Since 1957, Malaysian citizens have become accustomed to a de facto entitlement to publicly provided and highly subsidized health care and the country’s primary healthcare system is one of the most accessible in the world. In recent years, Malaysian government agencies have acquired controlling stakes in major for-profit healthcare enterprises. The Johor state government, for instance, controls a large diversified healthcare conglomerate which includes the largest chain of private hospitals in the country. Meanwhile, the Malaysian federal government’s sovereign wealth fund (Khazanah) controls the second largest listed private healthcare provider in the world. Government-linked companies now account for more than 40 per cent of ‘private’ hospital beds in Malaysia.
This novel situation raises many intriguing questions: Is this a “nationalization” of private enterprises in human services, or an infusion of the ethos and logic of capital into the institutional dynamics of the state? How are conflicts of interests playing out, as the state juggles its multiple roles as funder and provider of public sector health care, as regulator of the healthcare system, and as prime investor in the for-profit health services industry? Is a targeted approach to publicly provided services (as opposed to a universalistic approach) an attempt to harmonize the state’s competing priorities in public and private sector healthcare?