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?
Part 6: 1-CARE: Understand the people’s worry and manage it
Part 7: 1-CARE: Giving the poor the access to private practice
Part 8: 1-CARE: A matter of priority
Part 9: 1-CARE: Universal healthcare
- It is evidently become clear that the aim of 1-CARE (1C) is to shift the financial responsibility from the government to the people. In a gradual process from shift of cost it will be increase over time. Eventually the cost will be borne by the whole population. With rising medical care, the cost of SHI (social health insurance) will increase. The argument of UHC is flawed as we already have it in place. The government are issuing statements that is contradictory to each other. However the positive thing of 1CARE is that the people can have greater access to medical provider near their home.
- Some people think that I am against the plan. That is not true. The plan is fair provided that certain measures are put in place. Among the most important measures is that there is an irrevocable guarantee that whole operations of 1C would remain in government control in perpetuity. Hospitals and clinics can be corporatize but not privatize. The government must continue to allocate the budget for curative care where it would be use for expansion of the existing infrastructure. Everyone pays a flat nominal sum irrespective of position and occupation. Those with private health insurance paid by themselves or their employer can augment the SHI coverage. Those who cant afford to pay fro SHI; the government must pay for them. The timeline and action-plan of 1C must be made a public document prior to the execution of the program. The government must show that it is able to control the price of chicken as an indication to control the price of healthcare.
- If the above measures are not put in place and we follow the current MOH plan, we would face rising cost of doing business and increase migration of business to other areas across the borders. Unemployment will rise in this country. It would be unfair if the contribution were tied up to family income, as it would mean increasing the taxes of the middle income and higher income group. As it is this group is paying the upper income tax bracket which is subsidizing the needs of the lower income. Any form of scale down tax would be extremely unfair to the salaried worker.
- When we look at the issue of SHI, it cannot be addressed from the impact on medical coverage only. One has to look at the total financial impact on the families, inflation and reduction of family disposable income.
Doc, have you ever wondered why is it that a total revamp of current system does not seem to upset the entrenched vested interests in the current system, namely pharma, insurance, private healthcare providers, etc?
For eg, why insurance companies are not making any noise about a mandatory unversal insurance plan? Why private hospitals are not upset about being in an “integrated system” with govt hospitals?
Is it a coincidence that govt going all around the world selling Malaysia as a premier medical tourism destination? Or that 1Care SHI only covers generic drugs, while Malaysia aspires to be a global generics manufacturing hub?
This document may be enlightening:
http://www.kpkk.gov.my/pdf/tahukah_anda/ETP_bi/chapter16.pdf
here are some choice quotes:
- “When examined from a profitability and growth lens, the Malaysian health sector opportunity looks extremely attractive…”
- “Moving forward, it is now time to reframe and position healthcare as an engine of economic growth.”
- “our expectation is that focus on the largest economic engines will directly impact the healthcare infrastructure and *indirectly* result in better quality care for the rakyat”
I think the most fundamental issue is that we do not trust this present govt anymore. We have a minister of health that told a blatant lie (tear gas in Tung Shin Hospital). In the last decade, we hear of new hospitals that cannot be used for some time because of numerous problems; that is if they are ever completed at all. We have seen the MOH buy over 2 consecutive buildings from Sabah Medical Centre at grossly inflated prices. We have seen “supporting” services and the supply of drugs being privatised at huge cost. So how do they expect the people to trust the current bunch of clowns?
valid point
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the sad thing about our 3rd world country like malaysia
is that we like to copy what advanced country like singapore
is doing, not realising that we are still operating in low income
mode.
Does anyone realise that cityliner bus drivers are paid rm 468
per month and drivers are paid miserly overtime rates at rm 2/hour?
Why talk about big things when we have really pressing bread
n butter issues not resolved?
That is why I have nothing but contempt for chingkie mca
ministers and pariah kolings timbalan menteris in hr who
talk a lot of shit but do nothing. So what can the
towering melayu tun madey of kerala and sucessive umno-N[ok]-fc
leadership has achieved other than show of the pootjaya and the
twin towers.
And bik rozie and najib are planning another monumen-100 storey
of melayu’s stupidity in this world, They will join tun madey of
kerala as the greats of malaysia?
The propensity to appoint con-sultans has given civil servants plenty
of idle time. And during this idle time they look for expansion and
self glorification.
in their minds will be -
what great ideas can I sell to the simpleton bik mama -najib so that
I can make tons of money ?
look at all the past epu dg’s and key civil servants
in the infrastructure services. My sources told me they are all millionaires
In conventional thinking , one goes into business to become rich.
In boleland malaysia one join the civil service to become millionaires.
Ideas to replace perfectly good services suddenly surface?
The question is-
Is there a need.?
Look at football . Not the pariah malaysian football though.
If a coach in a premier league is successful in his approach , why change
the
coach?
last night chelsea looked like a real pariah and their place in the cl is finally
lost for good . And all the tinkering by the owner comes to nought.
