Archive for category Health

This is an election to determine whether rakyat Malaysia will vote for a sustainable future for our children or a sustainable corrupt BN government?

Earth Day is an occasion to remind us that our mother nature is deteriorating over the last few decades, natural resources has been robbed off by corrupt government and their cronies that brought pollution, deforestation and degradation that hampered the livelihoods of people.

During the United Nations Climate Change Conference in 2009, Prime Minister Datuk Seri Najib Tun Razak announced that Malaysia has agreed to reduce its carbon dioxide emissions by up to 40% by 2020 compared with 2005 levels, however, polluted industry that has been rejected by other developed countries such as Lynas rare earth refinery plants are allowed to operate in Kuantan and given 12-year tax exemption.

BN is also pursuing constructions of giant petrochemical hub in Pengerang, giant aluminium smelter plant in Sarawak, two nuclear plants in the country, BN government has clearly proven that it is pursuing economic development at all cost at the expense of the environment and people’s health.

If BN continues to run the country, Malaysia will never achieve a sustainable, low carbon and resource efficient future. Only a Pakatan Rakyat that pledge to make Malaysia a cleaner, greener, safer and healthier place to live will reject rare earth plants and nuclear plants to ensure our future generation can live in a better world.


A tale of interdependence

By Goh Keat Peng | September 20, 2012

We spend a lot of time on independence, for example, the independence of a nation. But perhaps not enough time on interdependence of the people within an independent nation. These two processes are of dire importance to all human beings.

Here in Malaysia, three days ago, a nineteen year old girl died; on the very day she was to have reported for work for the first time as a kindergarten teacher. The fact that she had come to this point when she could be considered for such a job was in itself a testimony of her courage, discipline, persistence and determination. For her heart (as a bodily organ) was faulty and in 2007, a donor heart was found but upon transplantation was rejected by her system. A second donor heart became available to her and she underwent the arduous process of heart transplant a second time. This one served her for almost five years till her sudden death. She is heart-achingly mourned by her parents and the organ donor’s parents and many others throughout the land.

There are many stories within this one story. In fact, an entire ecology of human relationships was involved. The story transcends many generations, many taboos and prejudices, bringing many souls/lives together. This was a story involving an intricate web of human relationships that demonstrated the best of human courage, kindness, generosity, goodwill and good conduct. As well as the realities of human interdependence which lifts the human spirit through its heart-warming and inspirational qualities.
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Public engagement meet on healthcare system a letdown

Dr Steven KW Chow | Apr 5, 2012

The title of the Event was ‘Pelancaran Siri Jejalah Public Engagement – Kajian Sistem Kesihatan Malaysia’ but what really happened was a paradox.

As a media event it was well organised.

The members of most of the mainstream media were at hand.

They, together with the large number of government servant attendees still in their uniforms or with their name tags, virtually made up the bulk of the crowd.

The robust public presence that was supposed to be the objective of this engagement was clearly missing.

Thus it was not surprising that the discussion was devoid of substance and spirit. Read the rest of this entry »


1 Care: Show us the mathematics

— John Teo
The Malaysian Insider
Feb 19, 2012

FEB 19 — 1 Care for 1 Malaysia sounds like a very good slogan but behind this impressive slogan and all the controversies, rhetoric, claims and counter claims lies a very big and fundamental question of where is the funding of such a massive overhaul of our healthcare system going to come from?

We know that the basic principle of part-government and part-public funding underlies this concept and the reason behind this shift of funding policy is the ever-escalating health costs which the government cannot continue to provide funding for indefinitely.

Let me quote two very important facts. 1) According to the 2012 Budget that was announced by our prime minister, the allocation for health totals RM1.8 billion, which is equivalent to 3.7 per cent of the total budget. There were other ministries that have higher budget, notable ones being the Ministry of Defence.

The World Health Organisation recommends that at least five to six per cent of a total budget be allocated to health. Many other countries allocate up to seven to eight per cent. Malaysia is way below that mark. Read the rest of this entry »


Not a penny more, BN

— CL Tang
The Malaysian Insider
Feb 15, 2012

FEB 15 — After handing out one-off payments of RM500 to the poor, the government turns around and is now asking for a handout from the taxpayers, under the guise of paying for an improved healthcare system.

