Class divisions in access to healthcare — what about Malaysia?

By Azly Rahman

‘Why can’t all Americans have the same access to healthcare to those enjoyed by members of Congress?’ is a popular question on the ObamaCare debate.

At the time of writing I am following the debate over universal healthcare for all Americans. If the US$1 trillion Bill passes, it will help insure 32 million Americans that do not have access to healthcare.

This is another controversial issue in the tradition of Democrats and Republicans. This is a good case study of one of the enduring issues of an advanced capitalist state.

I know friends who do not have health insurance and who question the human rights dimension of it – right to life, liberty, and the pursuit of happiness, endowed by the Creator who insist that ‘all men are created equal’ and cautioned by the Enlightenment thinker Jean Jacques Rousseau that “… everything is good in the hands of the Author of Things and everything degenerates in the hands of Man”.

From the point of view of the Democrats, the health insurance system is broken and in deep crisis. Millions cannot get proper medical health. The insurance system is predatory. Expanding health coverage and lowering prescription drug prices, and giving insurance rebates to companies are the main features of this proposal.

From the Republicans’ point of view, Americans need health reform but not to the point of bankrupting the country. A Bill which covers the cost of abortion is the controversial part of it; that Americans must not pay for those who do not have the respect for life. The Bill is said to be a wrong approach that will make winners and losers in the system. Essentially it will open up other complications in virtually all aspects of the system.

Whatever the outcome of it, Americans will still be divided ideologically on this issue. The argument is emblematic of the American political philosophy: what is the role of the government vis-a-viz the social contract between the ‘ruler and the ruled’?

It is a classic Jeffersonian-Franklinian debate. America has evolved into a country envisioned by Benjamin Franklin – America which is more of the big business and less on the man on the street.

Americans are taught to not trust governments; its history is that of a revolt against British colonialism famed by the slogan ‘taxation without representation’ and therefore ‘give me liberty … or give me death’, as the revolutionary leader Patrick Henry said.

Americans went to war and bankrupted the nation. It was a Republican war. That drained trillions of dollars, perhaps contribution to the near-collapse of the American Empire, as many a Complexity theorist would propose. The Butterfly that flapped its wings in Baghdad, near Saddam Hussein’s mansion has contributed to the turmoil in the Obama Office.

Rights of all Malaysians

But what is the situation in Malaysia, as we have evolved as a modern state enculturalised by happenings in other advanced countries such as the US?

How do we care for the sick? Essentially is there also a class system in our healthcare system? Do the poor get the same treatment as the wealthy members of parliament or those in the list of billionaires?

With the proliferation of private hospitals, are we creating the foundations of a class system that will inherit the problems the Americans are trying to resolve?

Or is this merely a natural progression of an economic system that is also predatory in culture – that the rich will be richer and the poor growing in numbers?

With the urge for Malaysian private hospitals to venture into ‘medical tourism’, will our good doctors abandon their Hippocratic Oath in favour of professional hypocrisy?

Marx would say that we are defined by the economic condition we are in – we are homo economicus. I suppose how we live and how we die and how we are taken care of in-between this period of ‘borrowed time’, depends on how the state defines what human rights mean vis-a-viz our ability to pay for healthcare and how we lived our lives as a economic beings.

We must consider that each human being is a cog in the wheel of Capital. Those who own the machines of production oftentimes influence policies through political-economic arrangements.

A wealthy country such as Malaysia that prides itself on tall buildings and a growing number of billionaires ought to start reflecting on the need to ensure that each citizen will have affordable healthcare.

One wonders what the limit of wealth creation is and where the moral dimension is in capitalism, when the rich control the lives of the poor.

By shaping ideology and creating installations to change the social relations of production – and by doing this through the control of mind, media, machinery, and materials – we expect that wealth is to be shared. Socialism for the rich must be replaced with capitalism for the poor.

It’s 11pm here in New York. The historic Bill has just been passed, 219 to 212 in the House. God bless the life of 32 million more Americans. Let Malaysia learn from this victory!

