Yek Yow Ngan – MOH and Assunta wrong


I read with anguish the recent death of Madam Yek Yow Ngan, 51, a marketing executive at the Nanyang Siang Pau. Madam Yek was apparently involved in a car accident on Sunday morning, 27th May at about 3am at the 8th mile Puchong Road and was subsequently surrounded by a group of men with parangs and iron rods.

She was rushed to the Assunta Hospital where she was admitted at 4.10 am by her son, Allan Yeong Hon, with multiple injuries and in a state of coma.

Active resuscitation was apparently carried out at the emergency unit at the Assunta by the nurses and doctor there including intubation and infusion of 4 units of blood. Her condition stabilized at about 5am.

She was subsequently wheeled in for CT scans and X-rays and was being transferred to the ICU when the question of costs arose.

The son, apparently unable to afford the charges, requested for a transfer to a government hospital.

She was subsequently transferred by ambulance at 5.45am in a “stable condition” to the General Hospital, Kuala Lumpur when there was no response from the nearby University Hospital. She arrived at 6.10am. She however died 3 hours later at the GHKL at 9.40am, Monday morning 28th May.

Her distraught family, unhappy with the medical turn of events, complained to the Ministry of Health. The Health Minister has seemingly absolved Assunta Hospital, saying that the Hospital had followed proper procedures.

He further clarified that since emergency treatment had been rendered before the question of payment arose, “the hospital had done nothing wrong” and this he deemed was fair. These events were apparently further confirmed by officers of his “medical practices” division which concurred with him.

There are two pertinent issues here, as in almost every emergency case reported in the media.

The first is scene time, so critical in emergency responses, and this; the victim’s son has appeared to have done well by rushing her to a hospital in less then an hour. In fact, he is quoted as saying, “”We sent her to Assunta Hospital as it was the nearest hospital from the scene of the accident”. Certainly he appears to have brought her to the appropriate hospital.

The second, more contentious issue, is the question of funding.

It must be emphasized that trauma and emergency victims frequently brought to private hospitals but later turned away or transferred out has never been about the absence of emergency and definitive treatment but in fact has always been a question of funding.

Who funds this treatment? Private Hospitals are on their own and as in New Zealand recently, risk having their electricity cut if they don’t pay their TNB bills. There is no bail out here.

Madam Yek required 4 units of blood, meaning she could have been bleeding actively and definitive treatment in the form of surgery could have been urgently required.

There are today time bars for trauma victims and patients with acute coronary syndromes (heart attacks) where response time needs to be less then 60 minutes and 90 minutes respectively.

In fact, in patients with severe trauma, this “golden hour” may even be as short as 15 minutes before certain factors set in that may make the shock irreversible. Strategies such as “Damage Control Surgery” (DCS) are currently employed where trauma surgeons frequently operate on patients just to stop the bleeding first for fear patients exsanguinate.

It is also as a result of this “time-bar” to treat these life-threatening conditions that Tony Blair recently authorized the upgrading of emergency units in the NHS at significant costs.

Sadly though, for Madam Yek, while the haggling, arguing and bargaining was being carried out, her 60 minutes was running out and with it her life was slowly slipping away from her.

The Assunta Hospital certainly knows the consequences of delayed definitive treatment for patients in hypovolemic shock but chose to stall after administering emergency treatment knowing very well that there could be dire consequences.

As for the MOH, it must now realize that no amount of regulations nor Acts of parliament is going to bring back Madam Yeh’s “golden hour”.

In fact all these rules being enforced by it’s so called” medical practices division” is a charade, clearly missing the wood for the trees.

The MOH has to solve this problem of funding for emergency patients especially when the appropriate hospital is a private one and patients are locked into this time bar.

The MOH must realize that real hard work is required in determing a minimum fee schedule for patients stuck in this limbo. The State cannot wish this one away as the Will of God especially since Malaysians today have seen the colossal waste that is going on in almost every Ministry.

A billion ringgit can save a 100,000 patients at RM10,000/- per patient. Whatever happened to the public funds donated that were placed in the Ministry’s Trust?