The people must now realise that this is a government that has neither the vision nor the will to move Malaysia forward in the global marketplace. After a lousy victory in 2008 general elections, the Barisan Nasional (BN) government has virtually been on a re-election campaign mode since, devising short-term populist agendas such as KR1M, BR1M, etc., none of which addresses the current malaise the country is facing — stagnant wages in the face of rising costs in the midst of a long-drawn out, slow global growth.

As it stretched out is left hand to hand out cash to poor households, its right hand is dipping into the pockets of ordinary Malaysians to fund its lavish spending and greedy cronies. Read the rest of this entry »


Why should I care about 1 Care?

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.
Read the rest of this entry »


Restructuring the Malaysian health system: Is there a need?

— Academy of Medicine of Malaysia
The Malaysian Insider
Feb 14, 2012

FEB 14 — We observe with concern and interest the recent discussions by the ‘rakyat’ and explanations by the Ministry of Health Malaysia (MOH) in the print and electronic media regarding the planned National Health System Transformation. We agree that there are deficiencies in the present system that need to be addressed and applaud the Director-General of Health’s pledge to engage the ‘rakyat’ and stakeholders in its planning.

There is no denying that the Malaysia’s Health System is acknowledged internationally as being successful in providing health services to the ‘rakyat’. Notable successes include:

1. Reduction in mortality and morbidity and increased life expectancy, rising from 56 yrs for male in 1957 to 72 years in 2006; and 58 yrs for females to 76 years correspondingly. Infant mortality rate is comparable to developed countries.

2. An equitable public sector and universal access to comprehensive treatment; where everyone has access to medical treatment up to tertiary level at a nominal fee; and for the poor for free. Read the rest of this entry »


Why revamp our healthcare system with 1 Care?

— CK Chooi
The Malaysian Insider
Feb 11, 2012

FEB 11 — Many have written on this subject. Most are concerned about the implementation, costs, bureaucracy and effectiveness of the 1 Care scheme. Perhaps there is another holistic approach the government can consider.

Best treatment for the rakyat

Even in most developed countries those who did not have medical insurance will have to accept public health care and those who can afford it are treated in private hospitals. This is a reality of life, all citizens accept this. Have we heard anyone complain that he should be treated in a five-star private hospital when he knows well that he cannot afford it? The government cannot lose votes on this score. Malaysian citizens are mature enough to realise this fact —not all men are equal! We have the poor, the middle class and the rich — every society has this social structure. Read the rest of this entry »


Malaysian health reforms socio-economics: Part 5

— David KL Quek
The Malaysian Insider
Feb 11, 2012

FEB 11 — Why the need for Health Reform now?

This is the question that has been posed by many people. What indeed are the key reasons for the government to embark on such a radical transformation of our health system? There is no easy answer. But I would venture some socio-economic and health economic possibilities.1

Although one cannot discount or exclude political reasons or even patronage-linked considerations, I would not wish to embark on this line of speculation, because essentially this would only detract from the real issues at hand. Also, it would be hard to prove what are at best, innuendoes and almost surely shaped by partisan motives and beliefs. But it would also certainly be impossible to allay public fears and anxieties that these sorts of political interjections might play a role in any government policy makeovers. So perhaps, these possibilities should at least be highlighted so that they might be forewarned and prevented from hijacking such a monumental policy shift for personal or partisan reasons.

Major reasons for this proposed health reform are: widening public-private disparity in healthcare delivery; attempt to slow down rising healthcare costs; government policy shift to reduce health care subsidy; implementing W.H.O. mandate to provide so-called universal coverage for health; social health insurance to tap into another copayment mechanism for healthcare payment; and forming an autonomous national health authority. Read the rest of this entry »


Malaysian health reform socio-economics: Part 4

— David KL Quek
The Malaysian Insider
Feb 10, 2012

FEB 10 — Out-of-Pocket and Catastrophic Payments

So what is so terrible about out-of-pocket (OOP) payments for healthcare? Why are health economists and policymakers so enamoured with this unsavoury OOP payment that this healthcare financing mechanism has been universally targeted to be eradicated, or at least reduced?

