Malaysia health reform socio-economics (Part 3)

— David Quek
The Malaysian Insider
Feb 09, 2012

FEB 9 — Ability-to-pay model in healthcare financing

Ability-to-pay encompasses the concept that people or households would choose an economic activity or service according to their capacity to afford such an activity based on their perceived hierarchy of needs, and also what goods or services to give up or sacrifice.

If healthcare or medical services are priced too high and are perceived as too unaffordable, health care considerations might be placed under such a low hierarchy of needs that it could be sacrificed for more urgent day-to-day needs and essentials.

That is why most countries around the world, if not all, offer a basic basket of health services (safe clean water supply and sanitation, childhood vaccinations, preventive child-maternal health services, etc), which are not taxed and are freely accessible to all, without the need to consider affordability or ability-to-pay. Thus, there is no question of having to consider these basic health services as an economic sacrifice for all income groups. The question arises as to how big or wide a basket of such health services, any country can afford to provide, without the need to impose co-payment mechanisms or additional taxes. Continue reading “Malaysia health reform socio-economics (Part 3)”

The 1 ‘S’Care scheme

— The Black Cactus
The Malaysian Insider
Feb 08, 2012

FEB 8 — In the last few weeks, there has been immense debate on the proposed national health scheme dubbed 1 Care in both the internet and the mainstream media. A collective conclusion shared by both the public and the very professionals alike (who play a major role in the system) is the uncanny ability to fully comprehend the confusing entity which remains an uncertainty till today.

This commentary was written to achieve the following objectives

1. To help the public understand why this system was proposed and what led to the genesis of this scheme;

2. If possible, to pressure the government to be more transparent in providing information on the 1 Care scheme to allay fears among the general public; and

3. To help the layperson understand the unaddressed policy issues but highly crucial perspectives surrounding the 1 Care scheme Continue reading “The 1 ‘S’Care scheme”

Malaysian health reform socioeconomics (Part 2)

— Dr David KL Quek
The Malaysian Insider
Feb 08, 2012

FEB 8 — 1 Care health reform phases

In the 1 Care Health Reform plan, there are four proposed phases of transformation that could take anything from 10 to 15 years (according to officials), depending on the uptake of the various phases and programmes, as well as its implementation progress.

Importantly, the Health Ministry increasingly understands that it would require general public acceptance, as well as significant consensus and (if possible) seamless buy-in from as many stakeholders as possible.

There is recognition that if the public fails to accept this in toto or in part, then there might be need to re-tweak or re-design certain aspects of the reform plans. Just how much the bureaucrats or our political masters are willing to change and adapt remains to be seen.

Therefore, it is crucial, indeed essential, that the public and interested stakeholders take an active role in providing enough input to help make this reform the one that they want. We should not simply accept a top-down programme designed by bureaucrats, and selectively enacted by policy makers. Why? Because, it would be disastrous if this reform fails or runs into the usual gaffes, just a few years down the line. Health care is simply too unforgiving and vital to fail or be subject to arbitrary social experimentation, no matter how good the intentions! Continue reading “Malaysian health reform socioeconomics (Part 2)”

Malaysian health reform socio-economics

— David KL Quek
The Malaysian Insider
Feb 07, 2012

FEB 7 — Is the Malaysian health system really in trouble that it requires such a drastic revolutionary change? Is 1 Care for 1 Malaysia Health Reform the answer? Will this proposed radical change make our health system more efficient and effective as touted by officials?

Or, is this proposed reform too ambitious and sweeping that it could possibly lead to severe disruptions to our current health system that we are so used to?

More importantly, would this health reform plan become another government-linked corporate entity which, instead of benefiting the public, only enriches a few favoured cronies or insiders? The difference now is that this will be a humongous multibillion-ringgit exercise and the fattest cow to milk to date!

Sadly, at this juncture in time — in the name of social development, modernisation, and economic necessity even — there have been so many government-linked projects being scandalised and mired in corruption accusations and profligate leakages.