The Ministry should forget about all its grandiose telemedicine projects, questionable traditional medical schemes and unnecessary Acts and solve real problems such as first responders, pre-hospital care, ambulance services, health economics, health prevention and education.

These real life and death problems are the ones doctors, nurses, patients and hospitals face everyday.

Madam Yek was brought to the nearest appropriate hospital alive but for reasons of finance was transferred to another hospital after a time lag of two hours which may have led to her death.

Both the Ministry of Health and Assunta, in their frantic attempts to clear each other of all blame, appear to have forgotten a very important detail in the death of this unfortunate lady — it is called conscience, something no qualifying examination is ever going to teach you and a quality which appears to be in short supply both at the Ministry of Health and Assunta Hospital.

  1. #1 by nicktay on Tuesday, 5 June 2007 - 8:47 am

    I think the Hospital didn’t do anything wrong, however, it didn’t do the RIGHT Thing either. The doctors should have advised the Son that Time was of the essence, and that they had to operate as soon as possible in order to save his mothers life. When it comes to Emergencies, Hospitals should be focused on Saving Lives, even though we fully understand that they need to make a living to. How can you Make a living, if by making your living, lives are lost.

  2. #2 by good coolie on Tuesday, 5 June 2007 - 8:59 am

    The answer lies in compulsory medical insurance for all. Premiums being charged in a progressively higher way such that the more well-off subsidise the poorer. People should not lose their lives for being unable to pay medical fees.
    On hind sight, Assunta should have given this person further treatment and, later, covered her expenses through donations, especially so since Assunta has different standards from the usual run of private hospitals. Look at Assunta’s crest (the disguised cross!). But to be fair to Assunta, hind-sight is not insight.

  3. #3 by palmdoc on Tuesday, 5 June 2007 - 9:24 am

    So many armchair CSIs coming out of the woodwork when we don’t know the precise details of the unfortunate lady’s injuries. Without facts how on earth can anyone make any judgement calls here?

  4. #4 by HJ Angus on Tuesday, 5 June 2007 - 9:43 am

    The government can easily set up a RM1billion fund for such emergency treatment since they are spending more than RM3b each year on the surplus civil servants all taxpayers are carrying.

    This fund will be used to reimburse emergency/accident patients for the critical first 2 days of any treatment in all hospitals. In fact with an insurance scheme the annual cost should be lower.

  5. #5 by uliang on Tuesday, 5 June 2007 - 10:05 am

    While I sympathize very much Allan and his family members for their loss I believe that Assunta Hospital and MOH are not at fault in this matter.

    After all they (the hospital) did administer emergency health-care. It was only the issue of cost that caused Allan to transfer his mother to another hospital. But the way I see it, it was also Allan’s choice to take that risk, and-with due respect-the consequences that come with it.

    So it will not do for Allan to then turn around and start blaming MOH and Assunta for high costs. Health care is expensive; didn’t he or his mother have insurance coverage? (correct my ignorance here…)

    Yes, the response of MOH and Assunta may have been high handed and insensitive, but that’s another issue. If anyone is to be blamed is is certainly those brutes who caused the accident in the first place.

    I cannot agree with Ahmad Sobri’s assessment here.

  6. #6 by Jimm on Tuesday, 5 June 2007 - 10:18 am

    She just happens to be the victim of circumstances and it’s all started when she ‘bumped’ into a motorcycles. That’s show how we Malaysian will act when they can get themselves above the law.
    Another reason is she just a commoner and it’s hard to catch those involved in the cause of her death. The law enforcer just cannot have to ‘force’ to break the case as the zone was ‘guarded’ by their network or ‘partners’.
    I believe that no one (after the accident) are to be blamed for her death.

  7. #7 by undergrad2 on Tuesday, 5 June 2007 - 10:22 am

    This is how an accident like that would have worked out if it were to happen anywhere in the U.S>

    Within minutes somebody would have called 911. The 911 operator would be in contact with the ambulance from the nearest hospital. Within minutes several ambulances would be speeding their way to the scene of the accident. The paramedics would go to work immediately to keep the victim alive and the ambulance would be making its way to the nearest hospital.

