National Health Financing Scheme…. more money for who?

By Liow Kevorkian

I refer to Health Minister Datuk Seri Liow Tiong Lai’s statement to the New Sunday Times stating that to ensure all Malaysians get adequate healthcare, wage earners will have to make scheduled monthly contributions to the proposed National Health Financing Scheme (NHFS). The self-employed, those who have an independent income as well as employers would also have to contribute.

I do hope the Pakatan Rakyat take their gloves off and beat this guy to a pulp on behalf of us tax payers before this entire scheme becomes another national shark swallowing contributors’ and tax payer’s money ripping another financial hole in our already empty treasury. The current Health Minister who has no significant support from even his own community and his hopelessly inefficient Health Ministry officials must first be made accountable for all the healthcare disasters that have made this country firmly entrenched as a third world nation in healthcare.

We can first start with all the useless hospitals built all around the country only to make the BN’s cronies rich, including the current disastrous misadventure at the Section 7 Shah Alam Hospital and in Kota Kinabalu…no hospital at all! We can then move on to why these “new” hospitals started leaking, why the government has to pay for drugs at 20 times they used to cost before, why drug label holograms have come in, why only Bumi doctors are given top specialist posts, why only Malay doctors are given specialist scholarships, why non-Bumi doctors are consistently excluded from civil service top positions and instead these positions are given to expatriates of other Muslim countries, why only Bumi companies are allowed to tender for medical equipment or pharmaceuticals.

Why almost all Health Ministry Pengarahs, DGs, Deputy DGs and Deans of Medical Schools posts are given to only Malays or Pseudo-Malays. And why Health Ministry officials involved in massive corruption deals in the Ministry like failed multibillion dollar vaccination facilities and hospital software programs resulting in massive losses to this nation remain unpunished.

Before the people of this nation are forced to cough out even more money, the Health Minister must first answer and ensure that these corrupted deeds are dealt with first. The people of this country will not pay even one cent more unless the Health Ministry or this government comes out clean on these ludicrous deals that has left this nation now saddled in deep debt for decades to come.

Let’s not even talk about how this government sweeps under its carpet the unacceptable mortality and morbidity rates caused by its poorly trained specialists and its supporting staff. It is no secret that civil service doctors literally get away with murder with tax payers having to foot the bill for negligence suits over and above the death and maiming of patients. Its specialists and doctors still remain unpunished by even the government controlled Malaysian Medical Council even though the government’s own hopelessly biased courts have made the Ministry, its DG and its doctors liable on many occasions.

Malaysia cannot implement the NHFS without first correcting the gross inefficiency of the MOH. No use putting the cart before the horse. Almost everyone in the health industry know for a fact that this government is directionless. This confirms the fact that the government is not interested in change at all. We live today in a world where life expectancy has increased and costs of healthcare of the modern human being is technologically on that very steep exponential rise.

Like it or not, the modern Malaysian man, woman or child needs maintenance. Read that as healthcare. And this maintenance with current available technology is beyond many governments’ abilities, let alone a small nation like Malaysia. The zillion dollar question is, when we now have no financial resources, how do we sought this out? Do you invest in pricey acute, hospital based medicine or preventive healthcare or both?

Look around. The Aussies, Kiwis, Europe and Malaysia’s motherland…Britain. They are all pouring a greater proportion of their resources to that little guy out there called the …GP. Yep the General Practitioner. The GP needs to prevent and control hypertension, diabetes, heart disease, renal disease, early geriatric problems, almost anything from vaccinations to the flu before that flu becomes a full blown pneumonia.

And who killed the GP instead of developing them??? Yep the Barisan Nasional and its dense Health Ministry “head in the sand” health officials. So you now have a situation where patients walk into ERs (Emergency Rooms) and expect to be treated even at 2am for constipation. The BN dug its own grave. They now have to lay in it.

And what of the side effects of sidelining the GP? You now have a scam specialty called Emergency Medicine with all the expensive salaries, allowances, etc etc with very very expensive ER Departments being built at almost every General Hospital. What is this? Another rip-off by the government to build giant GP clinics as part of its hospital set-up? You shouldn’t then complain if patients walk in at 3am for a flu, especially if you close your community clinics at 4pm sharp should you? Now, which dimwit came out with this idea to burn Malaysian tax payer’s dollars? And who are the bigger nincompoops who actually approved it?

