Part 1: 1-CARE : Scouting in the dark
Part 2: 1-CARE: Who pays for it?
Part 3: 1-CARE: Is it fair for the people to pay?
Part 4: 1-CARE: The way I would do it?
- I was very worried when I read the news that I might have to pay up to 10% per month of my monthly salary as part of my contribution to the 1-CARE healthcare fund. To me that is atrociously high. The cyberspace is full with all sort of news including that it will be launch within the next few months. This forces me to read and meet up my college mate who is a senior person in MOH and has knowledge of the project. I spent several hours with him this afternoon in Putrajaya.
- Firstly from what I gather the politicians have hijacked the project name. It was known as NHS but was renamed as 1-CARE to be inline with 1-Malaysia. Whoever did it must be regretting now as it has create a serious political backlash. If implemented today, BN will lose Putrajaya in GE13. I was told that in the project is still at Phase 1 of a 5 phase plan. The problem that I have at this stage is why different personalities within MOH are saying different things at different places. They are contradicting themselves. I think at this stage to avoid confusion, only the DG of MOH should release statements about 1-CARE. Even the Minister should abstain from saying anything.
- On the 10% issue of payment, the Minister has made their statement today. From my discussion yesterday, I was told that the actual figure is 9.4% of monthly household income and this is not the total amount paid by the people. It is to be shared between the government, the employer and the people. The magic number reflects the highest margin of contribution and not a single flat number that applies to everyone. From my discussion yesterday, the issue of implementation has not even begun.
- Unfortunately after listening to what my friend, my comfort level did not improve. I became am more worried. The reason I am worried because the model of implementation is unclear to me. I plan to have another talk with him and several other people. In the meantime public arousal is being raised. The government past mistakes and lavish expenditure has made the public to scared to believe the government. Personally we can’t blame the people when we see the government actions. Even the GLC’s is no longer trusted as there is a total lack of independence. For the government to do this, they need re-earned the government trust. Otherwise, maybe it is best to scrap it for now.
Doc, go to http://www.taknak1care.weebly.com to see their archive of info collected. For intellectual analysis, there are several MOH docs, international studies, citizen proposals, and even the MOH DDG’s discussion with taknak1care.
Of potential interest to you may be the “Privatisation in disguise” section.
http://biz.thestar.com.my/news/story.asp?file=/2012/2/10/business/10711407&sec=business
lim kang ho is proxy of hishammuddin hussein who also built DUKE hiway.
RM 80 BIL means RM 8 BIL NET WORTH for Ghani,Lim and ….
From MI:
Yesterday Health Minister Datuk Seri Liow Tiong Lai said the proposal for business groups to be charged a 10 per cent levy of their income for an insurance fund under the 1 Care scheme would be reviewed.
Doc, do you understand what does it means?
He has no idea on the implications of what he said! I think he wants all employers to migrate to Singapore!
Singapore government will be very happy!! No wonder Singapore economy is now bigger than Malaysia!
Hi guys… please read this.. interesting
http://www.chicagotribune.com/news/politics/sns-rt-us-usa-healthcare-courttre8152bl-20120206,0,6674187.story
For argument sake : If other insurance companies decide to offer a cheaper insurance premium for identical services under 1-Care or NHS, and people are not obliged to buy 1-Care insurance premium under H3, can H3 cope without handouts from FG/MoH? I think H3 needs mandatory 1-Care/NHS insurance premium contribution under EPF scheme for it to work.
Zul
This is one point of contention that i had discussed with the MOH people. H3 is a trustee insurance company. It can create products and compete with private insurance companies. Private insurance companies can never develop H3 kind of product because H3 will accept all without underwriting (selection). The private insurance companies will put in the conditions and exclusions. If they dont they will go bust! By natural competition, H3 will win. The question is we dont want people to come in and go out at their whim and fancies. Payment has to be by compulsion from certain cut off date. Once you are in, you cannot leave and you have to pay.
I am very ok with your proposal Doc… I hope you can convince the DG. He has got two years to perfect the scheme and to get it endorsed by the cabinet. I hope they are not hasting it just because of GE13… I think it is a good scheme. Instead of building more hospitals, the FG/MoH can give that money to H3, and the people can choose for hospitalization care at any government or private hospitals.
ahhh thank you.. i hope the big people in MOH see it as as well
Zul,
I suggest you watch Yes Minister (Big Brother). Ignore those mindless sub-humans. Understand apart from common politics, civil servants especially the top echolen who would screw up the entire scheme.
Raffick,
Good luck to you! Remember, they are very good at “creative inertia”. Plus, I would rather change the present government first before embarking on any schemes
looes74,
I have that book and I have read it. Don’t you worry bro… I am looking at other consideration.. more to alignment of things with Islam which is constant irrespective of time, place and leaders.
Doc if you think it’s good then it must proceed. In this current environment if you hear everybody nothing moves. Just like your tender model. It’s the conviction that maketh a leader. People see this at the end.
