By Shamini Darshni | February 15, 2012
The Malaysian Insider

FEB 15 — When the idea of a national health financing mechanism came up in the mid-2000s, the question of how the funding scheme would be implemented caused much concern.

As a journalist then with an interest in public health issues, I followed the arguments made, then observed how the idea of “the rich paying for the poor” disappeared.

Logic suggests that the then-proposed national health financing mechanism — or scheme, as it was also referred to — had gone back to the drawing board. Today, it seems that the same idea has been repackaged under 1 Care.

Rebranding aside, the idea of 1 Care is noble. But the sketchy details are worrying. Why a major announcement is made without being accompanied by proper details boggles me.

And yes, Mr Director-General, Malaysians are sensitive when it comes to parting with their money. How can we not be, when we already contribute to EPF, Socso, income tax, service tax, sin tax and a higher cost of living (my jaw dropped when 10 rolls of toilet paper and three packages of my favourite 3-in-1 coffee chalked up almost RM60)?

The DG had also said that the 11 technical working groups are still studying the 1 Care system and details on the paying mechanism will be revealed in due course. He goes on to say that apart from the RM34 billion set aside, the costs of medical visit and treatments will be borne by a central government agency that will pool contributions by “the government, employer, employee and those self-employed.”

He had said: “Under the idea, we optimise the system, you can choose your doctor and you can go to any clinic, private or government as the costs will be paid by an authority handled by the government… it’s very simple. Say you need to be hospitalised and this system allows you a two-person per ward stay, but if you want one which you don’t want to share, then you have to pay for that option.”

What happens to our insurance commitments? From where I sit, it seems like double payment for a single service. We need answers.

Under the existing two-tier system, there are still Malaysians unable to access even primary healthcare. I shudder to think what happens to the Orang Asli villager who suffers a heart attack, but lives a week away by boat or foot from the nearest hospital. Would 1 Care ensure that people with no access to healthcare in the first place be able to access their human right?

Or is 1 Care just going to be another fund that the government can tap into to provide housing for 20,000 people at our risk?

Would 1 Care include treatment for anti-retrovirals for people living with HIV, methadone replacement for drug users wanting to kick the habit, mental illnesses, and other diseases that insurance companies refuse to cover? Only then would 1 Care be useful.

I would be open to contributing if I knew my fellow Malaysians, irrespective of colour and creed, were getting the medical attention they needed, whatever the condition. But I would need to know that my contributions were safe from corruption and preferential treatment, and would not be a burden to my existing financial commitments.

Access to healthcare is undeniably important. If details on 1 Care were solid facts with proper statistics to show why we need to contribute to this programme instead of the government increasing the overall healthcare budget, perhaps we would be more open to hearing out the idea.

But with the latest move by the government to consider using EPF contributions so others can purchase homes, coupled with the National Feedlot Corp scandal, can we trust the government to protect our interests?
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Shamini served as a news journalist for some years and now works as a media and communications manager at a private university. When she’s not stabbing furiously at her computer, she’s in a bar somewhere drinking in great music or at home devouring her favourite authors. She can be reached at [email protected].