Many health authorities from the WHO and World Bank have analysed this in great detail, taking into account especially poor countries around the world, including those in Asia, Africa, Central and South America. Malaysia too has been included in many multi-country analyses to ascertain if common themes and determinants are shared within the disparate health systems in the regions.

When one looks at poverty levels and unequal economic systems, the health determinant as a function of economic underdevelopment and social aberration unfortunately looms large in some really poor nations. While poverty per se cannot all be attributed to just ill health or the lack of access to proper health care, impoverishment as a result of quests for healthcare has been a classic example of what poor countries are doing wrong. Read the rest of this entry »


Malaysia health reform socio-economics (Part 3)

— David Quek
The Malaysian Insider
Feb 09, 2012

FEB 9 — Ability-to-pay model in healthcare financing

Ability-to-pay encompasses the concept that people or households would choose an economic activity or service according to their capacity to afford such an activity based on their perceived hierarchy of needs, and also what goods or services to give up or sacrifice.

If healthcare or medical services are priced too high and are perceived as too unaffordable, health care considerations might be placed under such a low hierarchy of needs that it could be sacrificed for more urgent day-to-day needs and essentials.

That is why most countries around the world, if not all, offer a basic basket of health services (safe clean water supply and sanitation, childhood vaccinations, preventive child-maternal health services, etc), which are not taxed and are freely accessible to all, without the need to consider affordability or ability-to-pay. Thus, there is no question of having to consider these basic health services as an economic sacrifice for all income groups. The question arises as to how big or wide a basket of such health services, any country can afford to provide, without the need to impose co-payment mechanisms or additional taxes. Read the rest of this entry »


The 1 ‘S’Care scheme

— The Black Cactus
The Malaysian Insider
Feb 08, 2012

FEB 8 — In the last few weeks, there has been immense debate on the proposed national health scheme dubbed 1 Care in both the internet and the mainstream media. A collective conclusion shared by both the public and the very professionals alike (who play a major role in the system) is the uncanny ability to fully comprehend the confusing entity which remains an uncertainty till today.

This commentary was written to achieve the following objectives

1. To help the public understand why this system was proposed and what led to the genesis of this scheme;

2. If possible, to pressure the government to be more transparent in providing information on the 1 Care scheme to allay fears among the general public; and

3. To help the layperson understand the unaddressed policy issues but highly crucial perspectives surrounding the 1 Care scheme Read the rest of this entry »


Malaysian health reform socioeconomics (Part 2)

— Dr David KL Quek
The Malaysian Insider
Feb 08, 2012

FEB 8 — 1 Care health reform phases

In the 1 Care Health Reform plan, there are four proposed phases of transformation that could take anything from 10 to 15 years (according to officials), depending on the uptake of the various phases and programmes, as well as its implementation progress.

Importantly, the Health Ministry increasingly understands that it would require general public acceptance, as well as significant consensus and (if possible) seamless buy-in from as many stakeholders as possible.

There is recognition that if the public fails to accept this in toto or in part, then there might be need to re-tweak or re-design certain aspects of the reform plans. Just how much the bureaucrats or our political masters are willing to change and adapt remains to be seen.

Therefore, it is crucial, indeed essential, that the public and interested stakeholders take an active role in providing enough input to help make this reform the one that they want. We should not simply accept a top-down programme designed by bureaucrats, and selectively enacted by policy makers. Why? Because, it would be disastrous if this reform fails or runs into the usual gaffes, just a few years down the line. Health care is simply too unforgiving and vital to fail or be subject to arbitrary social experimentation, no matter how good the intentions! Read the rest of this entry »


Malaysian health reform socio-economics

— David KL Quek
The Malaysian Insider
Feb 07, 2012

FEB 7 — Is the Malaysian health system really in trouble that it requires such a drastic revolutionary change? Is 1 Care for 1 Malaysia Health Reform the answer? Will this proposed radical change make our health system more efficient and effective as touted by officials?

Or, is this proposed reform too ambitious and sweeping that it could possibly lead to severe disruptions to our current health system that we are so used to?

