Health: 1Care - Letter to the Editor on Health Care Reform

[pywong]

Watch this carefully. There is a proposal of 1Care which is mandatory for all.

http://www.slideshare.net/palmdoc/letter-to-the-editor-hc-reform

From Msian Med Resources

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.

6. The government will be expected to contribute to the insurance premiums of government pensioners, civil servants and five dependants.


7. But the problem is: 1Care does not cover all your medical expenses. Only for a prescribed basic list of what “you can have” healthcare items. Anything more than basic you will have to pay your own.

8. Your long-serving independent familydoctor will have to join the system or will not be allowed to see you under the 1Care scheme. The robust, cost- effective independent clinics serving the country will be replaced by 1Care clinics.

9. You cannot pick your own doctor.1Care will allocate a doctor to you.

10. If you want to see a doctor of your choice, you’ll need to pay for that from your own pocket. Your allocated doctor will decide when and which specialist you can see if the need arises (a process called gate-keeping).

11. The NHFA will pay GPs RM60 (present proposal) for each patient as consultation fees. It does not include medicine. Compare this with presently, for cough and coldvisit, the GP would charge RM20-RM30 for consultation and medicine. With 1Care: consultation for GP visit is RM60 and this does not include medicine.

12. You cannot see your doctor as and when you feel the need arises. There will be a rationing system in place as well. There will also be rationing for specialist care with the GP as the gate-keeper. Likewise if you wish to see the specialist of your choice or go to a hospital of your choice, unless referred by your allocated doctor, you will also have to pay out of your pocket.

13. Even if you only see the doctor once in a year, you will not get a refund from 1Care. Your medical costs are prepaid in advance irrespective of whether you become sickor not.

You are also expected to make an additional co-payment for your visit. This is to discourage you from seeing doctors too often.

14. You will be prescribed only medicines from a standardised list of not-the- original medicines in keeping with WHO List of essential Medications.. This will save cost for 1Care and maximise profit for the insurance companies. Insurance companies will have major say in the price and the range of this standardise medicine list. It will likely to be the cheapest medicine.

15. The doctor will only give you injections. You’ll need to get all other medicines from a pharmacist, even if it means hauling three sick children with high fever along a hot, dusty busy street looking for the nearest pharmacy.

16. If you do not like what is given to you, you can get alternative care by paying out of your own pocket.

The Big Picture

Each year, we all pay a total of RM44.24 billion a year for healthcare – now called National Healthcare Hospitals and clinics ( an integration of public hospitals and clinics, private hospitals and private GPs. which in essence is a privatisation of public and nationalisation of private healthcare facilities)


All this will now go under 1Care.

This means 1Care will get almost RM45 billion a year.

The administrative cost is likely to be 10% or about RM 4.5 billion

The poor

Who will then care for the poor and the marginalised population when the private and public healthcare corporatize and turned into independent commercial entities each competing with the other for business and profits?

Public hospitals and clinics are service-driven will become corporatize/privatise and have to be profit-driven

So who will serve the people in remote places?

Who will serve the very poor people?

Situations

What happens when the government introduces 1Care?

The whole system of independent one-stop GPs will be restructured and converted into 1Care clinics like the UK NHS general practitioner system.

Before:

Ali has always having skin rashes for many years. He has to see his doctor once a month to get treatment.That would mean he will have to see his doctor 12 times a year just for this illness. What if he has other illnesses?


Now:


But now, Ali’s doctor has allocated only a budget equivalent to six visits a year. Regardless of how many time Ali would need for his yearly treatment. What happens then? A rationing system will kick in. If the doctor sees Ali too many time,his “P4P” (Pay for Performance) profile will be poor and he will be paid less.


To start with, Ali will probably cannot just walk in and expect to be treated. He will have to make an appointment. There will be a long waiting list. What if Ali needs tobe treated for fever or some painful joints? He will also have to wait for his appointment. If he cannot wait and wants immediate treatment from another doctor he will have to pay on his own. This is what the NHS UK system is offering its patients.


Lim has an appointment to see his doctor over a knee ache. Just before his appointment, he has an ingrown toe nail that has become painful. At the clinic, after his doctor treats him for his knee ache, he asks his doctor if he could look into his ingrown nail. His doctor says “No, the system does not allow me to do that. You must make another appointment. This visit I can only treat and bill for your knee ache. 1Care will accuse me of over-servicing my patients. I have no discretion here, all is by SOPs” This is what the NHS UK system is like today.