    The identity of the victim is not relevant. Whether he or she has health insurance is not relevant. The sole aim is to keep the victim alive long enough for him or her to be brought to the ER.

    At the ER, doctors and nurses would go to work immediately. If surgery is required, the surgeon would get to work immediately – all that within the ‘golden hour’ critical to life. If the victim is conscious he would be asked his or her name. Relatives would be informed.

    A Mexican drug dealer who the night earlier had slipped across the border from Mexico would get the same treatment as any citizen. It does not matter if he is a criminal alien without a penny to his or her name. All that matters is saving a human life.

    How is that possible? Who pays for the medical expenses? The tax payers do. They do it when they pay their taxes.

    Malaysia is obviously about a couple of hundred years behind.

  8. #8 by megaman on Tuesday, 5 June 2007 - 10:24 am

    emergency service in Malaysia is basically no-existent …

    better pray hard hard that you do not get involved in accidents otherwise u better pray harder that you do suffer major injuries …

    emergency medical services are expensive to provide & maintain, and almost impossible to profit from. Even developed countries are struggling with this aspect but at least they are making an effort to continuously improve their emergency services.

    As for Malaysia, well … the saddest thing is that the government don’t even bother to put in the necessary effort and investments.

  9. #9 by marmitecrab on Tuesday, 5 June 2007 - 10:31 am

    This is not the first time a private hospital has been blamed for someone’s death. The failure to prevent her death lies not only with Assunta hospital but with the system itself. Assunta is a private hospital with profits to look after. They cannot just take matters into their own hands and treat first, then recover the costs later as suggested by a contributor earlier. If they were to do so, then that would set a precedent and other hospitals may be compelled into doing so and believe it or not, they would rather not.

    So what are we left with? Insurance is one way. Another way would be the setting up of a fund to assist in emergency cases like this. The fund would enable all private hospitals to recover their costs first, then leave it to the operator of this fund to try and recover from the patient. But having said that, this proposal would likely be open to abuse and some patients might claim poverty to escape paying back for services rendered.

    So there is no real solution to this situation unless we change our mindset and realise that if we don’t help others, we’re also not going to help ourselves.

    And the other issue is to also make these road bullies fear the law and that there are consequences to their actions. But that’s another mountain to climb, isn’t it?

  10. #10 by madmix on Tuesday, 5 June 2007 - 10:35 am

    Lesson to be learned:
    If you do not have medical insurance or do not have money set aside for hospitalization in a private facility, do not go there even if it is nearer. Go to a government facility and in PJ, it is the University Hospital.

  11. #11 by ilovepenang on Tuesday, 5 June 2007 - 10:37 am

    2 points come to mind:
    1) What happened to the nearby University Hospital? Arent they supposed to help trauma victims asap? There’s a big signage outside the hospital. Something goes like “Trauma dan kecemasan”…

    2) Is there any arrest done on the parang wielders? They must be brought to justice as a stern warning and to prevent such an unfortunate event from occuring again.

  12. #12 by marmitecrab on Tuesday, 5 June 2007 - 10:43 am


    Obviously we’re not the US or any other such country where their emegency medical services have evolved to placing priority on saving lives first. While they practice “stay and play” whereby their main aim is to stay and treat the patient first by administering first-aid and stabilising the patient before transporting to the nearest hospital, our system is “scoop and run” whereby the ambulance technicians merely provide very basic first-aid (in some cases, nurses travel with the ambulances to provide this treatment) and then transport the patient as quickly as possible to the nearest public hospital.

    To do what you suggest, our ambulance technicians have to undergo serious training ala US emergency services. Our ambulances will also have to equipped as such. This involves getting the right training in order and also purchase of expensive equipment. I don’t think it is impossible but it would require a lot of political will and a change in mindset.

    I once attended a conference for emergency services personnel and one of the main challenges being faced was that a lot of the emergency caregivers (ambulance techs, doctors and nurses alike) take the deaths of their patients as “God’s will”. Hence, they will only do what is minimum and if the patient survives or dies, it is “God’s will”. No amount of training or equipment can save you if that is their attitude.