There is apparently now a “war” between these substandard “Jack of all trades, master of none” ER “specialists” who now hold onto emergency patients trying all soughts of medical and surgical acrobatics before calling in the “real” specialists. The end result? Some hospitals “equipped” with these ER specialists has actually seen a 3 fold rise in mortality at its ER department. This scenario is now an open secret in the industry.

In the very first instance an experienced, alert GP could have actually counseled and treated a patient to avert a catastrophic ailment. Like please take your hypertension medication before you blow that artery out in your brain. Or how about you not taking Xanax before you drive that car. Or how about, you the bus driver, coming in for your urine amphetamine test before you drive off the cliff with 40 passengers.

There was a time when doctors were giving out milk to mothers to be and children and billing TNB. And TNB actually howled “Cheats!!!” and joined the entire chorus who sang “MCO” (Managed Care Organizations). Just so to save a few bucks? And for what? Today, if that GP had been allowed to develop and flourish, perhaps they could have been the conduit to educational counseling. Dont speed on the road. Healthy food. No miracle herbs that actually knock off your kidneys. Safe sex. Condoms. No smoking, etc etc. And if the government had invested that small amount into that little guy called the GP, we today will not be crying ‘CORPORATE HOSPITAL!!!!” And you know what? The Ministry of Health had to join the band wagon. They had to go ahead and build even bigger “IT” hospitals…with NO SPECIALISTS!!!

But the biggest blunder has to be the government’s “QUANTITY better then QUALITY attitude”. Just look at the number of housemen in our hospitals??? On some wards, more housemen than even patients! This mass low quality production of doctors is akin to Masterskill, MAHSA, etc, etc dishing out loads of physiotherapists and nurses who now have no jobs and are on the breadline.

Just walk into HSBC’s call center in Cyberjaya and you will find all these “health personnel” doubling up now as call center personnel. To rub it in almost all of them are saddled in deep debt courtesy of their massive study loans, with they receiving legal notices, black-listed by credit rating agencies, names splashed in newspapers as loan defaulters and passports blocked off – all before you are 23 years! Only in Bolehland can this occur. Just so some crony can milk the tax payer to feed his university cow to churn out a bankrupt graduate. It is actually better then the AP buisness.

Healthcare in Malaysia to the middle class in Malaysia is economically and technologically out of bounds not because of its lack of resources but because Malaysia has a huge boulder on its head called the Ministry of Health who have no management expertise and are completely clueless as to the strategies that need to be employed in a 21st century globalised Malaysia.

And why? Because it is run by civil service medical bureaucrats who technically become “policy makers” when they hit Jusa C and actually decide for the nation without having to work even one day in the private sector where the real world is ticking away! Just shut the hopelessly corrupted MOH down, and the free market will sought itself out on its own. Just like water, electricity and sugar. And only then should the insurance companies kick in. But if you choose to do it the other way round, you better be prepared to deal with an even larger financial leak five years down the road. Hopefully by then there will be an Obama born in whatever that is left of this nation to bail Malaysia’s sorry healthcare skin.

  1. #1 by Fatty Doc on Monday, 12 July 2010 - 12:01 pm

    Very nicely written article, I must say. Most are facts which most public and non-medical people wouldn’t have known if not for this article to be published!

    We must thank Chua Jui Meng back in those days, who first started off by approving those Muslim foreigners who were “invited” to come work in BolehLand, with expatriate immunity and pay; they got double our salary, but worked only half of that becoz of their incompetency. Better ones were kept in the west, but most lousy ones were thrown to the sabah/sarawak, even to remote districts serving as specialists or MOs.

    I am not sure, but rumor told me, that later CSL tried to iron out all this “import doctor” shit hole, but he came out with the PHFSA which further angered the medical fraternity; and even causing a Malay doc end up in jail. For good or bad, I leave it to you all to think about it.

    NHFS might be a good thing, as we see Medicare in Australia or NHS in the UK, but in Bolehland, I am not too sure if their intention is a good one, or is it becoz the govt is trying to milk the tax payer further!

    No matter what, from a GP point of view, probably the NHFS would bring good news for the new GPs, but definitely not for the old and established GPs (becoz of fair share patient policy, they might lose the existing patients to the new GPs)

  2. #2 by k1980 on Monday, 12 July 2010 - 12:05 pm

    Sounds like Obama’s Medicare Insurance.