Mutu lives in a remote rubber estate.One day he had chest pain and went to the nearby 1Care clinic..He has blood pressure problems since young and has had fits. A hospital assistant saw him. Because of a change of his medications to the cheapest not-the-original medications, his blood pressure went out of control and his seizures returned. He developed a fatal stroke and died This is already what is happening when essential origina lmedications are replaced with the cheapest .The cheapest medications is not necessarily the best for the patient and certainly not the safest.

[pywong]

​What 10% increase? NBot yet, 10% of income. In some countries likeAustralia, Medicare surcharge (national healthcare scheme) is only 1%
of income.

Some background reading :
http://myhealth-matters.blogspot.com...reform-in.html

http://www.prn.usm.my/old_website/chi/main.html

http://www.moh.gov.my/images/gallery...try_health.pdf

http://thestar.com.my/news/story.asp...3345&sec=focus

http://www.fnfmalaysia.org/2011/05/1care-to-tell-us/

And vids..
http://www.lepak.tv/watch/323b07e591...-health-system

[pywong]

​Uploaded by EyesWideOpenclOvOb on Jan 11, 2012Join the #taknak1care facebook page
http://www.facebook.com/pages/taknak...16000501814386

The Malaysian Government is about to introduce a mandatory national healthcare system called 1Care, which will force you to give up to 10% of your monthly income to pay for basic healthcare.

What's worse, after paying so much,
• You cannot pick your own doctor. The government will choose one doctor for you;
• You can only see your assigned doctor 6 times a year;
• You can only see the doctor for one problem at a time;
• You get only cheap generic medicine.

If you don't like it, you'll have to pay more to see another doctor or get better medicine.

The government demands more taxes but are delivering less services! Ever squeezing the rakyat for essential services like water, electricity, public transport and now healthcare!

Every person in Malaysia deserves quality healthcare that is affordable and accessible. We all need to understand this critical issue that will severely affect this and future generations.

Don't let it happen!

[pywong]

Here's a prediction: UMNO is going to backtrack on this when they see the public outrage. They will wait for the furore to die down. When they think no one is watching, they will try to slip it in again, especially if they have a 2/3 parliamentary majority.

Dissent grows over rumoured healthcare tax under ‘1 Care’ scheme


By Clara Chooi
February 01, 2012


KUALA LUMPUR, Feb 1 — Public outrage is growing over a proposed “1 Care” scheme to restructure the country’s healthcare system that critics claim would force employees and businesses to contribute 10 per cent of their monthly income to a government-run insurance fund.


Although details of the scheme are still vague and Health Ministry officials have insisted it is still “too early” to sound warning bells, medical practitioners and consumer associations have banded together since last December to kick off the “Tak Nak 1 Care” campaign, hoping to shelve Putrajaya’s plans before they come into force.


Critics claim the scheme would force employees and businesses to contribute 10 per cent of their monthly income to a government-run insurance fund. — Reuters file pic

Calling themselves the “Citizens’ Healthcare Coalition” (CHC), the group have taken their cause online, using social media tools like Facebook, Twitter, blogs and YouTube to spread information about the scheme and gain wider public support.Among others, the group have started a “#TakNak1Care” Facebook community page, a Twitter account using the handle @taknak1care and uploaded on YouTube, several video clips urging Malaysians to reject the scheme.


Their efforts appear to be gaining traction among netizens and have even caught the attention of Health deputy director-general (Medical) Datuk Dr Noor Hisham Abdullah, who has been personally involved in lengthy discussions with the group via their Facebook page.


The Malaysian Insider understands that “1 Care” is modelled in its entirety after the United Kingdom’s National Healthcare Service (NHS), a publicly-funded healthcare system, and was mooted in the 10th Malaysia Plan for the Health Ministry’s 2011-2015 strategic plan.
It is believed that the five-phase scheme has already entered its third phase, and the full initiative, post engagement with doctors and pharmacists nationwide, is due to be presented to the Cabinet by March.


