Fixing our healthcare system

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Posted on 23 February 2012 – 03:17am

Natalie Shobana Ambrose

“WHEN you’re older, this is where you spend all your money,” said the couple next to me as they compared my one purchase at the pharmacy to their bags of medication and vitamins.

I’m inclined to believe them especially after my cousin pointed out that the conversations at family get-togethers in recent times revolve around what medication the senior relatives are on which is usually followed by a brief assessment of our healthcare system, cost, efficiency and which doctors, clinics, hospitals are knowledgeable, affordable and have shorter queues.

There has been plenty of talk about healthcare around the world which has inevitably triggered us to think about our healthcare system. Not so long ago, the United States was debating Medicare reforms nicknamed “ObamaCare” and it seemed like a long, painful reform with many criticisms.

Downing Street is trying to reform its National Health Service (NHS) which has drawn widespread criticism especially since Prime Minister David Cameron is insistent on going ahead with the restructuring efforts.

All this is a constant reminder that healthcare is a prickly subject. And a prickly subject for everyone not just certain governments.

Here on our shores the healthcare debate has been heightened by a loose statement which abruptly introduced most Malaysians to 1Care – the proposed name for Malaysia’s healthcare reforms. It drew a lot of speculation and concern from the public with little concrete information and is now seen as another running bad news story for the government.

The reality is that publicly subsidised healthcare is expensive for the government and reforms are inevitable in this economic climate especially with healthcare costs projected to escalate. Even though some statistics confirm that Malaysia’s healthcare is 40% cheaper than that of Singapore it does not mean that it is affordable for every Malaysian.

Many Malaysians would agree that healthcare reform is necessary. Perhaps the current system is not sustainable and the truth is every system has room for improvement. The question is how should 1Care, the proposed new healthcare system be structured and funded?

It has been indicated that 1Care is being modelled after the NHS whose founding principles state “health care for all, free at the point of use, unrelated to the ability to pay”. Though an altruistic slogan, logically it is one that is almost impossible to be carried out in a sustainable manner in the long run hence why Britain is now needing more NHS reforms.

Selling it as a cheaper alternative ensuring universal healthcare coverage for all Malaysians then comes across as election-speak and brushing aside questions of the impact it has on taxpayers increases fears and speculation especially in a time when the government is reducing subsidies.

What needs to be done is for the public to be briefed and given tangible information on the cost and options. If the proposed system acts as does the Employees Provident Fund (EPF), what happens to dependants, retirees and the unemployed who cannot afford to contribute?

What also happens to unskilled illegal migrant workers, or those living in remote places with little access to healthcare or even international students? Who pays because we cannot and should not neglect them?

We can say that this 1Care system is only for Malaysians but even as a student in London, I used the services of the NHS, paying for medication but not consultation and was entitled to other free services such as hospital treatment in Accident and Emergency, hospital treatment (if the doctor recommends it) and family planning services.

If 1Care is modelled after Britain’s NHS, then these too are legitimate pressing questions that need to be addressed and the information disseminated to the public.

We have excellent medical staff but our facilities leave much to be desired. Last year an exposé on the maternity ward of the Kuala Lumpur Hospital not having hot water shower facilities, questionable hygiene and inadequate toilets caused an uproar. Of course, the government had allocated RM300 million for upgrading services in the last Budget. However the reality is there are many more cracks in the system that have not been highlighted or addressed.

At the core, what Malaysians want is access to good health services and will be willing to contribute if mechanisms are in place to safeguard the system ensuring that if implemented the 1Care fund will not be the go-to fund for unrelated projects. Neither should the fund be streamed into the accounts of political parties. With the track-record of government initiatives becoming liabilities it is only fitting that healthcare reforms be negotiated in a transparent manner with the different stakeholders to ensure the best interest of the rakyat is the priority.

Natalie wonders if 1Care will actually care for the people. Comments: [email protected]

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