1Care: Healthcare for the people or for the cronies

AFTER the massive whacking of Barisan Nasional (BN)’s bid to introduce a 1Care national health scheme (NHS), let’s look at the idea from a different and more positive perspective.

The Health Ministry has confirmed that 1Care would entail mandatory monthly contributions from all Malaysians – meaning, the government is going for your pockets, despite paying all kinds of taxes and service charges.

It is extremely illogical, nauseating to say the least, for a “caring” government to even think of asking the rakyat to surrender 10% of their monthly salary to support 1Care.

Trying to introduce a health care scheme for the rakyat is a noble effort and idea. But the works of the scheme stinks.

For the people or for the cronies

It is acknowledged globally that the Canadian Health Programme is genuinely pro-rakyat with no loopholes for any chance of mismanagement and mishandling.

Any opportunity to link 1Care with any local or foreign insurance and reinsurance company will be a disaster. This linkage can only lead to total commercialisation, thus creating limitation and excess clauses in the programme policies.

Also, any reinsurance will lead to invisible out-flow of huge amounts of funds to foreign land.

Malaysians need a real health programme and there is already a successfully tested health programme in Canada, so why opt for an inferior UK-NHS scheme?

The most important question: Is 1Care for the rakyat or for insurance companies backed by cronies of those in the corridors of power?

In Canada the employed, the self-employed, the unemployed, the rich the poor all get the same top level of medical treatment. No one is denied proper medical care due to lack of money. The Canadian system allows its citizens to pick their own doctors, go see whichever doctor they want to see, and extra billing i.e. extra charges by the doctor is NOT allowed. (No gravy for BN cronies, you see!).

The health care system covers all basic medical care including doctors, surgery, hospital stays, etc. There is no limit on how many times citizens can see the doctor in a year or limit to the cost of our medical treatment. Whatever is necessary? For example, a Canadian sees his doctor and gets laboratory tests once every three months on a regular basis and not a penny out of his or her pocket. Or if one feels some aches and pains, he or she can go see a physical therapist or a chiropractor and it is all covered.

Canadians who opt to get any extra medical care not covered, such as cosmetic surgery or traditional Chinese medical consultation or get acupuncture treatment, they have to pay the first 20% of their income and the rest are tax deductable.

The poor

Upon implementation of 1Care, who will then care for the poor and the marginalised population when the private and public healthcare corporatisation compete for business and profits?

Consider:

> Public hospitals and clinics are now service-driven but upon corporatisation or privatisation, they have to be profit-driven;

> So who will serve the people in remote places? and

> Who will serve the very poor people?

Consider the following hypothetical situations:

What happens when the government introduces 1Care? The whole system of independent one-stop general practitioners will be restructured and converted into 1Care clinics like the UK NHS general practitioner system.

Before

Ali has been suffering from 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 times 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 to be 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 authority to make any discretion, all is by SOPs (Standard Operating Procedures). This is what the NHS UK system is like today.

Muthu 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 what is happening when essential original medications are replaced with the cheapest .The cheapest medications are not necessarily the best for the patient and certainly not the safest.

Every salary man must get a 5-9% deduction from his salary to fund this scheme. This money is taken and gone for good even if you don’t see a doctor.

Do you still want such a rotten deal? Don’t you think the government is taking us for a ride?

Jackson Ng is a Retired Journalist