Part 1: 1-CARE : Scouting in the dark
Part 2: 1-CARE: Who pays for it?
- As mentioned previously, MOH is 100% dependent on the Federal Budget for its operations. In 2012, the government allocated RM15bill (represent 8.26% of total OPEF) to MOH to cover operating expenses and RM1.8bill(representing 3.62% of total Dev Expenditure) to cover developing expenditure. The government says that they want to take the health care to the next level and hence there is a need to develop NHS. One reason why the public is opposing the system is because they are now force to share the healthcare cost. The working population has been contributing to the national healthcare cost via their income tax)
- At the airport today, I bumped into a friend who feels that there isn’t a need to have NHS as Malaysia has strong revenue and it has not been prudent in spending money. The problem is in everything that the government does they do not get the maximum bang for a buck. Their inability to manage finances properly are causing the country to run into a budget deficit and they are now pushing for direct additional taxation to the people. He strongly disagrees with NHS. I asked him on why did Singapore government runs NHS (Medisave) despite having with a strong financial status and governance. He could not answer me.
- Many do not understand that there are 2 parts of the NHS. On one part, it is about improving the healthcare services. This is something that everybody support and demanded. The second part of NHS is about managing the finance i.e. managing the provider-payor relationship.. The people want the government to fund it without taxing the people further. They expect the government to improve its financial management system. In Singapore, the government imposed Medisave as intended to reduce the over-utilization of healthcare services. In Malaysia overutilization of health care services can be widely seen. I am sure many of us have seen people taking huge amount of drugs from hospital but do not consume them. They did it because they don’t pay for it.
- To a limited extent I agree with the Singapore model. It is a model that ensures that everyone put some money aside for healthcare needs. The money is used to pay hospital bills. It covers everyone regardless whether the person is employed or otherwise. It is fairer to a certain extent. For the working population, they don’t mind doing it, as their income tax is low. In Malaysia the idea of further income deduction to subsidize healthcare cost has a lot of opposition from the employer and employee because our tax is very high.
- For Malaysia to achieve the objective set in NHS, it must approach it from a holistic view. For the employed group a few percentage of the existing income tax is deducted for NHS. Additional cost on top of the existing income tax is simply unacceptable. The employer can also contribute. Each individual must maintain his or her own health account. Maybe EPF can be the manager for such an account since they have good experience in managing money. The money in the account is used to buy NHS insurance scheme or public insurance scheme. The insurance is then used to pay for the health care cost. What is key is that to ensure that H&S insurance remains stable and low; the cost of health care services must be strongly regulated.
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Quote: “Maybe EPF can be the manager for such an account since they have good experience in managing money. The money in the account is used to buy NHS insurance scheme or public insurance scheme. The insurance is then used to pay for the health care cost. What is key is that to ensure that H&S insurance remains stable and low; the cost of health care services must be strongly regulated.”
Dear Doc,
The government realised that there is a need for H&S Insurance (HSI). FG first brain child was Sihat Malaysia Insurance plan (approx 10 years ago). It took off quite okay, somehow, I don’t know why it just died off. H&S Insurance is still available from those companies but it is not standardise throughout. There a lot of abuses from policy holders in HSI, which has made it really a non-profitable business for the company.
Dr R-Sihat Malaysia is not a government initiative but rather PIAM. I was involved in the scheme. It died because of several reasons. Among them (1) Doctors abuses (2) TPA weakness
FG second step ahead was HSI through EPF funds, was “approved” ages ago, approx 5 years ago. I suspected, it did not kick off because the UMNO goons are fighting for the piece of cake. EPF members are allowed to purchase HSI policies from their EPF funds.
Dr R- I had some knowledge about this as well. There was never such scheme about H&S with EPF but rather critical illness. I was one of several few within the industry that objected to the scheme (at personal level) as I felt it would be cheaper to buy H&S rather than buying “a lottery call CI” and more beneficial to the members.
I strongly believe that, we need to regulated the private hospitals FIRST in the fees, charges and service provided before HSI from EPF are in place. We have heard of lawyers being shark. The private hospital and medical center are becoming huge killer shark at the mercy of the sick.
Dr R- I agree with you 300% and has said this clearly in my post
I do not agree on EPF managing on too many things.