Thus, it would be foolhardy to implicitly trust the government to do the right thing despite the economic rationale or correctness, indeed despite even the most honourable intentions! We are dealing with the health choices and rights of the public, which could become severely disrupted and endangered if or when hurried reforms turn out to be another debacle of catastrophic proportions! We cannot afford a failed social experiment of this magnitude! Continue reading “Malaysian health reform socio-economics”

1Care: What ails Malaysia’s healthcare system?

— Mustafa K. Anuar
The Malaysian Insider
Feb 04, 2012

FEB 4 — Supposedly based on the UK National Health Service (NHS), the 1Care scheme is said to be aimed at financing the supposedly increasing costs of public health care while making it still affordable to the lower-income group.

But we fear that, like most other “restructuring” schemes in the past, 1Care will deliberately result in the escalation of costs to ordinary Malaysians and the outsourcing of contracts to corporate interests — financed by public funds.

The direct beneficiaries — private hospitals, health management organisations, pharmaceutical firms and those administering the national health financing fund — are likely to profit handsomely from this scheme at the expense of the public.

We recall how the costs of pharmaceuticals soared after the Government Medical Store was privatised in 1994. A similar rise was seen in the costs of general hospital support services after they were privatised. Continue reading “1Care: What ails Malaysia’s healthcare system?”

Anti-1 Care group demands Putrajaya kill proposed healthcare scheme

By Clara Chooi
The Malaysian Insider
Feb 02, 2012

PETALING JAYA, Feb 2 – The newly-formed Citizens’ Healthcare Coalition (CHC) came out for the first time today to demand the government shelve its proposed “1 Care” insurance scheme, warning that its implementation would spell “disaster” for Malaysia’s healthcare system.

The pact insisted that the present two-tiered model was superior to “1 Care”, which it predicted would only turn healthcare management into a “business”.

“We believe the (current) Malaysian model is superior for the Malaysian environment. We do not want healthcare to be turned into a business.

“We believe there should be both public and private sectors – public as a service-oriented model and private as a corporate model… it is not possible for a service sector model to be corporatised,” Federation of Private Medical Practitioners Associations of Malaysia (FPMPAM) president Dr Steven Chow said during CHC’s maiden media briefing at the Global Business and Convention Centre here this evening.

According to CHC, “1 Care” is a new national healthcare system that will force all households to surrender nearly 10 per cent of their monthly household incomes as contribution to a government-run Social Healthcare Insurance (SHI) scheme.

The group insists that the scheme would not achieve its objective to provide equitable access to healthcare for all segments of society and would only increase costs. Continue reading “Anti-1 Care group demands Putrajaya kill proposed healthcare scheme”

Salient points – 1Care

By DrNGSC

  1. The government plans to introduce a new healthcare system called 1-Care. It includes an insurance system to fund for healthcare.
     

  2. The National Healthcare Financing Authority will be in charge of 1Care – and it is likely to be turned into a GLC.
     

  3. Based on available information, every household will be made to pay up to 9.4% of gross household income for social health insurance. The payers will be the individual, the employer and the government via taxes, exact proportion still being worked out)
     

  4. There shall be no choice. Everyone has to pay. There is no opting out. We have to pay upfront. It will no longer be fee-for-service; it is fee-before- service.
     

  5. There has been no information on exactly how this payment will have to be made or how the government will collect from self-employed people.
      Continue reading “Salient points – 1Care”

1Care: Prioritise, not privatise patient care

Dr Ng Swee Choon | Dec 24, 2011
Malaysiakini

We refer to the letter from the Director-General, Ministry of Health: ‘Gov’t not abdicating responsibilities thru 1Care’ on Dec 17.

We fully agree with the need to improve the quality and delivery of health services for the rakyat, provide more choice to patients and preserve the strengths in our current health system. Continue reading “1Care: Prioritise, not privatise patient care”

Surcharge who?

Sdr. Lim Kit Siang, You might be interested in my experience in Sabah, trying to save Government/Taxpayers’ Money:

When I was serving in Sabah, in 1989 I think it was, and called for quotations to buy ‘Dental Drills’ for use in the field by Nurses, to fill Children’s teeth. You may not know that the Children in Sabah had really very poor Dental Health, and there was an urgent need to do as much as possible, by way of stretching both equipment and personnel available. Continue reading “Surcharge who?”