  13. #13 by bbtan on Tuesday, 5 June 2007 - 10:47 am

    “A billion ringgit can save 100,000 patients at RM10,000.00 per patient. Whatever happened to the public funds donated that were placed in the ministry’s trust?” – Ahmad Sobri

    Who can argue with such query? Well maybe MOH and PM and those who don’t care.

  14. #14 by bbtan on Tuesday, 5 June 2007 - 11:00 am

    “Malaysia is obviously about a couple of hundred years behind” -undergrad2

    Obviously, the “infidel” government of the US is more caring than the Hadhari government.

  15. #15 by pwcheng on Tuesday, 5 June 2007 - 11:29 am

    From my experience with Assunta, I am not sure what they are telling is all truth. Money to them is supreme and everything else takes a back seat. The moment you are in you are at their mercy, unnecessary tests that can cost you a bomb and they will try to keep you in as their guest longer than necessary.
    They are even worse than hotels, the extra half an hour or one hour stay while waiting for somebody to pick you, they will charge you for half a day.By right they should warn you of the extra charge when you request for the short extension.
    This is a real life situation that I have with them.

  16. #16 by marmitecrab on Tuesday, 5 June 2007 - 12:04 pm

    Assunta, like any other private hospital has the right to charge whatever they wish, as long as it is approved by the govt. And private hospitals charge you for every single thing, from the gloves they use, to the cotton balls, gauze, syringes, etc.

    If you ever need emergency services, either be prepared to pay or go to the nearest public hospital. Let’s learn from this and not harp on it as though Assunta or any other private hospital is going to change their policy.

    Best recommendation – get insurance!

  17. #17 by k1980 on Tuesday, 5 June 2007 - 12:11 pm

    First, ambulances without petrol, then no money, no admittance into private hospital…. Now this nonsense in Bolehland’s hospitals—-

    Tioh Geok Piu, 56, could not have surgery at the Malacca Hospital where he arrived an hour after the 1.45am incident as the CT scanning machine had malfunctioned.
    Calls to three private hospitals — Putra Hospital, Makhota Hospital and Pantai Specialist Centre — proved futile….Makhota Hospital public relations executive Jessica Yeo said Tioh could not be treated as the hospital’s cardio-thorasic surgeon was on leave. Pantai Specialist Centre chief spokesman said no beds were available at the hospital’s ICU. Putra Hospital chief executive officer Radhana Salleh said she would investigate the matter.

  18. #18 by winc on Tuesday, 5 June 2007 - 12:13 pm

    Well…. this is the level of “health care” we had elected.

    Highways and building rectifications and repair works because of the irresponsibles can amount to millions but life and deaths worth nothing more than passing the buck around for not having enough funds.

    Come on Malaysia.

  19. #19 by k1980 on Tuesday, 5 June 2007 - 12:17 pm

    The proposed qualifying examination similar to Britain’s PLAB (Professional and Linguistic Assessments Board) or the USA’s USMLE (United States Medical Licensing Examination) should be made compulsory ONLY to the administrators and directors of both public and private hospitals. With a passing rate of 5%, we would be able to see off 95% of those incompetent/money-grabbing cut-throats

  20. #20 by k1980 on Tuesday, 5 June 2007 - 12:23 pm

    A law need to be enforced to require ALL private hospitals to have big signboards at their entrances: NO RM10,000 NO ADMITTANCE( YOU DIE YOUR BUSINESS-LAH)

  21. #21 by Jong on Tuesday, 5 June 2007 - 1:05 pm

    No need to look so far across oceans, just south of the border to Singapore, there’s plenty to learn.

    Their public and private medical emergency services is world reknown, put its neighbours to shame. But Bolehland is too ‘proud’ to learn from Singaporeans, instilled into them the past 25 years.