Dr R- EPF role is purely creating an additional saving accounts for future to pay premiums after retirement
What we need is HSI providers forming a body to monitor the private hospital and medical center on their fees, charges and service provided.
Dr R- That would be H1 in my proposal
I do not think Malaysian Medical Association is doing enough for the Rakyat and for the HSI providers. It would sound silly to ask for your own pay cut. We have complaint about politician are in for their own interest, so is Malaysian Medical Association, they have their own interest to look after too.
Dr R- MMA stands for Malaysian Medical Association ie it is an organization that takes care of the interest of its members. Just like any other organization, they are suppose to look after their member interest first, everything else is second. Sad but it is true
We intervention from FG to form NHS policies on these areas.
Thank you for your input Doc,
We need to seriously work on it.
Something, somewhere, ain’t right. I don’t have the missing puzzle to put it together.
FG is not forward coming on the matter too. Too SLOW.
FG is definitely slow about explaining things to the public. Both me and several MOH officers agree to this fact. I think they dont have people who is brave enough to face the public and explain in simple terms
The problem ion our Healthcare is the massive amount of leakages. They have not even begun to address this problem and yet they want to impose tax on us just to perpetuate the leakages. Shah Alam Hosp is a prime example. All medical supplies have to be bought thru ‘BUMI” contractors whose only job is to sign the forms and place a hefty markup on the original cost.
This is just the tip of the iceberg. Eliminate greed and corruption and we will have more than enough to finance all the projects and healthcare without any additional burden to the Rakyat.
Daryl
You are right about leakages.
Raffick,
Something to ponder upon!
Dear Doc,
Err.. Why do we need to compare with Singapore…
Why don’t we compare Malaysia vs Cuba (whereby our GDP were 4 times more ) .. but our “per capita” is just slightly a little more compared to Cuban “per capita”
By the way… in Cuba … their medical services is either free or low cost…
If anyone raised the issue of total population (Malaysia only got 3 times more than Cuba) … please do tally it with the GDP and “per capita” …
For me, it’s all about corruption and mismanagement …. therefore I would not support any moves to implement 1Care until all the corruption and mismanagement has been corrected.
FYI … I do post the comparative graph on my blogs for everyone to check and make calculation…
Is it wrong to compare with Singapore especially when WHO rated them highly in the healthcare provision services
Raffick,
Singaporeans set aside for medisave through CPF. Last check, CPF contributions (combination of employer’s & employee’s) stands at 36% of salary. Contribution in EPF is half of it.
I am ok if the money comes from EPF. The question where does the money go to…….Some cronies sucking it…..
Raffick,
Khaw Boon Wan, Penang born used to be Minister of Health…..not too long ago
Unlike Malaysia, Singapore has no natural resources like oil, timber, natural gas…etc. It mainly depends on small population of tax payers. During good times with budget surplus Singapore government giving out bonus to Singaporean. And Singapore government does not has looting, deliberate mismanegement or wasting speding going on! .
Would Malaysian be happy to pay for contribute healthcare costs while the rampant looting, mismanegement or wasting speding going on? Now the government may say the contribution is minimal from public say 5-10% but do you trust they would not increase the cost to higher….and higher….% in future.
Can the government first explain how they spend the few hundred billions oil money from Petronas? Even ex PM, Dr M one time asked ex-PM Abdullah Badawi to account for the oil money!
Regardless how noble 1-Care, the people will not benefit. I can’t prove it but my guts feeling tells me that 1-Care will be a fail project.
Salam
1-CARE will fail if the best brains are not allowed to run it and we allow politicians to interfere
Doc,
That goes without saying, otherwise, why should they want this new plan if not to getmore money to line their pockets? I am sceptical about the whole idea. None of their projects so far genuinely benefit the rakyat totally.
I don’t blame you one bit when the government has failed to gain the people trust
So just change the government laa…..This time make it whole sale…….We need to have a level playing field before start making critical assessment on both side. Not just me say so……Abdul Kadir says so……He’s also as good if not better Salahhudin Ahmad
“Maybe EPF can be the manager for such an account since they have good experience in managing money”
That was in the past. Now EPF which is for saving for retirement of employees is being used as the piggy bank or rather ATM to finance schemes which isn’t its purpose such as directly financing the housing loans of those with very poor credit ratings.
What I meant is EPF have the resources and infra structure to create a Medical Saving account that can kick start immediately.