5,000 private doctors call for Jeyakumar’s release

Malaysiakini | Jul 19, 11

The Federation of Private Medical Practitioners’ Associations, which represents some 5,000 private doctors nationwide, has joined hands with others in the medical profession in calling for the release of Sungai Siput MP Dr D Jeyakumar.

“We are extremely concerned at the continued detention of our colleague, Dr Jeyakumar Devaraj, whom we all recognise and acknowledge as a law-abiding, competent, kind and diligent doctor.

“His public service record is exemplary and, to the very best of our knowledge, he is certainly not a threat to our society,” the federation said in a media statement today.
Continue reading “5,000 private doctors call for Jeyakumar’s release”

Another case of police probing themselves

Malaysiakini Your Say | Jul 17, 11

‘Expecting the police to investigate the police assault on Tung Shin Hospital is like asking a robber to testify to the honesty and kindness of another robber.’

Two special police teams to probe Tung Shin claims

Sarajun Hoda: How stupid does the police think Malaysians are? The people do not trust the police anymore, so why would they trust their investigations?

It is like asking Ali Baba to investigate his 40 thieves. People do not trust Najib’s government. People do not trust the police. People do not trust the judiciary. The Agong perhaps is their last hope, and who should call for a royal commission of inquiry.

Saengch: I hope the police team sent to interrogate the doctors is not there to intimidate them into changing their words.
Continue reading “Another case of police probing themselves”

Liow, it’s all your own doing

Malaysiakini Your Say | Jul 17, 11

‘You lied with a straight face. Put simply, you shot yourself in the foot. Your lie has blown right back in your own face.’

Liow: Someone out there trying to get me

DannyLoHH: In his first public statement, the health minister used words like irresponsible, serious allegation with the aim to tarnish the name of Malaysia, if it didn’t happen means it didn’t happen, and it’s the truth to describe the non-occurring of police shooting water canon and tear-gas canister into Tung Shin Hospital compound.

The video is widely circulated online, which clearly shows that the attitude of Liow Tiong Lai is defensive of the police and dismissive of enquiries regarding mounting video and photographic evidence. In short, he has shot his own foot on TV.
Continue reading “Liow, it’s all your own doing”

Tung Shin should put people before gov’t

Malaysiakini Your Say | Jul 15, 11

‘Tung Shin missed the point: as a social entity with a mission, who should Tung Shin entertain first – the police or those who need help?’

Doctors: We’ll produce more evidence if challenged

Cala: Honorary secretary of Tung Shin Hospital board Chong Teck Hong has turned Tung Shin into a state apparatus.

From Chong’s perspective, the assumption is that the hospital is both a private property as well as a common-pool resource. The property is privately-owned by a certain entity or corporation. It is also common-pool resource, similar to commercial shopping centres like Subang Parade, since it cannot reject anybody from entering.
Continue reading “Tung Shin should put people before gov’t”

Minister Liow, photos and videos don’t lie

Malaysiakini Your Say | Jul 14, 11

‘Fearing the consequences of being called a liar, he flipped and has pointed the finger squarely now at the Tung Shin hospital’s board.’

Liow takes tear gas explanation to Twitter

Karma: How about MCA chief Dr Chua Soi Lek who said that despite video or photo evidence, it is an optical illusion that caused people to believe that tear gas could have been fired into the hospital?

Admit it. Police, except the good ones, were too focused on firing the rounds at the people and forgot their purpose was to maintain peace. No one was violent that day and no one was throwing any stones at the police, so there was no need to attack.
Continue reading “Minister Liow, photos and videos don’t lie”

Is Liow Tiong Lai afraid of the truth?

Malaysiakini Your Say | Jul 12, 11

‘Liow, were you there? Definitely no. Were the Tong Shin Hospital board members there? No. Why don’t you ask the people who rallied on that day?’

Tung Shin Hospital ‘not hit’ in rally crackdown

Anti-Fascist: Again the administration of PM Najib Razak wants to change a truth to a lie. No ethics, no morals, no principles. Unbelievable.