More importantly, would this health reform plan become another government-linked corporate entity which, instead of benefiting the public, only enriches a few favoured cronies or insiders? The difference now is that this will be a humongous multibillion-ringgit exercise and the fattest cow to milk to date!

Sadly, at this juncture in time — in the name of social development, modernisation, and economic necessity even — there have been so many government-linked projects being scandalised and mired in corruption accusations and profligate leakages.

Thus, it would be foolhardy to implicitly trust the government to do the right thing despite the economic rationale or correctness, indeed despite even the most honourable intentions! We are dealing with the health choices and rights of the public, which could become severely disrupted and endangered if or when hurried reforms turn out to be another debacle of catastrophic proportions! We cannot afford a failed social experiment of this magnitude! Read the rest of this entry »


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. Read the rest of this entry »


Anti-1 Care group demands Putrajaya kill proposed healthcare scheme

By Clara Chooi
The Malaysian Insider
Feb 02, 2012

PETALING JAYA, Feb 2 – The newly-formed Citizens’ Healthcare Coalition (CHC) came out for the first time today to demand the government shelve its proposed “1 Care” insurance scheme, warning that its implementation would spell “disaster” for Malaysia’s healthcare system.

The pact insisted that the present two-tiered model was superior to “1 Care”, which it predicted would only turn healthcare management into a “business”.

“We believe the (current) Malaysian model is superior for the Malaysian environment. We do not want healthcare to be turned into a business.

“We believe there should be both public and private sectors – public as a service-oriented model and private as a corporate model… it is not possible for a service sector model to be corporatised,” Federation of Private Medical Practitioners Associations of Malaysia (FPMPAM) president Dr Steven Chow said during CHC’s maiden media briefing at the Global Business and Convention Centre here this evening.

According to CHC, “1 Care” is a new national healthcare system that will force all households to surrender nearly 10 per cent of their monthly household incomes as contribution to a government-run Social Healthcare Insurance (SHI) scheme.

The group insists that the scheme would not achieve its objective to provide equitable access to healthcare for all segments of society and would only increase costs. Read the rest of this entry »


Salient points – 1Care


  1. The government plans to introduce a new healthcare system called 1-Care. It includes an insurance system to fund for healthcare.

  2. The National Healthcare Financing Authority will be in charge of 1Care – and it is likely to be turned into a GLC.

  3. Based on available information, every household will be made to pay up to 9.4% of gross household income for social health insurance. The payers will be the individual, the employer and the government via taxes, exact proportion still being worked out)

  4. There shall be no choice. Everyone has to pay. There is no opting out. We have to pay upfront. It will no longer be fee-for-service; it is fee-before- service.

  5. There has been no information on exactly how this payment will have to be made or how the government will collect from self-employed people.
      Read the rest of this entry »


1Care: Prioritise, not privatise patient care

Dr Ng Swee Choon | Dec 24, 2011

We refer to the letter from the Director-General, Ministry of Health: ‘Gov’t not abdicating responsibilities thru 1Care’ on Dec 17.

We fully agree with the need to improve the quality and delivery of health services for the rakyat, provide more choice to patients and preserve the strengths in our current health system. Read the rest of this entry »


Surcharge who?

Sdr. Lim Kit Siang, You might be interested in my experience in Sabah, trying to save Government/Taxpayers’ Money:

When I was serving in Sabah, in 1989 I think it was, and called for quotations to buy ‘Dental Drills’ for use in the field by Nurses, to fill Children’s teeth. You may not know that the Children in Sabah had really very poor Dental Health, and there was an urgent need to do as much as possible, by way of stretching both equipment and personnel available. Read the rest of this entry »


5,000 private doctors call for Jeyakumar’s release

Malaysiakini | Jul 19, 11

The Federation of Private Medical Practitioners’ Associations, which represents some 5,000 private doctors nationwide, has joined hands with others in the medical profession in calling for the release of Sungai Siput MP Dr D Jeyakumar.

“We are extremely concerned at the continued detention of our colleague, Dr Jeyakumar Devaraj, whom we all recognise and acknowledge as a law-abiding, competent, kind and diligent doctor.

“His public service record is exemplary and, to the very best of our knowledge, he is certainly not a threat to our society,” the federation said in a media statement today.
Read the rest of this entry »