Sitting beside her husband in the Intensive Care Unit (ICU) of Sungai Buloh Hospital, Chan Li Jin was struck by a Facebook post, according to the letter-to-the-editor of FMT.

It was from a specialist doctor at a government hospital sharing that his cousin, also a doctor, had accepted a job overseas. This decision was far from surprising, given the significant departure of health professionals from Malaysian government facilities over recent years.

The numbers speak volumes. Health Minister Dzulkefly Ahmad revealed that between 2019 and 2023, a staggering 6,417 medical officers and 1,046 medical specialists resigned from government service. The reasons behind these resignations are multifaceted, but the overarching theme is one of frustration and disillusionment within the healthcare system.

As Chan surveyed the ICU, she observed medical staff diligently attending to patients and consoling family members. Just days earlier, the medical team had carefully outlined her diabetic husband’s critical condition following a heart attack. His situation was compounded by an infection in his amputated foot, leading to complications affecting his vital organs. Despite these challenges, the care he received was commendable, with advanced medical equipment at hand.

Initially, they had sought help at a private hospital when her husband experienced breathing difficulties. However, the financial implications were daunting. The estimated cost for ICU admission, further surgery on his foot, an angiogram, and dialysis ranged from RM50,000 to over RM120,000. Realising their insurance coverage was insufficient, arrangements were made for an ambulance transfer to the government hospital.

This wasn’t a case of inadequate planning. For over two decades, Chan’s family had been paying nearly RM400 monthly for insurance. Yet, when faced with skyrocketing private healthcare costs, they found themselves turning to an already strained public health system. This raises a pertinent question: were they too conservative in their insurance planning? And what if government hospitals weren’t nearby?

The Rakan KKM initiative by the health ministry emerges as a potential solution. Aimed at providing “premium economy” medical services within government hospitals, this initiative promises lower fees than private facilities while maintaining effective care standards. It offers hope for those caught between prohibitive private healthcare costs and overburdened public services.

Most middle-income families find themselves relying on government health services. The clarity surrounding the health system’s direction is lacking, steering it away from its core mission of patient care. Health professionals face mounting frustration as they grapple with conflicting directives. Many choose to leave for better opportunities elsewhere, while those who remain are increasingly exhausted and distressed.

Criticism of the system is constant and unrelenting, making it difficult to correct its course. Private hospitals do play a crucial role in easing the national health service’s burden. However, access to these facilities is largely dependent on insurance coverage, which only about 54% of Malaysians have, according to the Malaysia Deposit Insurance Corporation.

Chan’s experience isn’t unique. Many families have faced similar dilemmas and financial strains due to medical costs. The prospect of Rakan KKM being rolled out more widely across government hospitals brings hope. With fees lower than private institutions and efficient care provided, it may bridge the gap for many families.

As her husband continued his stay in ICU, Chan realised the importance of the government health service. Without it, they would have been overwhelmed by anxiety over both her husband’s condition and the mounting hospital bills. Countless families have been torn apart by such financial strains.

To ensure the healthcare system remains afloat, Chan urges action. She suggests empowering patients to contribute more financially by revising the outdated RM1 registration fee to RM5 or RM10. Coupled with the Rakan KKM initiative, this could alleviate some financial constraints on the public sector. It might also allow for better compensation for healthcare workers and expansion of facilities.

While the healthcare system is not sinking yet, it requires collective effort to keep it afloat. It’s a pivotal moment for all stakeholders to work together and ensure its sustainability.