According to one CHC member, “1 Care” will replace Malaysia’s current two-tier (public and private) healthcare system by integrating both private and government hospitals, in hopes of ensuring more “equitable” healthcare for Malaysians across all socio-economic statuses.
Under the present two-tier system, Malaysians can choose between seeking treatment at private clinics or hospitals and pay out of their own pockets or via health insurance claims, or opt for treatment at government clinics or hospitals and pay only a nominal fee for basic, government-subsidised healthcare.


With “1 Care”, CHC said it would be made compulsory for all wage earners, excluding government servants and pensioners, and businesses to contribute 10 per cent of their monthly incomes to a government-run Social Healthcare Insurance (SHI).


“So those who can pay, will pay, while those exempted from paying, such as the poor and so on, would still qualify for free basic medical benefits offered under the scheme ... Basically, those who can afford it will pay for those who can’t,” the member said, speaking on condition of anonymity.


But, apart from the “fee-before-service” system under “1 Care”, CHC is also griping over the limited healthcare benefits offered under the scheme such as: a patient is assigned to a specific general practitioner (GP); visits are limited to six times per year; visits are limited to one ailment per visit and GPs or primary healthcare providers (PHCPs) are given Key Performance Indicators (KPIs) to meet and would be subjected to penalties.


“Under this system, PHCPs only profit by billing the SHI for their services. Like all insurance, the SHI won’t approve too many claims to minimise cost. PHCPs may be penalised for giving too much service ... or referring too many patients to hospitals or specialists.


“1 Care” is believed to be modelled after the UK’s National Healthcare Service (NHS). — Reuters file pic

“Doctors may have to provide less healthcare to avoid penalty... but you don’t stop paying or pay any less to SHI,” the group claimed in one YouTube video.

The CHC member explained to The Malaysian Insider that “1 Care” budgets a maximum claim of RM360 per patient for each GP from the SHI, which amounts to only six consultations in a year at RM60 each.


“And with the KPI quotas to meet, GPs would try to delay referring too many patients to hospital. Those who need to seek treatment urgently would then have to go to the hospital on their own and pay out of their own pockets,” the member complained.


When attempting to allay fears over “1 Care” recently, Dr Noor Hisham explained that it was merely at “conceptual stage” and that reconstruction of the country’s healthcare system was badly needed.


“Now in the public sector we spend RM16 billion and only recoup two per cent. On the other hand, we wouldn’t want to burden the rakyat so we are currently looking into various options and models.


“At this point of time nothing has been agreed upon. Until everything has been agreed to by the public and such, we need to study the cost analysis. However, there are already lots of assumptions and speculation and bad branding of the system like this TAK NAK.
“I wonder where they pluck the figures from without substantive data to support,” he wrote in one response.


But the CHC claims a new “1 Care Act” is due to be tabled in Parliament imminently, possible as early as the next sitting in March.


The CHC will brief reporters on the issue tomorrow in the build-up to the Selangor/Kuala Lumpur Healthcare Public Forum on February 12. The Malaysian Insider understands the forum will be opened by Selangor Mentri Besar Tan Sri Khalid Ibrahim and attended by Health Ministry officials.

[pywong]

Anti-1 Care group demands Putrajaya kill proposed healthcare scheme


By Clara Chooi
February 02, 2012

Critics claim the scheme would force employees and businesses to contribute 10 per cent of their monthly income to a government-run insurance fund.

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.


Even worse, the group has said, the SHI scheme only covers very basic healthcare expenditure and poses many limitations such as: every individual is assigned to a primary healthcare provider (PHCP) or general practitioner and cannot select his or her own doctor; the assigned doctor is only budgeted to see each individual a maximum of six times a year; “the cheapest, not-original medicine” will be dispensed; individuals will not be covered for all illnesses, especially intensive care; and if an individual insists on selecting his or her own choice of doctor, he will have to pay out of his own pocket.


The CHC also warned today that despite claims from the authorities that “1 Care” was still at the conceptualisation stage, its engagement with ministry officials indicated that the scheme has already entered phase three of its implementation plan.


“It is past conceptualisation, there already is a blueprint for implementation, which are basically the nuts and bolts of implementation process, to be ready by 2012.


“To us in the medical fraternity, ‘1 Care’ is definitely in the final stages of implementation,” Dr Chow told the press conference.


