2nd discussion (Jan 22, 2012 - Re: 1Care Social Health Insurance)
Azrul Mohd Khalib Hi all! To contribute to this discussion, please find link to the 1Care for 1Malaysia presentation by the Deputy Director General of Health, Dato' Dr. Maimunah Hamid which was done in 2010.
http://hsgm.moh.gov.my/v2/uploads/1Care_for_1Malaysia.pdf
Replies:
- #taknak1care thanks Azrul!January 23 at 12:21am · Like
- Nuraini Arsad from this presentation i don't see why so much funding is being asked to restructure, since it appears to move towards better integration and reduced costJanuary 24 at 11:25am · Like
- Nuraini Arsad the only part i have misgivings over is the pooling of SHI as a community plan into a general fund. yes, any of us can get sick even when we have taken precautions. and the elderly and desperately poor would need help to pay into the system. but, eventually this will raise debates that pop up every now and then in the UK about the rest of us, which is: why am i paying so much into the system to subsidise people who persist in risky health behaviours, ranging from smoking to promiscuity to merempit, who then become ill or cause others to become ill with very expensive diseases. people don't mind helping others who genuinely are trying but are in worse positions. we are a very charitable people and have always generally supported the concept of a sliding tax scale. but like the UK anger on benefit scroungers, people don't like being forced to subsidise others who purposely choose irresponsible and lazy lifestyles knowing the responsible people are forced by the government to support them. you can say that we already do, because of the general tax, but i guess when you ringfence the funds for medical funding, the perception becomes clearer that this is the case. our spending statistics do not appear to be that bad on global comparison. while i know now that the 10% number is not confirmed, the kinds of reforms being contemplated and the kinds of existing relationships we have in the country between government, medical providers and insurance providers, i'm sure it should not take 10% of everyone's income. that ballpark is simply not justifiable and we may as well proceed as is until someone can figure out how to do it without such a high cost.January 24 at 11:38am · Like · 4
- Hisham Abdullah I read with interest you comments. Some are real issues. As such we need to explore and study in dept how best and what best to do. Integrating and engaging in professional discussion is a good start. Let's hear our problems in the public and private sectors, how best to solve the problems to achieve quality care, universal coverage and equity regardless the government of the day. We have our strength and weakness too and we learn various models and systems. We should repeat the same mistakes and reinvent the wheel again. No harm listen to all parties knowledgable in healthcare and healthcare transformation. God bless we hope to come up with a good modal with the principle of good up to date quality care for all with minimal cost.January 26 at 1:24pm · Like
- Francis Ngu I am from Kuching, but writing from Melbourne. I have in the last hour gone through the first 10pages of the UNDP report, parts of discussion (maybe less than half) between DepDG and John Ng, the Statement by SChow GPPresident, and the MOH presentation posted here. I am all for health services reform in Malaysia, provided that it is sound and provides healthy growth for health care for the population in the long run; that the rakyat is not over-burdened by sharply risen payments of whatever guise; that the government does not abdicate from its responsibility in health care by steadily increased funding to the NHI to an amount of 6-8% of GDP in a span of 10 years; that it seriously addresses the inequity for residents in East Malysia(perhaps other remote regions in Malaya); that widespread public hearing is conductedJanuary 27 at 2:38pm · Like
- Francis Ngu --when the MOH has the courage to put real figures on the table (what % of salary for compulsory contribution, and at what threshold of salary, how much co-payment for OPD and hospital care, and any schedule for means-testing the public). The Pie chart presented above suggests to me that this 1Care government is not for any moment thinking about increasing its funding for the 1Care system of the future.January 27 at 2:46pm · Like
- Francis Ngu Both the UNDP and the MOH are making the flawed assumption that Malaysia will by a high income economy by 2020; it will remain in the mid-low income or worse off if this government stays in place ( there are both human capital and Big Capital drain out of the country). Is this a creditable and accountable government that can be trusted to carry out meaningful reforms even when there eventually comes about a great health care plan ?January 27 at 2:51pm · Like
- Francis Ngu I do support the GP president's contention that the GP sector can take over virtually the entire Primary care services (except perhaps remote places like EMalaysia), if 1Care is prepared to outsource. Just look Down Under, there are no government run Polyclinics, and no government doctors in some rural hospitals, GPs are paid to manage rural ward patients too !January 27 at 2:57pm · Like
- Francis Ngu The Prime Minister should be the first to know that an across the board 10% compulsory payment will spark an Arab Spring in KL. Will MOH suggests a sliding scale ? Is 1Malaysia going to be more socialist than all socialist governments in the world ? (By the way I am social democrat by orientation.) In a hugh-income economy Down Under, the compulsory payment is at 1-2 %, but workers have 5-20 times Malaysian employees income.January 27 at 3:06pm · Like · 1
- Ashok Kumar Nuraini and Francis have raised some very relevant points .Lets not rush into this new scheme and like all the previous Privatisation Schemes in the Country like Electricity , Postal Services , Water , Tolls rates keeping on rising and burdening the People . For example People like Samy Velu kept defending such increases from Highway Toll Collecters saying the Govt has to Pay the Concessionares Compensation as under the Concession Terms ( which are top secret ) says so if increases are differed 9 But that Money still comes from the Tax Payer's Pockets not Samy Velu's ) . The GST has been differed presumably fearing a Voter Backlash , Healthcare aka ICare is Plan B in the meantime . Lets not make a Mess of our existing smoothlly running Healthcare System though not without occassoinal but manageable irritations .In the meantime , lets not paint ourselves into a corner like what is happening to English in this Country with its Endless Debates while the Future Generation is paying the price with the exception of course of the previleged few what about the Rest of the People .Hopefully this is not thrust down the People's throats .January 28 at 11:22am · Like · 1
- Hisham Abdullah Thank you for all the comments. As i said earlier We in the MOH is responsible for the healthcare of this country, we have not even come up with a complete blueprint to be presented to the government. We need to explore study and come up with facts and figures. We need to reform the healthcare in this country to provide better quality care to our people couple with the principles of universal coverage, equity, accessibility with minimal cost. I thank Francis for his balance and mature views and I hope we shall be professional in our judgement in our concerns.January 29 at 6:18pm · Like
(Note: In a January 2012 briefing to the Malaysian Pharmaceutical Society, senior MOH officials revealed that the 1Care implementation blueprint was in the final stages of drafting. If the rakyat had not been alerted, it would have been implemented without our knowledge.) - Hisham Abdullah But in the mean time what we can do is to strengthen the existing services as I have elaborated earlier, such as retention packages for our specialists and doctors, decongestion program, cut wastage, value for money investment, improve efficiency and cost effectiveness of services. Focus on quality and performance to the upmost capacity with the minimal funding available in hand, this is stage one two and three of one care reform in the public sector. Time will tell if we are doing this right as the rakyat will be the judge our performance in the public sectors.January 29 at 6:24pm · Like