Wednesday, July 21, 2010

National health plan

National health plan still in first gear

A WOMAN with a 7cm tumour was referred by the Sungai Buloh Hospital to the Kuala Lumpur Hospital (KLH). A biopsy needed to be done to ascertain if the growth was malignant. She was given a date to see the oncologist at KLH – Feb 2011!
One does not need to refer to Paul the octopus to know that by then it may be too late for her. But the story of this woman, tragic as it sounds, is not unique.
Take a stroll along the corridors of the consultation rooms of KLH or University Hospital and you will meet patients who were given six months to a year for follow-ups, including those pertaining to serious and terminal diseases.

With the limited resources of drugs, equipment and professionals, it is a given that our hospitals just cannot cope.

As Health Minister Datuk Seri Liow Tiong Lai explains: "The government has limited resources, 50% are with the government and another 50% are private healthcare. But the 50% in government healthcare handles 80% of the population."

But the question is not so much do we have sufficient resources, but whether we are managing them well and whether we have our priorities right? The government spends only 7% of its national budget on healthcare. In Budget 2010, there was even an almost 5% slash from RM13.8 billion to RM13.1 billion. The Malaysian Medical Association had said we spend only US$400 (RM1,280) per patient in healthcare. Our neighbours spend in excess of US$1,000 (RM3,200) per patient.

The use of a PET Scan machine to detect tumours costs around RM8,000 at a private hospital, but only RM500 at the Putrajaya Hospital. However, by the time your turn comes, you could be dead. If you survive the one-to-six-month waiting period, it could be too late.

Such machines cost RM8 million – only RM112 million to supply one to each general hospital in the 14 states – far, far less than the RM800 million it would cost to construct a new parliament building!

And while 97% of our pharmaceutical cost is subsidised, one wonders if the annual cost of RM800 million could be lowered if a Sdn Bhd was not given the monopoly to import and distribute drugs to public healthcare institutions.

While we are very much ahead in access to public healthcare, in contrast with many developing nations, the fact remains that our most vulnerable are still not getting the healthcare they deserve.

The minister’s announcement yesterday that the proposed National Health Financing Scheme (NFHS) will not involve the insurance industry is welcome, as at least we know it is not another profit-oriented scheme.

But here again, we have another example of how public healthcare is a continuously tried and tested animal, without any conceivable means of making it fair, comprehensive and yet not lead us into bankruptcy. Sihat Malaysia, e-Kesihatan and now NFHS just go to show that when it comes to a solid national health plan, we are still unable to move forward.

When you talk about getting the EPF to subsidise one’s medical costs, the criticism is that if one needs to dig into one’s life savings for medical treatment, then there is something seriously wrong with our health policy.

Britain’s National Health Scheme, which even the US is trying to emulate, is not in want of flaws but seems like a good option – the only thing is that it would mean getting Malaysians to pay more in taxes. And knowing Malaysians, we hate spending a sen more on even the most crucial things.

But like it has proven in the scheduled reduction of subsidies, the government is capable of making non-populist decisions. However, if such decisions are accompanied by or culminate in improved service and care, it would definitely have done right by the people. Now if only the government could give us an AAA guarantee that our money will be used for our welfare …
By Terence

Healthcare is such a bane to write about. Terence welcomes feedback on improvements to our nation’s healthcare system at

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