So the photos and videos were lying? And the many eyewitness accounts were wrong? Were any of the board of directors at the hospital at that time?
Continue reading “Is Liow Tiong Lai afraid of the truth?”

We’ve made a big mistake, says Lynas boss

Malaysiakini | Jun 23, 11

Lynas boss Nicholas Curtis has conceded that his company made the mistake of failing to adequately engage the community in Kuantan over fears of radioactive waste from its controversial rare earth plant.

“We made a mistake, and it was a big mistake, of thinking that because we have met the (Malaysian) standards (of safety), that it was enough. It was not enough. Our obligation is to continue to engage the community in Kuantan.”

The Lynas chief’s mea culpa came after the emergence of stringent opposition to the plant, which is being built in Gebeng Industrial Estate, about 50km from Kuantan. The RM700 million plant will be completed by the end of September.

“I respect that emotions have (become) very high, but these are emotions, not facts,” said Curtis. The detractors of the project, he said, are “pushing emotional stories for political gains”.
Continue reading “We’ve made a big mistake, says Lynas boss”

Tikus Makmal in a Natural Experiment?

By Chan Chee Khoon, ScD (Epidemiology)

On June 7, 2011, in a live interview with CNN, Arnie Gundersen, a licensed nuclear power engineer with 39 years experience in managing and coordinating projects at 70 nuclear power plants in the US, noted that with the prevailing wind patterns after the Fukushima disaster’s radioactive discharges, air filter monitors in Seattle detected about half the level of “hot” (radioactive) suspended fine particulates as were detected in the air over Tokyo, 7700 km away.

Gundersen didn’t clarify what the baseline level of airborne radioactive particulates in Seattle was, pre-Fukushima, but if the measured levels in April 2011 were indeed largely blown over from Fukushima, it’s very sobering considering that Kuantan and Kemaman are within a 28 km radius of the Lynas rare earths refinery being built at Gebeng, which will be handling rare earth concentrates ground and milled into a fine powder for acid extraction at the plant.

The ARE experience from Bukit Merah in the 1980s tells us that beyond the dust-generating cracking, grinding and milling operations, powdery thorium cake waste was also spilling onto roads during transportation, during packing and unpacking, loading and unloading, and children were frequently playing in the vicinity of exposed mounds of the waste. Indeed, the thorium waste was reportedly offered to local farmers as fertiliser.
Continue reading “Tikus Makmal in a Natural Experiment?”

Our health and lives in exchange for FDIs

Malaysiakini Your Say | Jun 2, 11

‘We sometimes marvel at how parents in some Asean countries are willing to sell their daughters into prostitution in return for a few dollars. Now we know.’

Panel: Waste won’t be 100% radiation-free

Swipenter: “It is not easy to do a study on the impact of health from a rare earth plant as it requires a large number of samples and a long duration of study to demonstrate statistically significant results.”

The rare plant in Bukit Merah is not proof or good enough to show the negative effects on health on a long-term basis? This panel is just a eyewash – they cannot even name one safe rare earth plant anywhere in the world.
Continue reading “Our health and lives in exchange for FDIs”

MMA concerned Lynas plant will wreak harm

By Yow Hong Chieh | May 26, 2011
The Malaysian Insider

KUALA LUMPUR, May 26 — The Malaysian Medical Association (MMA) stepped into the controversy today over Australian miner Lynas’ rare earth plant near Kuantan, expressing “grave concern” that waste products could wreak harm on those living nearby.

The association, representing the country’s 13,000 doctors, stressed that the possible health risks presented by radiation from “extremely toxic” thorium outweighed the economic benefits from the project.
Continue reading “MMA concerned Lynas plant will wreak harm”

1Care: Unhealhy lack of public engagement

By Dr Helmy Haja Mydin | May 20, 11
Malaysiakini

One of the essential features of a successful healthcare system is the presence of a well-organised primary care service that provides comprehensive services to the public that it serves.

Primary care services are usually delivered by a general practitioner(GP) and should ideally deal with a wide range of healthcare issues, from dealing with minor acute ailments to keeping a lid on the development of chronic illnesses.
Continue reading “1Care: Unhealhy lack of public engagement”