1Care: What ails Malaysia’s healthcare system?

— Mustafa K. Anuar
The Malaysian Insider
Feb 04, 2012

FEB 4 — Supposedly based on the UK National Health Service (NHS), the 1Care scheme is said to be aimed at financing the supposedly increasing costs of public health care while making it still affordable to the lower-income group.

But we fear that, like most other “restructuring” schemes in the past, 1Care will deliberately result in the escalation of costs to ordinary Malaysians and the outsourcing of contracts to corporate interests — financed by public funds.

The direct beneficiaries — private hospitals, health management organisations, pharmaceutical firms and those administering the national health financing fund — are likely to profit handsomely from this scheme at the expense of the public.

We recall how the costs of pharmaceuticals soared after the Government Medical Store was privatised in 1994. A similar rise was seen in the costs of general hospital support services after they were privatised.

The mantra of so-called cost-effectiveness that is often promised with such restructuring or de facto privatisation schemes is highly questionable. Critics of the 1Care scheme justifiably claim that the quality of health care treatment will plunge. The new health care financing authority may impose limits on the number of hospital visits by a patient or introduce financial incentives for GPs to limit their number of referrals to specialists in the effort to trim costs and improve profit margins. The welfare of the weak and the poor will be sacrificed without any qualms on the altar of greed and profit.

In effect, 1Care will provide massive public subsidies for private hospitals. Payments out of the national health care authority’s funds (raised from the public via taxes and monthly public contributions) will serve as large subsidies to boost admissions, the occupancy and the bottom line of private hospitals and GLC-owned “private” hospitals. (With such a scheme in place, even government hospitals could end up behaving like private hospitals.)

An analogy would be the use of public funds given out as PTPTN study loans, which effectively acts as a huge government subsidy to private colleges, which have mushroomed. The cost is borne by indebted ordinary students, who have to make long-term study loan repayments.

Malaysians will probably have to pay 6-10 per cent of their monthly income in contributions to the 1Care fund. A significant chunk of this money will go towards the administration costs of the fund. The pockets of ordinary Malaysians could be hit even further if they opt for a GP of their choice. What about those who are unemployed or unable to afford health insurance contributions? How will they be able to get medical treatment under this new scheme?

There is basically not much that is wrong with the existing public health care system that cannot be fixed with a greater allocation of government funding and more effective management of personnel and resources. At present, the government spends around two per cent of GDP on public health care — a pathetic amount well short of the internationally recommended 5-6 per cent. Why not allocate more funds to our general hospitals, which already provides universal coverage to anyone who needs treatment, instead of squandering public funds on useless projects or allowing massive corruption to persist?

We call upon the government to reconsider its plan to implement this massive scheme. Spare the ordinary rakyat — already suffering from the effects of inflation — this additional heavy financial burden. Just allocate more funding to our general hospitals and ensure that it leads to a distinct improvement in the quality and efficiency of our general hospitals.

A government of the people has the responsibility and moral obligation to protect the interests of the rakyat — and this includes their health care. Tak nak 1Care! — aliran.co

  1. #1 by yhsiew on Saturday, 4 February 2012 - 7:24 pm

    Pakatan should not just stand by and watch but come up with an alternative health care proposal in its GE13 manifesto naming the proposal “We-Care” which involves dismantling the privatized Government Medical Stores, improving funding of the existing public health care system and proper deployment of staff, doctors, specialists and resources.

  2. #2 by drngsc on Saturday, 4 February 2012 - 7:40 pm

    I am sorry. But you asked the wrong question. Nothing ails the Malaysian Healthcare System. Yes, like all services, it can be improved to keep up with the times. But it is not so sick that it requires a complete overhaul.
    The question should perhaps be, ” What ails the Malaysian Government”. They are prepared to privatised their social responsibility, and outsource healthcare to a private entity.
    “What ails the Malaysian government when it is prepared to take away about 10% of household income, in these very challenging times”
    Are you prepared to leave RM 44.5 billion in a central fund for healthcare.

    PLEASE LET US ALL COME FOR THE SELANGOR / KL HEALTHCARE PUBLIC FORUM ON 12th Feb 2012, 4-6pm, at the Global Business and convention Center, Section 19/1 PJ. There you will get more details, facts and figures.

    “What ails the government of Malaysia”. Much, much, very much.

    It is time to change the tenant at Putrajaya. GE 13 is our best chance. Failure is not an option. Let us all work very very hard.

