for underserved regions. Programmes that retain talent in public hospitals will help ease capacity issues and reduce burnout. 

Third, it’s time to rethink healthcare financing in Malaysia. A national conversation on sustainable, equitable funding — whether through universal coverage, hybrid models, or public-private partnerships — could ensure that no Malaysian loses health or financial stability because of illness. 

Potential Solutions 

Some examples abroad show that creative solutions are possible. In Singapore, the MediShield Life programme provides basic insurance coverage for all citizens, supported by government subsidies for lower-income groups. Thailand’s Universal Coverage Scheme has similarly expanded access while controlling costs. 

Locally, Malaysia could expand programmes like Rakan KKM, pairing public hospitals with private resources, while improving workforce retention strategies and investing in preventive care programmes. Emphasising preventive medicine — vaccinations, chronic disease management and health education — could also reduce the long-term strain on both public and private healthcare systems. 

Why Optimism Matters 

Affordability, accessibility, and quality are the pillars of a strong healthcare system. Right now, Malaysia is navigating rising private costs, overworked public hospitals and unequal access. But there is reason to be optimistic. 

Policy reforms under the MHIT framework, increased healthcare budgets and growing public discussion show that solutions are within reach. What remains essential is a shared commitment — from the government, private sector, and citizens — to ensure that good health isn’t a privilege, but a right for all. 

At the end of the day, health isn’t just a personal asset. It’s the foundation for social and economic well-being. Only when Malaysia can ensure access, affordability and quality care for all citizens can we truly live the adage: Health is wealth — not just in words, but in practice. 

• Intan Baha is the chief sub-editor/ production editor of The Malaysian Reserve.

• This article first appeared in The Malaysian Reserve weekly print edition

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IF YOU could safely implant a chip in your brain to enhance your intelligence, would you? 

Some of Silicon Valley’s most powerful technologists want that future, including Elon Musk, who recently said he would ramp up production of his Neuralink brain chips this year as part of a noble effort to ensure humans can keep pace with superintelligent artificial intelligence (AI) systems that might one day go awry. Fellow billionaire Alexandr Wang, who is leading Meta Platforms Inc.’s program to build such systems (the good kind) wants to delay having kids until Neuralink or similar tech can augment their intelligence, capitalizing on the neuroplasticity of their developing brains. A venture capitalist once told me the true advantage of AI would come when you could plug it directly into your mind, making you the smartest person in the room. 

This pattern should feel familiar. Silicon Valley has invested trillions in building artificial general intelligence, despite no consensus on what AGI even means (and companies are now quietly backing away from the term). A similar dynamic is emerging with brain-computer interfaces: Grandiose visions built on conviction rather than strong evidence. 

Neuralink’s head surgeon Matthew MacDougall, for instance, told the Andrew Huberman podcast that pharmacological agents like LSD and psilocybin are more promising for plasticity research than electrodes-based chips, and that “you’re never going to get that broad targetability with any electrodes that I can see coming in our lifetimes.” Notwithstanding the obvious ethical problem of permanently “boosting” the brain of a child who can’t give consent, MacDougall suggests that Wang may be planning a family around capabilities that don’t work as imagined. 

But the enhancement dreams are not entirely fanciful when you look at how much the brain tech industry has grown. Global venture capital investment in neurotechnology, which includes brain-computer interfaces and neurostimulation devices, rose to US$2.3 billion (RM9.05 billion) in 2025 from US$293 million a decade earlier, according to market intelligence firm Pitchbook. The number of players in the field has grown sixfold, said Marcello Ienca, a professor of AI ethics and neuroscience at Technical University Munich, with most large technology companies investing in neurotechnology. 

Like other forms of technology that initially targeted people with disabilities then went mainstream — including the mouse and text-to-speech software — neurotech is also expanding from treating clinical issues like paralysis to enhancing the lives of people who are fit and well. Meta’s neural wristband can read electrical signals from muscles to control devices, while Apple has been awarded a patent for AirPods that can monitor brain activity and Bryan Johnson’s Kernel has developed a US$50,000 helmet for brain monitoring. 

Outlandish as they sound, Wang and Musk’s ideas are technically plausible. Ienca points to studies that have shown that non-invasive stimulation, typically with a help of a headset and electrodes, can slightly improve concentration and memory. Carolina Aguilar, who runs a Barcelona-based brain chip startup called INBRAIN focused on treating Parkinson’s and other diseases, says such tech could indeed help augment human intelligence one day, potentially with the help of large language models. “ChatGPT is offering memory, and memory is the opening of higher intelligence,” she said. 

But priorities matter. When asked about Musk and Wang’s visions of the future, Aguilar adds, rather diplomatically, that she’ll keep her company concentrated on eradicating disease before trying to optimise humans who are healthy. 

That would be especially wise if the tech company implanting a brain chip happens to be an advertising concern. The brain is the largest data repository in the world, and the race to enhance it will almost certainly be propelled by a race to mine it. Most brain-computer interface firms are focused on decoding information from inside our skulls, said Aguilar. That may open the door for such technology to usher in a strange new chapter of the data economy. 

Online advertisers typically build psychographic profiles on people based on their behavioural data. “They reverse engineer intentions,” said Ienca. “Now with brain data we can look straight into the source and collect data that most directly correlates to our intentions and beliefs.” 

Such data, if decoded on a device with mainstream popularity, would represent a new frontier for human privacy — or lack thereof. Our autonomy would be on the menu, too. Aguilar’s company is one of the rare few that can change neural activity, using deep-brain stimulation to treat Parkinson’s. She is sticking to clinical treatment, but what’s to stop other firms using such capabilities for a hyper-targeted form of marketing to manipulate intent? 

A kind of hybrid intelligence is technically feasible, but whether it manifests as mutually beneficial or parasitic on the part of a corporate giant depends largely on who controls the interface. Technologists shouldn’t slow down neuro-technology for clinical purposes and people in genuine need. But for healthy adults seeking a competitive advantage, and especially non-consenting children, the evidence points more darkly to a harmful trade-off that is best avoided. — Bloomberg

• This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

• This article first appeared in The Malaysian Reserve weekly print edition

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