  22. #22 by grace on Tuesday, 5 June 2007 - 1:40 pm

    Private hospital is not a hospital in real sense of the word. It is ‘Kedai perubatan”. The doctors there are no longer doctors. They are businessmen. Therefore they act like ‘towkay’ la. The only consideration they have is MONEY. Who cares about your life? To them,’NO MONEY NO TREATMENT’ is their motto

  23. #23 by observer996 on Tuesday, 5 June 2007 - 1:46 pm

    yeah , i read about the news and i thought it was really unfortunate to learn that these things happen from time to time.
    If we look at a bigger picture, we cannot put all our blames entirely on to Assunta which is a private hospital . The critical period is from after the patient has been stabilised to the period this patient started to deteriorate. The period corresponded to the moment she was in Assunta ICU in a serious but stable condition until the moment she reached KLGH about an hour later and received further therapy.
    Questions to ponder :
    1) WHY was the nearby UNiversity Hospital not accepting this patient???? They better come with a very good solid reason because being a teaching hospital, no doctors on duty , not enough resources and other lame excuses are not acceptable!!!!!!!
    2) Patient reached KLGH at 6.10am , from then , what sort of therapy this patient had been commenced on , who made the initial assessment and who triaged the patient, who looked after her vital obs . What i dont want to see is some health officers making an incompetent assessment and thinks that time is still on their side and should therefore wait for the consultants to make the call for the timing of emergency surgery when they reach hospital during office hour at 8am. Unfortunately, registrars are still not confident enough to make vital decisions !!
    3)Was there a communication breakdown during the interhospital transfer ? Was KLGH well aware of what therapy this pt was given initially and under what circumstances she was brought in. Did health officers in Assunta give every piece of vital information and were they spelled out clear ?
    4) This is to the son . I believed u made an informed decision. Assunta doctors would have told u the risks associated with not having further treatment in their hospital. And if the delay was due to ur reluctance/inaffordabilty to pay the treatment fees, u can’t really blame them i suppose . But u can look into carefully if there was a communication breakdown !! and also check with KLGH what ur mom received or was there a neglicence of not treating her immediately over there.
    Its interesting that ahmad sobri write about Acute coronary syndome and response time. My understanding is that if someone had a complete VF from the heart attack , we are only left with 3 mins to do sth before brain suffers irreversible damage, therefore only option is defibrillator ! for those with acute syndrome, rescue angioplasty needs to be done within 60 mins if pt presents to us within one hour of symptom onset or 90 mins if they present later .
    This is set out by the Australian heart foundation guidelines

    The only way to prevent this type of mishap is to have an effective health insurance policy nationally. The government is also not putting in enough money into the health sector . WHO advise every country to allocate at least 10% of GDP to its health ministry but at the moment our government is only allocation sth between 5-7% . sigh………….

  24. #24 by Jonny on Tuesday, 5 June 2007 - 2:08 pm

    In Malaysia, every Ministry is bleeding badly. All cash leads into the pockets of cronies. All enriched in one way or another.

    Healthcare suffers.

    The not so well off are left but with the excitement of adrenalin rush – typical of mat rempits.

    Come on. Call for the General Election now!

  25. #25 by k1980 on Tuesday, 5 June 2007 - 2:39 pm

    The Hadhari PM has 10 million pounds (RM67.22 million) available for Pusat Latihan Prestasi Tinggi (PLPT) in the Pusat Penyelidikan Tun Abdul Razak (TARRC) di Brickendonbury, England but accident victims are left to rot/die in Malaysia.

  26. #26 by karenleehs on Tuesday, 5 June 2007 - 2:52 pm

    Let me share my experience I had with the Selayang Hospital (government hospital with high tech facilities so to speak)

    My brother-in-law had an accident where he slided and fell from a 10 metre waterfall from Templer’s Park and suffered severe head injuries. Good samaritans brought him to Selayang Hopital and he was placed at the Emergency room for observation from 6.00pm till 9.00 am the next morning….. all this with his forehead badly swollen and his eyes were significantly bruised…. while under observation, he went for a normal x ray and wasn’t even given any pain killers though he complained of a bad headache….. at around 11.00 pm on the same night he vomited a lot of blood and was told to wait again…….

    The very next day, we sensed something was not right as he could no longer recognised us and his pain was becoming unbearable. We asked for a discharged and wanted a copy of the x ray…. he was then wheeled in again to the x-ray room for another x -ray to be taken…. in the end, we did not receive any medical report nor x ray report and our request for an ambulance tranfer was denied. We had to very carefully place my brother in the car and transported him ourselves.