Another CHC spokesperson, Dr T. Jayabalan concurred, adding that numerous technical working groups have already been formed while even Prime Minister Datuk Seri Najib Razak himself had made special mention of “1 Care” during a speech in 2010.


“Another thing is that there have been numerous roadshows held by the ministry... the last one was 10 days ago in Seremban. Definitely, it is afoot,” he said.


But both Dr Chow and Dr Jayabalan agreed that it was still “not too late” to convince Putrajaya to shelve “1 Care”, with the latter pointing out that “elections is around the corner”.


“They (the government) might turn around and say... okay, if you don’t like it (we will shelve it). And elections is around the corner too,” he said.


“If the government does not respond, then they are arrogant,” said Dr Chow.


The duo added that CHC’s “Tak Nak 1 Care” campaign activities are fast gaining attention from the public and in the coming weeks, more would be done to spread public awareness.
“On our side, our association plans to inform its members, hold similar forums in Ipoh, Kuantan, Kota Kinabalu, Kuching and Penang.


“We will inform members so they can duly inform their patients, so as much information can be transmitted to the ground,” said Dr Chow.


“The change that can come is through informing others. What action the people would want to take, we will support.


“We will probably also be submitting memorandums, get the NGOs to get the rakyat to petition... We can see far ahead that the country is headed to disaster if it disbands its present (healthcare) system for an American system,” said Dr Jayabalan.


Apart from the forums, CHC has also kicked off its campaign online, using social media tools such as Facebook, Twitter and YouTube to spread its message.

[pywong]

A few days ago (1st Feb 12) it was at the conceptual stage. Today (4th Feb 12) it is in its 'final stage'.

3 days only!

Inilah memang MalaysiaBoleh!

1 Care in its ‘final stages’, say Health Ministry officials

By Yow Hong Chieh
February 04, 2012

KUALA LUMPUR, Feb 4 — Putrajaya’s controversial 1 Care scheme, which critics claim will tax citizens and businesses monthly to foot the country’s growing healthcare bill, has already entered its “final stages”, Health Ministry officials told a pharmaceutical seminar last month.

This is despite the ministry’s repeated denials and assurance to the public that it is “too early” to sound warning bells about the scheme, believed to be in phase three of a five-phase implementation plan.

The Malaysian Insider understands that ministry officials had told the Malaysian Pharmaceutical Society (MPS) during a seminar on January 15 that it was already finalising 1 Care proposals and that a Pharmacy Act would be tabled at the next Parliament sitting in March to facilitate the transition to the new insurance scheme.

“The 1 Care transformation proposals are now in the final stages,” the ministry’s health policy and planning deputy director Dr Nordin Saleh had told MPS, according to the minutes of the seminar obtained by this news portal.

The Malaysian Insider understands that Health Ministry pharmacy board deputy director Azman Yahya had also explained that the new Pharmacy Act would see the government outsourcing the dispensing of prescription drugs to pharmacies.

Doctors, on the other hand, would only prescribe drugs identified in a standard list, which will be covered by 1 Care’s National Health Financing Scheme (NHFS), while patients will have to pay “out of pocket” for medicines not included in the list.

A drug pricing system may also be introduced once the standard list has been compiled and pharmacies will be reimbursed for all prescriptions, which will comprise mainly generic drugs whenever possible.

The proposed 1 Care scheme, which is fast turning into a political hot potato, is expected to replace the current two-tier healthcare system and force citizens and businesses to contributed nearly 10 per cent of their monthly earnings to a government-run insurance fund.

Under the current system, patients can choose to seek treatment at either private clinics or hospitals and pay out of their own pockets or opt for government clinics or hospitals instead, where they will pay a nominal fee for basic, federally subsidised healthcare.

Already, public outrage is fast growing over the prospect of additional taxes under Putrajaya’s bid to restructure Malaysia’s healthcare system, despite talk that the new scheme would ensure more equitable healthcare for Malaysians of all classes.

Leading the charge is the Citizens’ Healthcare Coalition (CHC), a group comprising medical practitioners and consumer associations that has taken its cause online.

The pact, which started off with some 17 associations, kicked off its “Tak Nak 1 Care” campaign last December using social media tools like Facebook, Twitter, blogs and YouTube to spread information about the scheme and gain wider public support.

