PETALING JAYA: Universiti Teknologi Malaysia associate professor Dr Nanthakumar Loganathan said Malaysians living in rural areas continue to face financial and logistical hurdles in accessing healthcare, underscoring a deep divide between city and village households.
He said healthcare spending patterns remain “completely unbalanced” between urban and rural areas, with city dwellers enjoying easier access to specialist hospitals, private clinics, pharmacies and insurance.
“Urban households typically spend more on medicines and private services because they can afford insurance and live near pharmacies.
“For rural families, government hospitals and clinics remain their main option, as they rely on subsidised care.”
He also said while rural households may appear to spend less on healthcare overall, serious illnesses often expose families to sudden, overwhelming costs.
“They may need to travel long distances to state hospitals, face lengthy waiting lists and sometimes spend more out-of-pocket for critical treatment,” he said, adding that many must also pay for transport and overnight stays.
He said healthcare spending has become a growing source of insecurity among rural households.
Although government hospitals provide most services either free or at a minimal charge, the shortage of doctors, specialists and modern equipment in rural facilities forces patients to travel.
“This means more income lost, more time spent waiting and sometimes, poorer treatment outcomes compared with urban households.”
He also said rural families often view government hospitals as their only hope.
“The mindset of rural families is different from those in cities. They are not interested in private hospitals because such facilities are not available in rural areas and the market is not viable for private players.”
Nanthakumar said states such as Sabah, Sarawak and Kelantan are particularly vulnerable due to lower GDP per capita.
He added that while the government has rolled out initiatives such as cluster hospitals, Telehealth and e-healthcare services, particularly in East Malaysia, these remain in early stages and require stronger commitment.
“Government subsidies such as the RM1 clinic fee and the Flying Doctor service do help, but they are not enough to address rural needs. The government must improve rural transport, connectivity and healthcare infrastructure so that all communities could benefit equally.”
He urged the Health Ministry to prioritise rural and remote communities in the next national budget.
“To ensure healthcare programmes reach rural areas, the government must invest in both digital and physical infrastructure. Expanding cluster hospitals in smaller towns could also reduce overcrowding in major hospitals and bring specialists closer to underserved communities.
“Healthcare is a basic right. For rural Malaysians, the issue is not whether they want treatment, it is whether they can get it in time, without financial hardship. We must close this gap.”
For many villagers in Baram, Sarawak, access to healthcare remains a daily struggle despite the presence of community clinics.
Dora Paren from Long Kevok said her village clinic could only handle minor cases.
“Yes, in the village we do have a community clinic, so we can get basic treatment. But if it is an emergency or we need more serious care, we have to go to hospitals outside the village, such as in Long Lama or Miri Hospital.”
The journey is long, costly and often dangerous, especially during the rainy season when muddy or flooded roads become impassable.
“Sometimes, we even have to stay overnight in town if the treatment is not completed,” Dora said, adding that patchy mobile coverage also makes it difficult to call an ambulance during emergencies.
She said because of these challenges, villagers remain dependent on the limited services of the local clinic.