    We went to Gleneagles and was immediately taken to the emergency room. The late Dr. Arumugan operated on my brother-in-law on the same morning itself and managed to remove the clot, bone splinters and place a metal disc in replace of his broken skull……… Had we waited at Selayang, we would have lost our brother-in-law……..

    Conclusion…… decision making by the immediate relative is important. Worry about the cost later, one could always pay by credit card first then sort out the payment witht the bank.

    When faced with emergency situations, never ever send your love ones to the government hospital ….. you are sending them to the mortuary.

    Third, always ask…. push for action even if you are at the private hospital….. because hey, we are in Malaysia…. we are famous for our Tidak Apa attitude…… do you think the nurses will place utmost urgency with your love ones???? They have seen so many of such cases… they don’t even bother…….

    We can’t change the whole nation, we can change ourselves…. be alert and knowledgable to handle crisis at hand……

  27. #27 by kelangman88 on Tuesday, 5 June 2007 - 3:35 pm

    US good in this. Malaysia very bad. Mmm….very humiliating to be said as Islamic country. At least, if secular, Islam won’t get the bad name. Good religion. Bad administration.

  28. #28 by TheThinker on Tuesday, 5 June 2007 - 5:02 pm

    I don’t know if we are anywhere near achieving best practice as yet but I do know this . . . that compared to all other private hospitals . . . Assunta is the only one that would have taken her in immediately to stabilize her condition . . . although they may have faltered after that, the fact is that other private hospitals would have denied her entry all together, without giving her so much as a band aid.

    Public Hospitals on the other hand aren’t much better, I remember my grandmother being discharged from UH without a stable heart beat !! . . . We then moved her to Assunta being the most affordable private hospital where she finally recovered.

    My point being, Assunta may have not taken the best steps in the given situation, but in my opinion it’s better than any other hospital in this country would have.

  29. #29 by mwt on Tuesday, 5 June 2007 - 6:52 pm

    marmitecrab (at 10:43 am) has a valid and pertinent point. It‘s “god’s will”.
    Who created this reality? The choice, manner and time of death are always yours. You created your reality wherever you go. In each life you choose and create your own settings or environments; and in this one you chose your parents and whatever childhood incidents that came within your experience. You wrote the script. Like a true absent minded professor, the conscious self forgets all this, however, so when tragedy appears in the script, difficulty or challenges, the conscious self looks for someone or something to blame. You form your experience; you form your past, your present, and your future. You are responsible for each daily moment, individually and en masse. You make your own reality: your dreaming reality, your waking reality, and all realities in which you have existence. There are no accidents. Your joys come from you, and your successes, and your failure, or what you think of as failure.
    You are in physical existence to learn and understand that your energy, translated into feelings, thoughts and emotions, causes all experience. THERE ARE NO EXCEPTIONS
    Death is greatly misunderstood as being the end of it all, of coming too soon. Death always seems to be something just out of your understanding, responsibility, control and power. This is completely inaccurate. Death is a transformation – from one way of being into another. A death is just a night to your soul.

    No one “dies” before his or her time. When the soul is ready to release the body, when it has accomplished what it came here to do, it moves on. There is always a reason. To realize that each soul is making these decisions is a beautiful, healing and freeing experience.

    No man or woman consciously knows for sure which day will be the last for him or her in this particular life, that each calls the present one. Mortality with its birth and death is the framework in which the soul, for now, is expressed in flesh. It seems, perhaps, easier to have no conscious idea of the year or time that death might occur. Unconsciously of course each man and woman knows, and yet hides the knowledge.
    The knowledge is usually hidden for many reasons, but the fact of death, personal death, is never forgotten. It seems obvious, but the full enjoyment of life would be impossible in the framework, now, of earthly reality without the knowledge of death.
    Life and death are but two faces of your eternal, ever changing existence, however feel and appreciate the joy of your own being.
    Always remember, whether you die today or tomorrow, you have lived before, and will again, and your new life, in your terms, springs out of the old, and is growing in the old and contained within it as the seed is already contained within the flower.
    Remember life implies death, and death implies life.
    Death is therefore as creative as birth, as necessary for action and consciousness, in your terms. Rest assures that death is another beginning. You had lived before and will live again.
    For a “money or your life” account of this reality, goto

  30. #30 by WFH on Tuesday, 5 June 2007 - 7:38 pm

    Many have written above that one cannot do without medical insurance because the costs are getting much too high, and that Assunta Hospital cannot/should not be faulted.

