Here is a summary of the budget incentives that is beneficial to our older population.

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There is a much-welcomed increased health allocation this year. For the warga emas, there are the following health benefits:

1. Increased tax exemption for adult children for their parents' medical fees (RM5000 to 8000).

2. Inclusion of vaccines such as influenza and pneumococcal within tax rebates for medical expenses

3. Increased investment in virtual consultations which may also benefit seniors.

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Welfare benefits for older persons have also increased:

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1. Bantuan orang tua goes up to RM500 from RM350.

2. The Home Help volunteer programme and Pusat Activity Warga Emas receive more allocation.

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Older persons have also been included in re-employment initiatives and employers who take on older employees receive tax cuts.

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The Malaysian Society of Geriatric Medicine would like to praise the government for producing what can be considered the most elder friendly budget to date. The increase in tax relief for adult children unfortunately only continues to promote the dependence of our older population on their adult children with 90% of older Malaysians reporting a monthly income of RM1,000 or less in the National Health and Morbidity Survey 2018- the Elderly. Anyone who has ever accessed our private healthcare system will recognize that RM8,000 barely covers even a single healthcare encounter requiring hospitalization. Our older population remains universally uninsured. Hence many will have to continue to depend on the public health system for their medical care. While we all recognize that our public health system provides excellent world class healthcare, and with the number of older persons increasing rapidly, this will continue to stretch healthcare budgets. An urgent overhaul in healthcare funding is what is urgently needed. We also approve of the decision to centralize healthcare budgets which we hope will improve efficiency and equity and also lead to more funding going toward programmes in Geriatric Medicine. Funding allocation should take into account the need to curb the negative effects that have resulted from the various movement restriction orders as well as COVID-phobia on non-COVID illnesses.

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The inclusion of pneumococcal and influenza vaccination in the tax relief on medical expenses is most welcome, and while this is merely a small step towards a national adult vaccination program, which really should be in existence, with public-funded influenza and pneumococcal vaccines for vulnerable groups. This still represents a big step in terms of recognition of the importance of preventive measures in healthcare for adults and that vaccines are not just for children. This may just be the turning point towards a proactive rather than a responsive healthcare system. Furthermore, any initiative to promote adult vaccination is likely to benefit older persons the most, as they are the ones far more likely to succumb to pneumonia and flu. The budget speech, however, appeared to mention individual, spouse and children, and did not specify tax relief for parents’ medical bills. As it makes little sense to include vaccinations in one and not the other, we do hope that this was a mere oversight, and that adjustments will be made in future in the implementation to include vaccinations such as pneumococcal and influenza in tax relief for medical bills for parents.

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Investments in telehealth and telemedicine through the enhancement of virtual clinic capabilities within the public health system is a welcome move. This initiative is also likely to benefit older adults whose family members struggle to facilitate their travel to clinic appointments with traffic jams, parking, accessibility of buildings, and difficulty obtaining time off work being among some of the issues. Being able to consult virtually will therefore, hopefully, be here to stay even after the COVID-19 pandemic. Training is very much required, however, for our healthcare professionals, who may view this change with trepidation as many do not possess the requisite IT skills and even fewer feel they possess the competency to conduct consultations virtually. With the limited numbers of geriatric specialists- meaning not just doctors but also allied health professionals with specific geriatrics training, telehealth and telemedicine will remove geographical boundaries, increasing and speeding up the likelihood of older persons residing in remote areas at both sides of the South China Sea accessing specialist geriatrics care.

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Our verdict on Budget 2021?  6 out of 10!  Good effort, feels a bit like too little too late, but nevertheless it is better late than never.