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Wednesday, February 1, 2012

1Care scheme faces flak prior to launch


Despite much government hype, another attempt to restructure Malaysian healthcare services signals a dismal future for the rakyat, who currently enjoy a vast assortment of medical subsidies.

This is the view of the opponents of 1Care who have taken their campaign online, hoping to educate Malaysians as to what they feel would happen when the government rolls out the ‘1Care for 1Malaysia’ health insurance scheme.

The ‘TakNak1Care’ or ‘Say No to 1Care campaign’, on Facebook andTwitter is run by the Federation of Private Medical Practitioners’ Association, Malaysia (FPMPAM).

The ‘Malaysians against 1Care’ campaign has thus far generated about 454 likes on Facebook and 20 followers on Twitter. A couple of interactive multimedia presentations on the disadvantages of the proposed system have also made it is online.

NONEFPMPAM is hoping to prompt Malaysians to air their views online before the proposed scheme goes live nationwide, arguing that health services are a social good, and not a profit-generating commodity.

In their argument, the FPMPAM said that 1Care is not only expensive as Malaysians will have to contribute 10 percent of their monthly income to a regulatory body for basic healthcare, but also restrictive in the options it gives patients.

Speculation is rife over initiatives being taken to table a bill to moot a national healthcare financing authority (NHFA) in the upcoming Parliament sitting in March.

“After paying so much, you cannot pick your own doctor as the government will choose a doctor for you, and you can only see your assigned doctor six times a year,” said FPMPAM.

Further points raised by FPMPAM include that a patient can only see the doctor for one problem at a time and then get generic medicine.

However, this is not the view of the government, which first proposed such a scheme in the 1981-1985 Fourth Malaysia Plan, before reviving it as 1Care in 2009.

1Care emerged after a two-decade hiatus when the Health Ministry began formulating a workable scenario on the basis that healthcare is a social responsibility to be borne by all stakeholders.

‘Use according to need, pay according to ability’


Health director-general Dr Hassan Abdul Rahman, in a statement last December, reasoned that a national health financing scheme (NHFS) would ensure quality services are provided to the population based on the principle of “use according to need, pay according to ability”.

To realise the initiative, he added, the existing health financing system must also be changed to pool together “different sources of funding for health; better manage the nation’s health funds; and control dramatic rises in healthcare costs”.

NONE“The proposed health financing transformation is a combination of Government General Revenue and Social Health Insurance (SHI). It involves pooling contributions from the self-employed, employees, employers and the government.”

The government, however, maintained that under the proposed system emphasis will be on “preventive care”, where patients will be registered to a primary healthcare provider (PHCP), who would act as the first point of contact for medical care.

“Patients will not incur any charges when receiving care from their doctor for services within the defined benefits package. However, patients may be charged a small co-payment for prescriptions and certain appliances.

Access to secondary and tertiary healthcare, under the new scheme, would require the PHCP’s referral.

This will promote optimal use of specialists and hospital services for those who really require higher level care.

NONE“When referred, patients may choose to go to a government or private hospital. Patients do not have to make any additional payments for specialist services and hospitalisation that are within the defined benefits package,” Hassan had said.

Malaysians against 1Care, however, dispute that unlike a regular insurance coverage with a health and hospitalisation plan which offers the premium payer a wider scope of treatment, including access to listed private health services when necessary without incurring additional out-of-pocket payment, 1Care limits options.

“If you don’t like it, you’ll have to pay more to see another doctor or get better medicine,” protest the campaigners.

Malaysia’s total health expenditure for 2009 was approximately RM33.7 billion, a discernable increase from RM31.87 billion in 2008, reports World Health Organisation’s (WHO) National Health Accounts.

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