  3. #3 by Winston on Saturday, 4 February 2012 - 8:39 pm

    If billions or tens of billions can be splurged on unnecessary
    hundred-storey buildings and other non-essentials, why can’t
    more be allocated for healthcare?
    The health of the citizens is far more important than any
    And for five and a half decades, the BN government has been
    extremely parsimonious with its budget allocation for health
    With our plentiful natural resources which included petroleum
    as well, we should have a world class health system without
    all this nonsense. And no sweat!!
    So, can the BN government tell its citizens whatever happened to
    all the wealth that should have been accumulated all these decades?
    Why should we be in this state of penury?
    Can it still say that it is a caring government?
    If you cannot govern the country properly, just get lost!
    Don’t waste our time!!!

  4. #4 by boh-liao on Saturday, 4 February 2012 - 10:54 pm

    1Care is iSuck, at d end UmnoB/BN kakis n their cronies JIAK ka liao, suck rakyat DRY

  5. #5 by Loh on Saturday, 4 February 2012 - 11:24 pm

    UMNO always thinks that it is alright for the public to suffer a little so that a few people can be made successful as billionaire. That is why we have the NFC project, for example.

    A good proportion of Malaysians are suffering from malnutrition at the current inflated prices and deflated incomes. By paying 9% of their gross income to 1-care, they will need 9-cares.

  6. #6 by raven77 on Saturday, 4 February 2012 - 11:48 pm

    You mean we now actually have to pay for incompetence…?

  7. #7 by k1980 on Sunday, 5 February 2012 - 2:46 am

    //Malaysians will probably have to pay 6-10 per cent of their monthly income in contributions to the 1Care fund. A significant chunk of this money will go towards the administration costs of the fund. //

    Ask those teachers who were coerced to join the now-bamkrupt “Bank Guru” about 15 years ago

  8. #8 by monsterball on Sunday, 5 February 2012 - 3:46 am

    First…”1Malaysia” ”
    Now..”! Care”…another slogan.
    Who really cares..for all Malaysians?
    UMNO b government?
    Then why delay the 13th GE and keep promoting….advertising for votes.

  9. #9 by k1980 on Sunday, 5 February 2012 - 6:19 am

    Will Malaysia’s healthcare system go the way of its financial and education systems?


    In 1993, the World Bank produced a 400 page report on the Asian Economics, and Malaysia was dubbed the “Tiger of Asia” with an annual growth of 9% in comparison with South Korea’s 6% and Singapore’s 7%. Our GDP per capita stood at US$350 in contrast to South Korea’s US$130. Foreign Direct Investment (FDI) was also at its highest of US$7.3 Billion, whereas our market capitalisation was ranked 1st in Asia at 14.6% (excluding Japan). Fast forward to the present, Malaysia has never recovered from the Asian Financial Crisis of 1997, and since then we have fallen behind Singapore, South Korea and Hong Kong, and now sit at par with Indonesia and Philippines….
    The Education Ministry’s statement that our education system is parallel to that of world standards is almost laughable and more so doleful when most notable politicians send their children to private schools and foreign education institutes to pursue their tertiary education

  10. #10 by Bigjoe on Sunday, 5 February 2012 - 8:46 am

    I believe what is most objectionable and unacceptable to Malaysian is that we have a two-tier healthcare system now where the public healthcare is heavily subsidised but now the govt is saying to move to one where the publicly healthcare CAN completely unsubisidized if they chose too. In other words, they are saying ‘trust us’ that they won’t remove subsidies completely or unaffordably based on the assumption they have a track record not removing subsidies.

    The assumption is inherently wrong because while some food and supposedly energy and water is subsidized, toll roads and other infrastructure have been exploited and even unaffordable to some.

    In addition, even if subsidies have to removed, why NOT something in between where SAVINGS is encouraged for long term healthcare first rather than an insurance scheme that remove govt responsibilities much more quickly and much easier to exploit by cronies? Why can’t we have a long term MEDICAL SAVINGS scheme where those who saved are provided some subsidies.