The Health Ministry, however, yesterday assured critics that the 1 Care scheme will not burden the public with undue costs.

Its director-general, Datuk Seri Dr Hasan Abdul Rahman, said discussions on the types of financial arrangements that will be made available and their implication to the government as well as taxpayers were ongoing to ensure an acceptable healthcare financing model.

“Any assumption or conjecture on the mode of financial impact for the individual taxpayer is very premature at this stage as discussions are being held at the moment to ensure a positive and workable model,” he had said in a statement.

Dr Hasan added that the ministry was taking proactive steps to ensure that Malaysians would not be burdened by healthcare costs, even as they continued to spiral upwards.

[pywong]

1Care: It's just a proposal, claims Tiong Lai.

Now that the Rats are up in arms, backtrack a bit and look for the next opportune time. Happens over and over.

Whatever BN proposes, reject. You have a 90% chance of being right.

1 Care 10pc medical levy just a proposal, says Tiong Lai


By Yow Hong Chieh
February 08, 2012
Liow says it is too early to condemn the proposed 1 Care system. — File pic

KUALA LUMPUR, Feb 8 — A reported proposal for all employees and businesses to pay 10 per cent of their monthly incomes to a 1 Care insurance fund for healthcare costs has yet to be finalised, Datuk Seri Liow Tiong Lai has said.The proposal has raised the ire of private medical practitioners and public after details of the social health insurance were posted online several weeks ago. The Health Ministry has also had briefings with pharmacists on the plan that seeks to overhaul the existing healthcare system.

“Nothing is final, even the 10 per cent salary (mandatory contribution) is a proposal... It hasn’t come to the policy stage yet,” the health minister told The Malaysian Insider yesterday.

Liow also reiterated that the healthcare system revamp was still in its “infancy”, and stressed that his ministry would consult as many stakeholders as possible before formulating the scheme.

“There’s no point doing things in a hurry. We’d like to engage the public so they may give feedback and even propose better models,” he said.

He added that he would hold a briefing soon to dispel rumours surrounding 1 Care.

The new scheme has come under fire from healthcare practitioners and the public, who claim that individuals and businesses will be forced to hand over 10 per cent of their earnings each month to a government-run insurance fund.

The Malaysian Insider reported at the weekend that the 1 Care system is close to completion, despite assurances from Health Ministry officials that it was “too early” for critics to sound warning bells about the scheme.

The Health Ministry told the Malaysian Pharmaceutical Society (MPS) at a seminar on January 15 it was finalising 1 Care proposals and that a Pharmacy Act would be tabled at the next Parliament sitting to facilitate the transition to the new insurance scheme.

According to the minutes of the seminar, the ministry’s health policy and planning deputy director, Dr Nordin Saleh, told MPS then: “The 1 Care transformation proposals are now in the final stages.”

The Malaysian Insider understands that 1 Care, mooted under the 10th Malaysia Plan, is modelled entirely after the UK’s publicly-funded National Healthcare Service (NHS).

It is believed that the five-phase scheme has already entered its third phase, and the full initiative, post-engagement with doctors and pharmacists nationwide, is due to be presented to the Cabinet by March.
The scheme is expected to replace the current two-tier healthcare system with one that integrates both private and government hospitals, in the hopes of ensuring more equitable healthcare for Malaysians of all classes.

Under the present system, patients can choose to seek treatment at either private clinics or hospitals and pay out of their own pockets or opt for government clinics or hospitals instead, where they will pay a nominal fee for basic, federally subsidised healthcare.

The Health Ministry has assured critics that the 1 Care scheme will not burden the public with undue costs, adding that talks on the financial arrangements that will be made available and their impact on the government and taxpayers were ongoing.

“Any assumption or conjecture on the mode of financial impact for the individual taxpayer is very premature at this stage, as discussions are being held at the moment to ensure a positive and workable model,” ministry director-general Datuk Dr Hasan Abdul Rahman said.

[pywong]

Yesterday, Liow Tiong Lai declared it's only a proposal. Today it's mandatory. You only need to ask yourself one question:

Can you trust BN?

This is the application of the "Boiled Frog Syndrome" strategy. Slowly boil the frog alive. If we don't stop it in it's tracks, we will not only be boiled, we will be fried!