It’s easier to say no and not doing anything now. Just like Phua n Izzah misleading statement on Epf but at the end there’s no help or solution again to the lower income household. The issue is not about Epf for it’ll be secured. But again were going into this welfare state and less on productive sector. Pr doesn’t want to raise this coz they’re in the same boat.
So if it’s your view it’s correct it must be pushed and defended. That’s how democracy is now in Malaysia. There will be plenty of soothsayers and rousers who are extremely partisan trying to throw this off.
Ellese
Maybe the following simple and answer questions would make everyone understand my position on the matter
(1) Does Malaysia need NHS (or whatever anyone one to call it)?
YES
(2) Why does Malaysia need NHS?
To improve the mechanism of the delivery of healthcare to the people and move in tandem with demands of the nation
(3) Is the government approaching in a right way?
NO. Based on what I had been told by the key people in MOH, I disagree with the approach. I have spoken with no less than 6 key personnel in MOH and all of them are contradicting themselves as well as pushing themselves first rather than NHS.
(4) Does the people in MOH appears to know what they are doing?
In general NO. Specifically they seem to understand the healthcare delivery part but not the the big picture. They are managing the tree and not the forest. The worst part of all is everyone that I talked to is looking at things in silos and wants to do it in their own way.
(5) Where should they start?
They should start with developing NHA i.e. the National Health Authority that will look in matters related to services provided by clinics and hospitals. The Authority should be parked under MOH. NHA will have distinct roles and powers and must not overlap with MOH. MOH new role would be looking at other things which include public health, food safety, research facilities, etc etc. It appears that many people are groping in the dark.
(6) Will add more later.. need to go to work
I like this. I’ve just read a healthcare reform commissioned by MOH. It’s dated but you’ve probably have read it. Reference is http://www.who.int/health_financing/countries/en/malaysia.pdf. I thought their commendation that our health care as remarkable and comparable with developed countries are good. Just for my understanding, on question 2 are there any particular delivery issues now that’s not mentioned in the report that we need to solve. For ease of reference the need to corporatise as mentioned in t report to my understanding is in essence to demarcate the responsibilities (though not advocating large scale corporatistion) with one of the main aim is to ensure competitive salary for those in public health sector. Are there any other health care delivery issues that require this new NHS structure to be in place?
Ellese
You mentioned about healthcare reform in the WHO article. I quote
“In general, the available evidence demonstrates that the Malaysian health system achieves remarkably high and equitable health status at relatively low cost.” It continue and compare with Canada and the USA.
It seems that our system excellent. If that is the case why change? The government can continue doing what it has been doing. If we manage leakages, corruption, we would have more money to sustain our healthcare system.
The report concludes “The recommendations that emerged from this diagnosis were for the country to proceed with a limited reform.”
If that is the recommendation, why proceed with 1-CARE which is about a total reform! Think!
Sorry doc. I dont know. I’m still not up to speed and that’s why I ask. I’m trying to grapple on what’s the big issue that require a reform in health care. This is what Ive gotten so far. If find too cumbersome just refer me to the read. I’ll take it from there. In essence I’ve no issue separating the operator and the regulator. On financing where it involves unsustainable activities or subsidies my believe is that financing cost be best borne by government. I think what you’re proposing is good but I can’t fully come to an agreement unless I appreciate it. Health is an industry I’ve never touched before. And what I read and experience don’t point to a major delivery issue. I appreciate now a need to provide impetus to staff salary. But not sure how the structure will address the rising costs of staff n management and most importantly the need to finance new infrastructure like more hospitals and beds which I find the bane in the health care industry. I Can appreciate in a certain way how insurance can finance this like in other countries but like the report say it has it’s own moral hazard n most importantly I can’t see how it can finance further new hospitals. At the end it may still need government funding to do this but I can’t see how the structure solve this delivery issue.
Ps: I’ve no angle on this issue. The article was the most comprehensive read I can find thus far. I thought some points actually strengthen your case (such as need for corporatisation) though not totally in agreement with your suggestion.
from reliable source, this is an extract of the statement soon to be issued to the press. it goes something like this, as in all other statement issued before…
“the project had gone thru various stages of progress and it is in the final part of implementation. from our research done, and the many consultations with professionals and expertise in the industry, and was even verified by selected institutions in our esteem country, we have concluded that this scheme will bring about tremendous benefits that will help the needy. we will continue to finalise the remaining proposals and submit our papers to the ministry for their approval. only then, we can implement all the great potentials of the scheme the people will accept readily. at this point in time, we are confident the ministry and even the general public will embrace this scheme with full blessing jjust as we are committed to serve and benefit the people.”
in summary, they said nothing at all.
Dear Doc,
It is unclear yet because they have not perfected the scheme yet. The scam have to look good to the Rakyat and the same time fills their pockets.
It is the same scam as with PLUS, Tenaga (IPP) and FELDA.
This is UMNO usual modus operandi. Dah biasalah…
UMNO pre initial plan was to privatise IJN. I had the opportunity to visit IJN recently, I was really shock to see the number of patients in IJN. Any surgery that deals with the heart, is a cash cow for UMNO. We are taking about big money here for heart surgery.