    Over time I have had experiences with SJMC, Assunta, Selangor MC (Shah Alam), KLGH, UMMC, Mt.E in Spore, yet another in another ASEAN country, plus many more visits to consultants in their private practices, and have expended, let’s just say in aggregate, multiples of 6 figures. Yes, it is VERY expensive, enough to wipe out the family reserves. It must be cautioned that even with medical insurance, especially the more affordable/less costly plans, one needs to worry about the Schedule whether your coverage is wide enough should some unfortunate event strike.

    In my opinion, there is no other way except for Government leadership and direction in this matter of public health. No compromise. The government cannot walk away on this one. In my further opinion, the medical sector must NEVER be driven by the private sector. Even though the private medical sector has been by now already entrenched in their “business” of running private hospitals, I still say the Government cannot afford to avoid or be lax in its responsibility to the Rakyat, to ensure that mechanisms exist that no one is turned away or sent off a private hospital on grounds of no upfront cash deposit or credit card imprint.

    If this government cannot think of a way to manage emergency health-care services, then it is doesnt deserve the job of governing, even if there are (arguable) successes in other areas.

  31. #31 by undergrad2 on Tuesday, 5 June 2007 - 7:48 pm

    The U.K. has a ‘cradle to grave system’. No personal health insurance is needed. When your wife goes into labour and is taken to hospital for the delivery, she does not have to pay a penny. Instead a nurse is provided to her later when she goes home. This nurse will make periodic visits to the house, giving free supply of diapers and milk and whatever assistance the mother needs.

    In a more capitalistic system such as the U.S. some 45 million do not have health insurance and are not covered. It is either not made available to them by their employer or made available but too expensive for them to pay the premiums. Many do not have coverage because they are either unemployed or do not have permanent employment.

    However, that has nothing to do with treatment at hospitals. They are never turned down because they cannot afford the cost of medical treatment. There are charities working closely with the hospitals ready to offer whatever financial help is needed to pay for the cost of the medical treatment. The Out-Patient clinic of the hospital would only ask you if you have health insurance, and if you do not you still get to see the doctor and receive medical treatment.

  32. #32 by terencesgk on Tuesday, 5 June 2007 - 9:15 pm

    From what I see, there is definitely no resolve from anyone (in authority) to prevent such incidents from happening. Having a medical insurance surely help but the cost of having one is definitely not cheap too. I doubt with what you can afford, you are protected throughout your whole life.

    Health services, being one of the most essential services around (life is at stake), must not be too commercialized, or need to be regulated further (especially regarding their charges). One of the reasons why premiums for health insurance is expensive, as I have been told, is unscrupulous charging by some private hospital. A relative on mine told me that she was charged >RM250 for a doctor visit to check on her heartbeat during one of her stay in a private hospital.

    The reason why we need a government is for them to take care of such services (healthcare, utilities, transportation). To provide such services at a price affordable to all, you definitely can’t make money. Yet, we see companies providing such services making millions after millions, years after years. Hospital charges aside, Mdm Yek’s incident has definitely shows the shortcomings of our healthcare system. Some commentators compared our system to that of S’pore and the US. I think the authority concerned, MOH especially, should really look into these. Failure to provide such services, at a price affordable to all, after collecting taxes from the people would definitely not wrong to be construed as failing the people.

  33. #33 by marmitecrab on Tuesday, 5 June 2007 - 10:09 pm


    Having medical insurance is better than not having if you want access to private healthcare services. Contrary to what you suggest, if done at the right time and through an experienced agent, the many plans available can be affordable to most people. And depending on what plan you purchase, you are covered for your entire lifetime.