1 Care to be made mandatory, says Health Ministry

February 09, 2012
KUALA LUMPUR, Feb 9 — The Health Ministry said today that the 1 Care national healthcare proposal will be made mandatory for all Malaysians, in an admission that is likely to fuel further controversy.


Despite insisting in the past week that the proposal was still at an early stage, Health Ministry deputy director for the National Health Financing unit Dr Rozita Halina Hussein said today that 1 Care would have to be made mandatory.


However, she said private healthcare providers would be given a choice on whether to participate in the new healthcare system that has seen stiff opposition from stakeholder groups.


She also denied rumours that the ministry had finalised a decision to force Malaysians to contribute 10 per cent of their salaries to finance the scheme.


There were also no plans to cap the number of medical consultations, she said.


Last night, director-general of Health Datuk Seri Dr Hasan Abdul Rahman also went on national television to campaign for the new scheme that critics have suggested will see a mandatory salary deduction for all Malaysians to finance it.


He said 1 Care would give Malaysians equal access to government and private healthcare.


But he did not give any details and also did not comment on the fact that most Malaysians already have access to private healthcare under the existing dual-track healthcare system.


Dr Hasan only said that the ministry has two years to complete the blueprint and that at present, it was still in talks with 11 technical working groups, stressing that the plan was not finalised.


Under the existing public-private system, Malaysians can choose to see a doctor in government-owned medical facilities or seek treatment in a private clinic or hospital.
Most companies already pay for their employees, and their immediate families, to receive treatment at private medical centres.


The government also pays for private medical care in some cases for civil servants.


But Dr Hasan told state-owned TV channel RTM1 in an interview on its show “Dialog” aired last night: “Wouldn’t it be wonderful if, without counting on whether it is government or private service, the public could afford easy access to healthcare, a simplified access with a high responsive rate.”


The 1 Care proposal has triggered a furore from the private medical service and alarmed the public after details of the proposed healthcare system were published online in the past few weeks.


Both medical practitioners and the public are growing increasingly unhappy and allege that individuals and businesses will be forced to pay 10 per cent of their income to the proposed government healthcare insurance on a monthly basis, among other things.


According to the proposal too, each person will be assigned to one doctor in a certain area and will not be allowed to choose another. Individuals will also be limited on the number of medical visits a month.


Yesterday, Health Minister Datuk Seri Liow Tiong Lai said the proposal for business groups to be charged a 10 per cent levy of their income for an insurance fund under the 1 Care scheme would be reviewed.

[pywong]

It's only an upgrade. You can't help admiring the audacity of cheek of these BN "mouthpieces".

1 Care merely ‘upgrade’ of current healthcare system, says minister

By Shazwan Mustafa Kamal
February 11, 2012


GOMBAK, Feb 11 — Putrajaya’s controversial 1 Care proposal is merely an “upgrade” of Malaysia’s current two-pronged healthcare system, Datuk Seri Liow Tiong Lai said today.


The health minister told reporters that any discussion of 1 Care was “premature”.


He repeatedly stressed that the matter is at a “discussion level” in what appears to be an attempt to allay the public’s alarm and fury following disclosures on the internet by prominent healthcare professionals, including those who were involved in talks with the government over 1 Care’s execution as far back as three years ago.


The health minister today denied 1 Care would force Malaysians to contribute 10 per cent of their salaries to finance the scheme. — file pic

“We are not changing the system; it is an upgrade. We are improving the system,” he said.He added that his ministry was looking at “many other countries” to base the 1 Care healthcare plan on.


“The demand for health has increased, the burden of health is now higher,” Liow said, attributing this as the main reason for an “upgrade” of the country’s healthcare plan.


When asked why the government did not just increase the current healthcare budget instead of introducing a new system, Liow said the country’s “healthcare budget has increased every year.”


“Last year, it was RM16 billion, a 10 per cent increase from the previous year (2010). We have been doing that,” he said.


The MCA minister confirmed that the blueprint on 1 Care is scheduled to be completed by the end of 2013, and that his ministry has been given a two-year timeline.


“If it (1 Care) is not suitable, the government can scrap it.


“What is important is feedback from professional bodies ... we can’t give information now, we don’t have information now, the committee is still discussing it,” Liow said.