  11. #11 by k1980 on Sunday, 5 February 2012 - 10:15 am

    Bn has not yet won the 13GE but it is already planning to further suck the rakyat’s blood through its “1Care”


    Unless we kick out Bn, I fear that soon we are going to have 1Reataurant menus serving a cup of kopi at different prices such as–
    Tuans– 80 sen
    Matasepets –RM1.20
    Kaki Bottois–RM1.40

  12. #12 by cemerlang on Sunday, 5 February 2012 - 10:23 am

    UK is a developed country. Malaysia is a developing country.
    Medicine is expensive. Panadol comes into different kinds and carries different pricing. What more to say for chemotherapy ? All these years, government clinics and hospitals have been giving large packets of medicines free. Compare to the hundred of ringgit spent in private hospital. Ask yourself. Why is it free ? Actually it is a vicious cycle. You pay the government in various ways; income tax and what not. That money is used to buy this and that including medicine. Now you have to pay. Which means the medicine is doubled in cost. Ask what is the actual price of the medicine ? Is it within what you pay to the government ? Or what you pay is not enough and you have to pay some more ?
    This gives the NGOs many opportunities to reach out to the poor and show that you care and the government only cares about the RM sign.

  13. #13 by boh-liao on Sunday, 5 February 2012 - 11:01 am

    Look around us, WHO is getting RICHER n RICHER, no need 2 pay tax too, n always SENDING $$ out of 1M’sia in2 OVERSEAS accounts

  14. #14 by monsterball on Sunday, 5 February 2012 - 11:13 am

    Forget about the government that cares.
    All they care are their pockets…party and fooling voters.
    Today…Prophet Mohammed’s birthday….Happy holy day to all Muslims.
    Tomorrow….last day of CNY…Cap Gor Mei…yam sin yam sin…yam yam yam sin.
    There after….Indian Thaipusum Day…Happy Thaipusum to all Malaysian Indians.

  15. #15 by boh-liao on Sunday, 5 February 2012 - 12:46 pm

    UmnoB n cronies oredi got 1 EAZI BIG FAT way of SUCKING $$$ in2 their pockets
    RM15.30 per car just 2 leave n return 2 JB CIQ/M’sia

  16. #16 by boh-liao on Sunday, 5 February 2012 - 12:59 pm

    Obviously, SOME1 or a GROUP of ppl desperate 2 create RACIAL RIOTS in M’sia
    They spread RUMOURS of race riots in Klang and their spread KL, dat Indians had attacked Malays with parangs
    Mayb d same grp desperate 2 stoke racial n religious tensions between Muslims n non-Muslims

  17. #17 by drngsc on Sunday, 5 February 2012 - 2:36 pm

    Boh Liao,
    Please be careful. Those kinds of posting could get you in trouble. They are just looking for excuses. Please do not give it to them. We want GE 13 soon.


    We need to change the tenant at Putrajaya. GE 13 is coming soon. It is our best chance. Failure is not an option. Please work very very hard. Get all your friends to register and to vote. We need every vote.

  18. #18 by waterfrontcoolie on Sunday, 5 February 2012 - 4:37 pm

    Come the forthcoming GE, Malaysians should demand every political partty to declare their basic policy on all issues that affect the interests of the general public. Any candidate who declares that he or she would toe the party line should be VOTED OUT. Those REPS are responsible to the voters not to the PM and Cabinet who need to be controlled! So we have to agitate on such Health issue, if the candidate cannot offer any view throw him/her out! Our health budget is not small by any sense; just like the education budget, the money is simply taken out of circulation without explaination. If the little dot can use the salaries of the Ministers into question, all Malaysians should raise all the GATE Issues at the GE. ABU should propagate on this!

  19. #19 by boh-liao on Sunday, 5 February 2012 - 4:55 pm

    2 #15: TQ 4 your warning
    But hey, I’m NOT CREATING news or SPREADING rumours
    They r oredi in PRINTS n in d CYBERSPACE
    D ealier we r AWARE of individuals or grp ALL OUT 2 create RACIAL TROUBLES/RIOTS d better, RAKYAT shld b mature enuf NOT 2 b easily misled by d DEVILs

  20. #20 by boh-liao on Sunday, 5 February 2012 - 5:47 pm

    In 1M’sia, there r ppl who love 2 give big title 2 others WITHOUT doing a proper in-depth assessment, like calling an ex-VC of a public univ “The Renaissance Man”

    REALLY? Y they no say dis same individual was responsible 4 d free DOWNFALL of dat univ since 1970s – he was in cahoots with UmnoB 2 Malaynize dat univ through Skim Latihan Akademik Bumiputra (SLAB)

    In principle, nothing wrong with SLAB, except dat during implementation, ANY1 MALAY (whether with good Honours degree or not) was accepted n given scholarship 2 further their higher degree overseas; some did not finish n still appointed as lecturers n important administrators (DEADWOODs)

