Health

National Health Financing Scheme…. more money for who?

By Kit

July 12, 2010

Letters 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.