Yesterday, the Health Ministry’s director-general also insisted that the controversial 1 Care proposal is still a “work in progress” and that the government could reject the scheme if it is found to be unacceptable to Malaysians.


Datuk Seri Dr Hasan Abdul Rahman took great pains to point out that the details surrounding the healthcare scheme are still “ideas” and “proposals” and that nothing has been set in stone, despite news reports stating otherwise.


“Talking about 1 Care, this is still very much (a) work in progress. There are 11 main Technical Working Groups (TWGs) with multi-sectoral participation, both public and private,” he had said.


Liow today denied 1 Care would force Malaysians to contribute 10 per cent of their salaries to finance the scheme, maintaining yet again that proposals have not even reached the policy stage.


“These are spins by irresponsible people,” he said, adding that the said proposal touched on a collective contribution between the “government, employer, and employee.”


Dr Hasan had offered an explanation yesterday, in which he clarified that RM34 billion has been set aside by the government and the private sector for this new scheme, and that under the scheme, all costs related to medical visits and treatments will be borne by a central government agency which will pool contributions from “the government, employer, employee and those self-employed.”


The deputy director of the National Health Financing unit, Dr Rozita Halina Hussein, said on Thursday 1 Care would have to be made mandatory, but that private healthcare providers would be given a choice as to whether to participate in the new healthcare system that has seen stiff opposition from stakeholder groups.


A source, however, told The Malaysian Insider that the healthcare scheme is at a “very, very advanced” stage of planning and is not at as preliminary a stage as the Health Ministry has made it out to be.


1 Care has come under fire from healthcare practitioners and the public, who claim that individuals and businesses will be forced to hand over 10 per cent of their earnings each month to the government-run insurance fund.


The scheme is expected to replace the current two-tier healthcare system with one which integrates both private and government hospitals in the hope of ensuring more equitable healthcare for Malaysians of all classes.
Under the present system, patients can choose to seek treatment at either private clinics or hospitals and pay out of their own pockets or opt for government clinics or hospitals instead, where they will pay a nominal fee for basic, federally subsidised healthcare.
The ministry has assured critics that the 1 Care scheme will not burden the public with undue costs, saying that talks on the financial arrangements will be made available while discussions on their impact to the government and taxpayers were ongoing.

[pywong]

'Why 1Care when we spend below WHO level?'

Terence Netto 10:18AM Feb 11, 2012

The government's mandatory healthcare insurance proposal, 1Care, already under fire over some its secreted details, came in for more criticism after being compared with international benchmarks.

PKR's putative spokesperson for healthcare, Dr Tan Kee Kwong, today drew attention to the World Health Organisation (WHO) recommended level of spending on healthcare in a country's GDP, saying the government spending on the sector lagged behind the world body's stipulation.

"The WHO recommendation is that member countries should spend 5% of GDP on healthcare," said Tan, who is trained doctor and as a Gerakan MP was deputy minister in the BN government before joining PKR in 2008.

"Right now, the government is spending only 2% of GDP on healthcare, which is way short of the WHO recommended level," he contended.

"I don't see why the government cannot raise the level of spending to 5% of GDP. All it has to do is save money from being splurged on unnecessary items like submarines and armoured carriers for reallocation to priority items like healthcare," asserted Tan.

He said the existing healthcare system in Malaysia, which is a combination of public and private sector care, only needs "some tinkering" before an optimum level is arrived at.

"More privatisation is not the way to go. The government should take as cautionary wisdom the experience of its privatisation of clinical waste," said Tan.

Proposed scheme 'highly unpopular'

He noted that the company to whom the disposal of clinical waste was privatised some years back now charges three times the cost incurred when the government was responsible for the disposal.

"That experience ought to be sufficiently cautionary on the part of the government in that privatisation is not the panacea for whatever ails our system of healthcare," argued Tan.

He claimed sources in the government had told him the Health Ministry's proposed new scheme was widely unpopular among its professionals, but a few influential individuals, going against grain, were plumbing for it.

"Hence the suspicion arises that these influential individuals are pushing the scheme to benefit cronies in the private sector who are angling for juicy bits of the project," surmised Tan.

‘From the looks of it, the entire scheme smacks of bad policy and poor economics," commented Tan.


What, why and how of 1Care