Likewise , najib must get a grip on the running of this country. Hiding
behind consultants like jala/apco /fbc/host of other silly shitheads will
ultimately show that his nudity -like the emperor who likes to wear new
clothes!
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A good and simple solution presented by TMI
http://www.themalaysianinsider.com/sideviews/article/why-revamp-our-healthcare-system-with-1-care-ck-chooi
Should read this too…
http://cipantapirtenuk.blogspot.com/
Why is this a reference? Facts pun tak betul. We can’t solve anything bro.
Bro… I think there are some interesting observations and opinions.
I don’t have the background knowledge on national health schemes around the world, so I won’t comment. The UK NHS looks like in deep trouble and so is the US Medicare and Medicaid.
I can comment on my own situation though. A check with my HR shows the company spends about 3-4% of overall employee costs on health care insurance – Private Hospital cover for employee+dependents, including a one-time RM60K cap for major life threatening illnesses such as heart disease, cancer etc.
On top of that I pay 2% of my income on supplementary health cover for the whole family, which gives me added flexibility on any hospitalisation.
Whatever I pay in taxes to the government health system I treat as my responsibility as a citizen.
So, for me, its a maximum 6% of income paid to profit-making insurance companies for Private Hospital health coverage for my whole family.
Strange….I suppose if I add in the funding needed for the Government hospital system, the 9% or 10% of household income that was being floated around makes mathematical sense. BUT that only makes sense if the Government intends to offload the entire Budget for the government hospital system to the NHS and make income earners pay for it, on top of their existing income tax.
It benefits government employees (no payment, just as now) and the lowest income group (below threshold), but for the rest, That’s crazy, and its electoral suicide…
“but for the rest, That’s crazy, and its electoral suicide…”
I think, as Doc said it is a flat nominal sum for all irrespective of occupation and position. However, that would be for a budget standard… but if you want a luxurious standard, you still can.. pay higher premium lah.. No obligation. Only the nominal sum is statutory. Is that electoral suicide?
Referring to your second paragraph, my view is that maybe we can start at 7% which is to be shared between employer (say 4%) and employee (say 3%) and to reverse the equation gradually with the employee paying higher. Yes, I can agree with you that the employer/government should pay in full for those who are below certain income bracket. For the high net worth employee I am in tune with you that it should be optional (i.e. can choose for a higher and more comprehensive coverage) but the contribution from the employer’s should be still made mandatory for the benefit of the aforesaid employee.
Dear doc,
Just saw last night some debate on NHS reform in UK. Crux there I narrow down to sustainability.
I’m still not in all fours with your proposal. I’m still reluctant on Introducing compulsory/ social health insurance scheme mainly stemming from cost and it’s moral hazard. At this juncture, I’m more for WHO’s limited reform recommendation. I thought on sustenability they recommend a 10-30 % increase in public health fees while we have more private wings to cross subsidize the public seems more acceptable to me. Insurance to them will only bring up the cost.
P.s. it doesn’t address long term sustainability. But uk current reform on their NHS does show none does ie we tinker improve and develop the system as we progress. I think unless there’s a major issue on delivery or inadequate funding we do it piecemeal. At the end we may still adopt your proposal.
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If a thing, subsystem or system have a possiblity of failure, then it
will ultimately fail
why would the proposed heath system fail?
it is complicated,cumbersome and components are managed
by politicians. And when economy gets tough or frens like
chingkie jho low persuading the bik missus for a piece of action,
components will get privatised like a chingkie farmer picking mango
from a lo-lying branch
And when a privatised entity become horribly wrong, it is
difficult for gomen to get back the pieces and make it smooth again
Case in point.
——————
One chingkie vingkie ask for the sewage privatisation. So chingkie’s
benefactor madey gave him on a silver platter. And when the
enterprise find difficulty in its operation another whisper found the
benefactor orderings its buy back from chingkie vingkie for a billion ringgit
or so.
Has the operation of the sewage operation become good with the
re-nationalisation of the ‘pojek’?
Certainly not. House or property owners may refuse to pay for
the charge and the courts may back the recalcitrant houseowners,
But gomen use admin countermeasure to collect unpaid
bills when one try to dispose of the property. Clever and
as madey -malaysia-boleh thingy made such outrageous
pojek possible!~
so I expect the gomen will put a nice blitz on the ‘pojek ‘ thingy
on tv / media /utusan/star
later if it win/lose the election it will implement.
pru 13
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if bn lose it will be a ‘scorched -earth’ pojek
if bn wins , mca/ some chingkie mf and melayu mf will harvest the
fruits ot this indecent pojek . A u-tolong-gua -N-gua tolong-u
in action.
A true umno-N[ok] -fc pojek in execution
What’s your stand? Do you want a reform of our healthcare? Why? If yes What do you want to achieve with the reform?