Abstract. Malaysia has a dual-tiered system of healthcare services: a government-led and funded public sector, and a thriving
private sector creating a dichotomous yet synergistic public-private model. As yet, we don’t have a unified system of universal
access to healthcare for every citizen. The public sector caters to the bulk of the population (~65%), but is served by just 45%
of all registered doctors, and even fewer specialists (25-30%). The heavily subsidised public sector is almost entirely borne by
budget allocations, with patients paying only nominal fees for access to both outpatients and hospitalisations. The private
sector on the other hand, has grown tremendously over the past 25 years. However, this two-tiered system with quite different
goals may be unsustainable in the longer term. There appears to be ambivalence as to whether to adopt a market-driven
healthcare system or to resort to single-payer National Health Service model where universal access to health care is
guaranteed. Closer partnership, collaboration and sharing of services and personnel may be the way forward. An integrated
system of medical information and expertise access may lead to greater cohesion and efficiency of healthcare services. More
cross-purchases of services should be facilitated where there are shortages. Information exchange can be made efficient
through the use of a unified system of health information portability mechanisms, while safeguarding and ensuring patient
confidentiality and privacy. Full integration of private-public healthcare sectors appears unlikely, but better partnership and
collaboration of services can be aspired to, where the best of each system can be harnessed for the healthcare betterment of
our citizens. We should aim for a more cost-effective system. A single or easily portable system of reimbursement should also
be considered.