    If let’s say RM100 is deducted every month from one’s paycheck, jibby would get 15,000,000 workers X RM100
    = RM1.5 billion a month!

    Can buy 12 more Scorpene subs with RM6 billion commission and no need for more Altans to blow up with c4

  3. #3 by k1980 on Monday, 12 July 2010 - 12:22 pm

    With the huge number of scorpenes, we can then invade Israel and chase the Jews from the holy land. Then we can defeat the Americans and chase them away from Afghanistan and Iraq. After that we bomb Russia and chase them out of Chechnya. That is why we must buy more and more scorpenes, with the money we get from the National Health Financing Scheme (NHFS). Am I right, Mr Abraham Ali of Perkasa?

  4. #4 by Tikus Belanda on Monday, 12 July 2010 - 2:31 pm

    I would suggest we take back Singapore since they were part of this Bolehland. Also over run Brunei as well since they cannot be a small country without our might. Take over the southern Thai, create a new state call Langkasuka as the Muslims there would definitely support BN.

    After that, buy from Indonesia island by island until all Indonesia is ours.

    As such rate, we would be taking over the whole SEA, very diplomatic & no violence. Better than Japan in WWII.

  5. #5 by Bigjoe on Monday, 12 July 2010 - 3:06 pm

    What is shocking is that Liow Tiong Lai being of a new generation of BN leader don’t get it that the fundamental fact that people are not going to give BN any money in any form until there is reform. There is no point talking the merit of any plan. Its fundamentally about police, the judiciary, the MACC, the civil service before the people will accept any plans.

    If these younger leaders are working on old assumptions that no longer works and just hoping it will work again somehow, we are all in a big trouble.

  6. #6 by Tikus Belanda on Monday, 12 July 2010 - 3:17 pm

    Insanity is doing the same thing over & over expecting different results.

    Look around & see who is giving all these insane propositions. Think the rakyat is stupid or what?

  7. #7 by limkamput on Monday, 12 July 2010 - 5:19 pm

    Sdr Lim, I am glad you have finally brought up more pertinent and pointed issues for discussion here. This paper is very well written, obviously by someone who knows what is going on intimately in MOH.

    How do we produce well-trained specialists when most doctors, especially those from very dubious universities from Indonesia, Egypt, Russia and India are recruited by the thousands?

    Yes, just “marketise” everything; it is better than this moronic government trying to do everything. Please, the government should do less not more. There is no need for you to regulate, “promote” (promoting my ass actually), control and monitor any damn thing. You only messed up everything be it health care, automobile, subsidies or price control. You moronic idiots have no idea how the economy/productivity/efficiency work.

  8. #8 by drngsc on Monday, 12 July 2010 - 7:46 pm

    Saudara Kit, If it is any help. The last discussion in Feb 2010 was a contribution of EPF + 7%. The exact proportion of split between employer and employee had not been decided in Feb 2010. We have protested and objected, but it looked like it has already been decided. We were called to be informed. They had suggested a UK-NHS like system with local modifications. We are just not ready. Somehow, I feel that they are after the pot of gold. I think that its implementation depends on the results of GE13. So folks, you all know what to do,

  9. #9 by HARGA diri on Tuesday, 13 July 2010 - 6:26 am

    Do you have the real, tangible, seen, solid cold hard cash ? If you cannot show us what you have, then let’s just continue the system where if you are sick, you go see a medical professional, you pay for all the treatment including services and tax. You feel worth it because you are controlling your own money. Don’t get an insurance unless you have the money for it. You have to pay whether private or public All fees must be either standardised or within a range. In an emergency situation, it will be you owe it until you are healthy and can pay up or face the law. Medicine is expensive. Studying to become a doctor takes at least 5 years. Studying to become other medical professionals take at least two and a half years.

  10. #10 by Godfather on Tuesday, 13 July 2010 - 12:12 pm

    They sit around in Putrajaya and brainstorm on how to raise money because the coffers are running really low after the decades of abuse of taxpayers’ money. So they come up with gems like GST, healthcare contributions, etc etc. Who else is going to pay for the scholarships promised to all SPM high achievers ? Who else is going to pay for the RM 35 billion subway contract in the Klang Valley or the RM 1.2 billion palace or the RM 12.5 billion PKFZ scandal ?

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