  1. #1 by best4rakyat on Wednesday, 24 March 2010 - 10:10 am

    Thank you Sdr. Kit Siang,
    This article is timely for Malaysian nonetheless not only our healthcare has often been overlooked by policy makers or government yet our education system etc etc including welfare has not been equally considerate too!
    A very good example though is in the initial stage by 5 states with reconcile good policies for people has shown better result than that of after 52 years of administration by BN as I can see.
    What about a good care or may be useful system for all aged malaysian? They are always ignored or not taken care of other than good pension scheme forever for only government servants etc.
    Good review timely with this US as for Malaysia for healthcare issue.
    Meantime, regard to proposal of meeting Sabahan in KL on 418 I suggest instead do include those others too. You may take a look at those around city center at St. Mary Cathedral next Merdeka Padang who often had been served meal. Thank KIT and in God we trust that this is always hanging in the mouth of Minister of Welfare and Works. What KPI they are talking about?

  2. #2 by rabbit on Wednesday, 24 March 2010 - 10:29 am

    Brot LKS… never think of that in PM brain. He can rather give away the funds to others…the One M is diffrent meaning.

  3. #3 by rabbit on Wednesday, 24 March 2010 - 10:37 am

    LKS, you must be kidding to PM, do you think he will dump the cash into deep sea? I think he rather keep inside…. hahaha

  4. #4 by Fatty Doc on Wednesday, 24 March 2010 - 11:14 am

    So is the recent hyped-up 1Care Program rolling out under the 10th Malaysia Plan another good thing for the public to enjoy heavily subsidized health care?

  5. #5 by yhsiew on Wednesday, 24 March 2010 - 11:23 am

    This is a tricky question. This capitalists say they put it a lot of sweat and hard effort in their business venture to earn big money and therefore they deserve to enjoy the fruits of their labor and have good access to better health care. Their argument is valid. On the other hand, the moralists say every human being has the right to life, liberty, and the pursuit of happiness, endowed by the Creator who insists that ‘all men are created equal’. Their argument is equally valid.

    In the case of Malaysia, a compromise can be reached if the government can set aside a portion of the EPF money for national health care provision – that is only my personal view.

  6. #6 by yhsiew on Wednesday, 24 March 2010 - 12:10 pm

    #5 Oops!

    “This capitalists say” should be “The capitalists say”.

  7. #7 by dagen on Wednesday, 24 March 2010 - 1:49 pm

    Equal? All of us? No. Here we have umno-the-GOD and then there are the rest of us.

  8. #8 by Winston on Wednesday, 24 March 2010 - 5:49 pm

    The health package passed by the American Congress tried to lessen the helplessness felt by the poor with regard to health care.
    Like America, our health insurance companies also denies insurance to those with an existing illness.
    They also deny insurance to those over a certain age; an age at which they need health insurance more than anything else.
    These companies also take it upon themselves to jack up the premiums when the policy holders submitted claims and become penalised.
    This shows that they have an utter lack of the purpose of health insurance.
    Insurance, in fact, all types of insurance, is the pooling of common resources by the policy holders to protect themselves in case of need. And if there be a need to increase the premiums, then ALL policy holders should be paying more, not just the claimants.
    This way the amount paid by each will be much lower as against the payment by only those who claimed.
    In the final analysis, the government, meaning a responsible government, must put a cap on such matters. And that includes, pharmacy charges as well as medical (doctors)/hospital fees.
    Only then will we see a more level playing field.

  9. #9 by drngsc on Thursday, 25 March 2010 - 8:12 am

    Yes, Healthcare is being looked over carefully under the coming 10Malaysia Plan. A healthy debate is critical now. What if the government propose a centrally run ” social health insurance ” paid for partly by increase taxation? Or is it better to ask the government to increase healthcare spending ( we are now spending 7% on healthcare, roughly about 4.3% GDP ) to retain the the present system with improvements. The US system is full of inefficiencies and very defensive. We should not copy most of it ( maybe some of it ). Lets hear what the rest have to say?

  10. #10 by jayenjr on Thursday, 25 March 2010 - 2:02 pm

    I don’t Najib/UMNO gives 2 cents about healthcare reform. He doesn’t even bother about political reform; what’s health care to him eh?

    Anyway, read this article by the Sun, on plans to limit 3rd party claims for motor accidents. Now, if the government co-insures the risks as proposed by the insurance companies, can we then appreciate what Najib’s mind set is?

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