Really, Healthcare For free?
posted in - Nation, - Palmdoc |The NST has this article which claims Healthcare will be “for FREE”
To ensure all Malaysians get adequate healthcare, wage earners will have to make scheduled monthly contributions to the proposed National Health Financing Scheme. The self-employed, those who have an independent income as well as employers would also have to contribute, Health Minister Datuk Seri Liow Tiong Lai told the New Sunday Times.
The government proposes to set up a health financing scheme that will give all Malaysians access to primary healthcare at any public or private clinic for free.
The scheme will also look at secondary healthcare coverage and the illnesses and treatments it might be able to cover, said Health Minister Datuk Seri Liow Tiong Lai.
Although much of the scheme has yet to be finalised, the rate of contributions
is expected to be based on wage scales, in which the rich will pay more. The poor will not have to contribute to the scheme but will still be covered.
“It works on the principle of the rich helping the poor, the able helping
the disabled, the young helping the old, and the healthy helping the unhealthy. All kinds of illnesses will be covered under this scheme so that everyone will have access to good adequate healthcare,” Liow said.
The funds will be administered by the proposed National Health Financing Authority, a statutory body under the ministry. New legislation may have to be passed and existing ones amended to make way for this scheme.
Regardless of how much one contributed, everyone would enjoy the same standard of care, said Liow.
Only workers aged 18 and above with an income that has reached a certain threshold, need to contribute.
Children will be financed by their parents. The poor and disabled who have no income or whose income does not reach the threshold need not contribute.
For those who wish to stay in a suite rather than a standard room, they will have to pay the difference.
So while the headlines tries to put a positive “spin” on things, in reality consumers will be “forced” to contribute to the National Healthcare Financing Scheme, something we have blogged about for a long time, but has not materialised. It seems it will not happen just yet, but in stages and the whole process could take “about 10 years or more” according to the Health Minister. He is upbeat about it and believes the whole thing can be done in “four phases”
The first phase is strengthening the healthcare system like governance and standards of care; the second is to grant more autonomy to primary healthcare providers in areas like human resource and management; the third is to integrate all public and private clinics so that they are all linked under a common network so that people can access either one; and the fourth phase will be the introduction of the national health insurance under the national health
financing scheme.
The integration of public and private clinics may begin sooner than you think and GPs may now be faced with a financing system based on Capitation whereby they are paid not as “fee for service” but according to a fixed number of patients allocated to them, irrespective of how many visits patients make to their GPs (which in turn has its upsides and downsides if you read the Wikipedia link). From the discussion in the MMR doctors forums, there is some concern that this may spell the end of 24 hour clinics and that instead of “walk-in” visits to your GPs, capitation based patients might be seen only by appointments. Solo GP practices are less likely to survive under a Capitation scheme and ultimately the winner will be large group practices.
Not everyone is enthusiastic about the proposed Healthcare scheme and some say it is “frightening” and prefer the status quo.
“What frightens us is that nothing is ready, nobody knows about the scheme,” said Selangor state executive councillor Dr Xavier Jayakumar today.
Under the country’s current health care system, Malaysians can seek medical treatment at a public hospital with just RM 2 for registration.
Consultations and medications are provided for free.
Under the new scheme, Xavier said that an uninsured person would have to pay consultation fees and for medications at market rate.
Pointing out that 70 per cent of the population had household incomes of less than RM 3,000, he said most would not be able to afford medical treatment.
“You have to have a very clear scheme on how the poor, the unemployed, the lower income population is going to benefit from the new scheme,” he said.
There is an Internet acronym – TANSTAAFL – which stands for There Ain’t No Such Thing As A Free Lunch. In healthcare nothing could be further from the truth. Healthcare is not free. It is expensive business and at the end of the day someone has to foot the bill. What the Government is trying to do is to shift the payment responsibility directly on the consumer rather than indirectly via public funding which is paid for mainly by taxes and other Government revenue. We are at a cross-roads as far as healthcare financing goes. Whatever the outcome I hope a sensible balance is reached and the poor are not burdened.
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July 15th, 2010 at 4:11 pm
Enforcement will be a big headache.I suspect many will opt not to pay. Many may even under declare their income to avoid paying the premium and indirectly gov will have reduced income tax revenue. For these people, what will happen to them? Do we reject them from hospital and clinic? What happen next is a surge of complaints that MOH is crude, uncompassionate and headlines appear in all the media and we will be back to square one. Notice that every new Health Ministers did mention something about NHS but nothing was done. They remain NATO (no action talk only).
July 15th, 2010 at 4:31 pm
“There is an Internet acronym – TANSTAAFL – which stands for There Ain’t No Such Thing As A Free Lunch. In healthcare nothing could be further from the truth. Healthcare is not free.”
Very true but in the Malaysian context, Malaysian want the gov to BEAR ALL the cost and pay nothing. Notice that the opposition is already starting to shoot the plan down. The only plan acceptable at current political scenario is increase the health budget (which only solve the problem partially and temporarily) and Malaysian pay nothing extra.
July 18th, 2010 at 9:49 pm
This Scheme was hatched more than a quarter of a century ago.
Studied by all sorts of experts although no details have been released to the public.
Now, supposedly in its final stages, it is still blur blur!
I think that to have a good health care system for this country, we should have:
1. properly trained doctors.
Recently, it was stated in an
article that four thousand
doctors were trained although
there were not sufficient
lecturers to do the job.
2. the present system should be
retained with modifications
to the registration fee.
Everybody should pay more
for the registration fee which
could be raised to RM10 or
an appropriate sum.
Those who cannot afford can
be exempted.
I think that this can improve the health care system instead of having a complex and unmanageable system.