Wednesday, April 23, 2008

privatization of malaysian healthcare

wanna contribute my two-cents too...

juz finish submiting my investigative study report for English , phew wat a relief . that thing have been a pain in my neck because i had my exams and i have to hand in by today..the thing is that my ESL teacher gave unsatisfactory marks for my 1st draft. so , had to do major revamp on the report....

the report looks into the viability of a privatized healthcare. THe focus question is should or should not Malaysia privatize its healthcare?? at first , i kinda agree that maybe we should privatized it because then maybe it can address all the ills of our current system..

but then , while looking through reports , studies , thesis papers ; i found that it would distratous to engage in a massive overhaul such privatization. It seems that it would be imprudent to rush into privatization because it might jeorpardize our current system. The present ills of our healthcare could simply be addressed with minor reforms and more commitment from those buggers who run the Ministry of Health and the Ministry of education(blame the Moe for poor quality of doctors).

First of all , our present public healthcare system is lauded as one of the best in the world and here is the catch , It is also one of the cheapest in the world when compared to other countries in the world. Ok , the best indicator is to measure the proportionate spending on healthcare against the GDP of the country. Based on the world health report , malaysia's proportionate spending is currently 3.8% of our GDP( 2003).it is one of the lowest in the world. Countries like India spent spent 4.9% of their GDP on healthcare , china 5.5% , Mexico 6% , USA 14% of their GDP and UK 7%. This below the level recommend by WHO which is 5% of the GDP and below world average of 7.9%!

Furthermore , government share on healthcare expenditure is 58% with the rest by private sector. Therefore , government spending on healthcare is around 2.21% ( 2003) of the total GDP.

Therefore , it can be concluded that our healthcare is seriously underfunded. But the fact remains that our healthcare is one of the best in the world . Like 90% of the population is within 3km of nearest health facility and our high mortality rate suggest that healthcare deserved all the credit it get. so , a simple solution to address all the current woes and ills our healthcare would simply increase its allocation!!!

Based on all of the above , u people must be wondering how the idea of healthcare privatization managed to surfaced... Ok it was first highlighted in the 7th Malaysian Plan ( 1996 -2000 )

the Government will gradually reduce its role in the provision of health services and increase its regulatory and enforcement functions. A health financial scheme to meet health care costs will also be implemented. However, for the low income group, access to health services will be assured through assistance from the government” .

The government then cited reason such as exodus of government doctor to private sector and reduce government's burden of financing the public healthcare. Would like explain the latter , the government will introduce National Health Fund as part of the privatization whereby it would like extra tax but solely marked for health purpose ( contribution by all employee would be compulsory like our current EPF)and it would be single payee for all health service. The mechanism of the fund and coverage of the fund have still not being decided yet. But , this alleviate the burden of financing the healthcare from the government. OK , would like to add that USA's healthcare is also privatized , but it consumed 14% of the GDP and on top of it it deprived 500 million of access to healthcare.

The exodus of doctor to private sector could be prevented by offering better pay to doctors , specialists and nurse. Increase allocation to MOH and doctor get paid simple. Instead government choose to spent billions to fund our affirmative action policy( like allocation to MARA , scholarships such as JPA , MARA ). Would like to highlight the millions gone in sending scholars to do medic in country like UK , Ireland( at cost of 1.1 million per person) who never bother to even pay back the whole sum ( or even half of it) and let alone come back to serve malaysians.

Then again , as for now government has privatized to branch of our public healthcare system such as the Hospital Support Service ( cleaners , maintanance ) and also the Government Medical Store( the one that supply drugs to hospital ) .

The privatization Government Medical Store to Remedi Pharmaseuticals ( now run 75% of distribution of drugs) for example ; shows an increase 0f 3.3 FOLD( compared to pre-privatization) in prices of drugs without any proper justification (such as inflation , increase of cost of production). this backed by a study by USM and University Sedaya. The study even question the reason of privatizing the GMS in the 1st place. since government still subsidize the system , we do nt really see the impact of this(yet). and who is paying for this,...the rakyat tax moneylah!!! also interesthing to point out that Remedi do enjoy some form of personal connection with the rulling party( cronisym again !!)

thatz for now....would come up with part two ...if i got time...
citation : and those stuff above are backed by WHO data or Government making it up

Sunday, April 13, 2008

Minister of Health in action

thatz my cousin ( that indian lady , dr.shamini)....the one behind that chinese man ( thatz our Health minister , Dato Lioa Tiong Lai) who is checking some patients forehead.

hopefully the new minister will put an end to all our healthcare woes. though i alwayz thought dato chua soi leck( former health minister) was the best.

but , have no idea why he is checking the patient's forehead. maybe trying to project a

caring health minister.