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Table 2.5
Australia, Malaysia, and Singapore comparison

Country Key Features of Health Strategic Purchasing Policies & Frameworks
Financing System

Australia How is the healthcare Since 2004, Medicare Chronic Disease Management
system financed? programme has offered Australian patients with
chronic or complex diseases access to 13 allied health
Mostly financed through professions via private clinics on referral from their
taxation, and earmarked general practitioner – with costs subsidised by
income tax (Medicare levy). Medicare.

Medicare levy is 2% of • Who is the purchaser?
personal taxable income and
other tax revenues. Medicare The Australian government (Medicare).
is the universal public health • What to purchase and from whom to purchase?
insurance programme.
Accredited allied health providers via private clinics.
Public hospitals are primarily The allied health providers include: aboriginal health
funded by the states, worker, audiology, chiropractic, diabetes educator,
territories, and government. dietetics, exercise physiology, mental health worker
(including social worker or mental health nurse),
Government policies occupational therapy, osteopathy, physiotherapy,
encourage enrollment in podiatry, psychology and speech pathology.
private health insurance,
including age-adjusted, • How to purchase?
means-tested rebate for PHI Fee-for-service
premiums, tax penalties (the
“Medicare Levy Surcharge”)
for higher-income earners
who do not take out
insurance, and premium
surcharges for people who
take out PHI after age 30.

Malaysia How is the healthcare PeKa B40 Scheme: Contracts private GPs to conduct
system financed? NCD screenings (hypertension, diabetes, cancer) for
low income residents aged 50+. Private clinics/GPs
Malaysia has combined must sign up as a PeKa B40 clinic to participate.
government-funded public Patients can be referred back to public sector
delivery of services with the healthcare facilities if their case is severe. M&E still
parallel delivery of privately ongoing (scheme launched in spring 2019)
funded private services; a
low level of government Social Security Organization Health Screening Program
financing for health (SOCSO HSP) Voucher programme is a government
(2.2 percent of gross voucher programme offered to all SOCSO members
domestic product [GDP] in who are 40 years age and above for NCD screenings,
2012); and reliance on a high such as for cardiovascular diseases, diabetes, and
share of financing from cancer. Receive voucher from your employer and
household out-of-pocket redeem at nearest private GP.
spending (35 percent of total
expenditure on health). • Who is the purchaser?
The Malaysian government.
Mostly financed through
taxation: direct taxes (60%) • What to purchase?
such as income taxes, and
indirect taxes (40%) such as There are mainly two types of services to purchase,
sales taxes. health screening and medical equipment that are
required in procedures/treatments.
• From whom to purchase?
Private or government clinics who have registered as a
participating PeKa B40 clinic. In order to engage
private clinics in PeKa B40, the MOH contracts directly
with private GPs for their participation.
• How to purchase?
Fee-for-service

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