    Dat was d beginning of d free downfall n ACADEMIC DESTRUCTION of dat univ

    Furthermore, dat ex-VC RETRACTED d promise of dat univ 2 a grp of academically bright scholars, d CAREER TUTORS, appointed by d univ with d PROMISE dat they would be lecturers after completing their PhD

    He REFUSED 2 honor d promise n left d career tutors on their own (hoping 4 them 2 resign)
    [Note: Almost all carrer tutors were nonMalays], USELESS n GUTLESS cheat

    His SUCCESSOR had more honor than him n righted d wrong, n appointed d career tutors as lecturers at dat univ; SALUTE 2 his successor

    2day, we read d CURRENT VC of dat public univ lamented dat 200 out of d 2,000-odd academic staff had failed their doctorates pursued abroad since 2008, some on university scholarships, and dat in d PAST “we were not too selective whom we brought into the university”.

  21. #21 by Kampong Orang on Sunday, 5 February 2012 - 6:14 pm

    Today, around 540pm, NTV7 which is pro BeEnd, broadcast about a small group of MCA in Klang protested against Pakatan government about they claimed broken promise by Pakatan Government of Selangor.

    This small group of MCA people are selfish (just because of small taxes) and protested to show they are righteous. They fail to see that the more taxes you pay to federal government, the more money they have and they would buy more RM56000 binoculars which was orignally RM2000.

    We know that MCA and Gerakan no longer represent the Chinese community. Whatever and whenever they attacked the Pakatan government in Selangor and Penang or Kelantan, the more they disrespect the people in these states.

    What we want now is not about reducing taxes but least corrupted government like Singapore. What we want now is capable of managing well of national resources like Singapore. This is because corruption is the cause of poverty as reported by Transparency International: http://www.transparency.org/news_room/faq/corruption_faq

    What we want is to have Bersih, Cekap dan Amanah (Clean, Efficient and Trustworthy) government not like ineffective Anti Corruption Commission and Polis Malaysia.

    What we want is judiciary independent not like the Mongolian mother’s case where the motives of the 2 special police personnels have never been investigated:

    MCA and Gerakan fail to realise and wake up that they have not helped even the micro thing like the hawker centre at Jalan Bangan Luar and don’t say about macro thing like helping financially the independent Chinese or Tamil schools.

    MCA and Gerakan: the Internet shall transform the way of truth and info and knowledge about corruption they support. These people are selfish like the UMNO, eating up much of money of Malaysia people and the natural resources (like Taib: http://www.sarawakreport.org) and we have not seen them protest agains Anti Corruption Commission and Polis about Mongolian mother’s murder and Taib, etc.

  22. #22 by Kampong Orang on Sunday, 5 February 2012 - 6:24 pm

    What we want now is Clean, Efficient and Trustworthy government like Pakatan shows in Penang about managing not only state resources but also national resources.

    We do not want any political parties like MCA, MIC, Gerakan, PBB etc. are corrupted During the transport minister, Ling Liong Sik walking around the nation, his corruption was hidden. Just like Mathir.

    We want a new government like the one in Taiwan who would investigate the previous president and put him into jail. We also want a new government to investigate preious prime minister like Mathir so that he could be put into jail. Mathir uses Official Secret Act to protect all the things he did and execute including IPP.

    We also want free and really independent Anti Corruption Commission.

    We also want ACC to stop any person to use money to buy vote. We also want to stop seeing UMNO using money (small green pow with RM2) to give to each primary school students during festive season. Like Abdul Aziz, put RM2 into his green pow (not ang pow) which printed his face and log of BeEnd on the pack and gave to each primary student in Kulim.

  23. #23 by boh-liao on Sunday, 5 February 2012 - 8:42 pm

    If RAKYAT want Bersih, Cekap n Amanah as mentioned in #21 n 22, then remember ABU, ABU, ABU in d next GE – kick out UmnoB, MCA, Gerakan, MIC, BN lor

  24. #24 by drngsc on Sunday, 5 February 2012 - 11:24 pm

    Maybe we should form ABBN

    We need to change the tenant at Putrajaya. GE13 is our best chance. ABBN. Let us all work very very hard for ABBN

  25. #25 by k1980 on Monday, 6 February 2012 - 5:14 am

    //Maybe we should form ABBN//

    No need one lah. Once unmo is ousted, the other component mosquito parties led by CSL, KTK, ect will dissolve on their own and their members scrambling to join PR.

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