    It is unfortunate one of your relatives got charged so much but you need to know that private hospitals have to charge according to the latest Schedule of Fees as laid out by the Malaysian Medical Association and they cannot charge more than what is allowed. In fact, a lot of private hospitals charge anywhere from 10 to 20% below what is stipulated. Private hospitals are also requested to provide emergency services first before asking for a deposit, which is what Assunta did. Please read the following excerpt:

    “Local News: Private hospitals are reminded that they must provide immediate emergency treatment
    Posted by: Lenny on Monday, April 10, 2006 – 04:47 PM

    Kuala Lumpur – Private hospitals in the country are reminded that they must provide immediate emergency treatment to patients without waiting for deposit payment.

    Health Minister, Datuk Dr. Chua Soi Lek said, they should also communicate with te patients and their relatives during the emergency treatment.

    Datuk Chua said, these aspects will be stressed in the Private Healthcare Facilities and Services Act 1998 (PHFA) which will be enforced from May 1.

    On the question of hospital fees, Datuk Chua said, the payment to private hospitals came under the “schedule fees” agreed to by the Malaysian Medical Hospital (MMA).

    The disparity in hospital fees between hospitals would be resolved when the new act was enforced which would empower the Health Ministry’s Director General and the minister to alter the “schedule fees” if they were unrealistic.

    The minister will also be empowered to decide o­n the nature of social contribution by the private hospitals.”

    Please take note that this was announced last year.

    And your comment that private hospitals are making millions, year after year is somewhat suspect. I’m not sure if they are all making so much money but the ones I’m familiar with are very likely to be just breaking even. Hospitals rarely make any money because of high overheads and cost of equipment, mainly done to attract the top specialists to consult at the hospital. It is the doctors who are making the big bucks. So if you want your fees reduced, please ask them for a discount.

    Finally, the government has not failed to provide such services as emergency services are still very much available to everyone. And at an incredibly affordable price. Don’t believe me? Try calling for an ambulance and try out the system. You may not be too satisfied with the service but it is there for you should you need it.

  34. #34 by pwcheng on Wednesday, 6 June 2007 - 1:31 am

    marmitecrab says “Assunta, like any other private hospital has the right to charge whatever they wish, as long as it is approved by the govt”. Yes you can charge anything that is reasonable, but when it becomes too obvious that they are unreasonable, it is like cheating. I think they are also taking advantage of the situation as when you are sick you tend to overlook at all these and just follow all their instructions blindly and pay what they ask you to pay.

    To me one must be ethical, especially for a hospital who must give confidence for the patient instead of indulging in unreasonable charges and unethical practices.

  35. #35 by marmitecrab on Wednesday, 6 June 2007 - 12:58 pm


    You need to ascertain what is unreasonable first. Because what is unreasonable to you may be reasonable to others. That’s why there is a Schedule of Fees for the hospitals to follow. You also need to do a comparison with other private hospitals to see what their charges are for the same services to determine if Assunta is really overcharging. I’m not defending Assunta, on the contrary, I feel that Assunta is not all that cheap either, compared to other hospitals. But what I’m stating is, be fair when you comment.

    When you are sick, the last thing you want to be is sicker by looking at an overinflated bill. Most people will check their bills first before paying. Unless they are covered by insurance, in which case, the insurance company will query the hospital for every single item on the bill.

    Finally, ethics is something the industry discusses all the time, year after year. The problem is, it is a neverending discussion and what is ethical for you may not be for others. No solution in sight.

    NB: While the medical industry is regulated by a Schedule of Fees, bear in mind the legal industry isn’t and lawyers can charge you anything they want under the sun and you have no recourse nor protection from it. Which is more a more important service? Saving lives or legal action? Think about it.

  36. #36 by RGRaj on Thursday, 7 June 2007 - 12:22 am

    The effects of living in a materialistic world. This is the cold hard truth. Everything is done with an ulterior motive.

    Florence Nightingales don’t exist anymore. So now you know why every year, medical seats seem to be in high demand among students. The “desire” to help people is crap. The truth is, it’s all for $$$.

    In conclusion, we’re simply reaping the results of our own sowing.

You must be logged in to post a comment.