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Thursday, March 4, 2021

YOURSAY | Vaccines for private hospitals – helping govt or making money?


YOURSAY | ‘What if private hospitals can procure the vaccines separately from the govt?’

Private hospitals want approval to procure Covid-19 vaccines from other sources

Anonymous_15897060865429524: Allowing private hospitals to sell an assortment of Covid-19 vaccines that paying customers can choose will create an imbalanced situation where the rich will take up the Pfizer-BioNTech vaccines and will be vaccinated faster. The poor will continue to wait in line and be left with Chinese Sinovac and Russian Sputnik V vaccines.

It will create a situation where Covid-19 becomes a "poor people's disease" and clusters will be focused in poor areas or "Covid-19 ghettos".

If you are rich, you get the best medicine and you get it faster than others. If you are poor, you wait for the subpar medicine and in the meantime, hope you don’t get sick. It reminds me of the film Elysium.

When private hospitals were asked to take Covid-19 patients to reduce the burden on public healthcare, they said cannot: “We are small private hospitals, we don’t have the resources, it’s the insurers’ fault. So sorry, we can’t do ‘national service’.”

But when it comes to selling vaccines, it’s “Yes, we want to do ‘national service’. We want to help reduce the burden on public healthcare. We have the resources to do it.”

The upper class will no doubt go buy the Pfizer vaccine from private hospitals. And you can be sure the private hospital will charge a premium. They know the rich will pay for it.

Drug cost aside, they may even charge a few days of ward stay for "monitoring", follow-up consultations, and of course, the administrative fees.

Hmmmmmmmm: Why not, if the private hospitals can procure the vaccines separately from the government?

This way, the government programme will still go on as planned while separately, new lines are opened for those who can afford to pay and either do not want to wait or they prefer other types of vaccines. The queues at the public hospitals will be reduced and this will speed up immunisation for the rest of the people.

If the private hospitals are not able to procure any vaccines separately, they can still be roped in to provide the injection services, perhaps for a nominal charge payable by the government (or even free of charge if they want to discharge their corporate social responsibility). The public can still be vaccinated for free even if they go to the private hospital in this case.

Also, in this case, since the vaccine is from the government, the private hospitals have to follow strictly the priority set by the government in their programme. There will not be any queue jumping as the vaccines will not be for sale. It’s a win-win for everybody.

For the private sector to want to sell Covid-19 vaccines, what is new here? You can get your appendix removed in the government hospitals for free or you can pay to have it removed at a cost at the private hospital. It’s up to you to choose if you want to spend that money.

For some people who do not want to wait, 10 times the cost may be nothing to them. Alternatively, if the costs are too exorbitant, the people will just continue to wait their turn for their free jabs. Richer people paying for their jabs in private hospitals help reduce the numbers queueing up in public hospitals.

Dr Suresh Kumar: I don't blame some of the negative commenters here. They see this proposal as a double-edged sword.

Firstly, people must understand that there are many healthcare providers who are not frontliners but continue to provide healthcare. They could be non-Covid-19 treating doctors, dentists, nurses, etc.

The most susceptible amongst them are the dentists. Imagine staring directly into the mouth of a Covid-19 patient at a very close range. But because they are not frontliners, they will not be eligible to be vaccinated in the first phase or even in the second phase if they are young and have no comorbidities.

The risk of these professionals contracting the virus and transmitting it to others is an existential threat. So, if they could be given a choice to be vaccinated privately by paying instead of getting it free from the government, why not?

Secondly, those who can afford it should be given the choice, provided there is no shortage of supply of vaccines in the market, which would not occur as countries like the US and India are capable of producing the vaccines in large numbers in a short time.

This should not be considered as jumping the queue. In fact, this would prevent queue jumping which is already happening now in government hospitals, depriving those who need the vaccines badly.

This would also allow for travelling for business and other professional purposes. And the most important factor is we would be able to achieve herd immunity quicker and the burden on the government will be reduced substantially as Association of Private Hospitals Malaysia (APHM) president Dr Kuljit Singh postulated.

About ethics, especially pricing, this could be easily controlled and regulated by the government so that unscrupulous hospitals do not take advantage of the pandemic situation to rake in profits. This should be viewed as national service by the private hospitals. We need to think pragmatically based on realities so that all of us can be safe and healthy. Stay safe.

GreenViper4010: I suspect that this request from the APHM is prompted by a desire for the private hospitals to "cash in" on a certain demand for vaccines on the part of those who can afford to pay or have their insurance companies pay for them.

The private hospitals are alarmed at the prospect of free vaccinations and simply don't want to "lose out" on an obvious cash cow. The pious expression of speeding up the immunisation process and "helping out the government" is vacuous and self-serving.

The fact is that the Malaysian healthcare system is one where the private sector is in cahoots with the insurance providers so both can make a profit at the expense of people paying ridiculous insurance premiums on top of their taxes for healthcare.

If you need evidence then consider the fact that one hospital in Petaling Jaya was recently charging RM395 for a Covid-19 test, another RM295, while public hospitals were giving tests for free. How much will the private hospitals charge for a vaccine shot? Did Kuljit mention that in his statement?

Gaji Buta: The government should supply the vaccines to private hospitals and force them to administer for free, using emergency ordinance, to speed up the process.

AZ: At the moment, there is a worldwide shortage of vaccines, so whatever that can be procured should be distributed based on a needs basis and not on the ability to pay. Once you start this, then the poor and vulnerable are definitely going to be left out.

The vaccine should be given to the whole population in a fair manner. I totally disagree with allowing the private sector to sell vaccines, but if and when there is a surplus of vaccine then by all means go ahead.

Yet Another Concerned Citizen: @AZ, there are actually two aspects to your argument.

From the angle of social justice - the worry is that this will disadvantage the poor. However, I am more inclined towards the view that the private sector's involvement in vaccine distribution will only help increase overall distribution efficiency, although likely disproportionately among the more affluent. If there is a need to make the vaccine more accessible to the poor, price can be regulated.

From the angle of global vaccine supply, as the World Health Organisation (WHO) has voiced out, there is a concern that vaccine hoarding among the rich countries will result in some countries not vaccinated in a timely manner.

The fear is that more dangerous strains of the virus will emerge as a result. This is something to worry about, as even if a country is able to vaccinate itself quickly for the time being, new virus strains may present even greater danger in the future.

However, while hoarding is an absolute evil, there is no data yet on how a slight increase in vaccine supply to one country will affect the overall vaccine supply to other parts of the world - and how this will delay the overall global vaccination programme. I think we should leave these concerns to WHO’s Covax (Covid-19 Vaccines Global Access) for the time being.

Bewise: If the private hospitals can source from elsewhere, then it’s up to them. As long as they are not eating into the public supplies.

We have to think positively. Let those who can afford it pay for the vaccinations, and the rest can get theirs free from the government.

A surcharge was mentioned that for every patient vaccinated in the private sector (out of pocket), the (surcharge) would be contributed towards a fund used by the government for the free public vaccination programme.

It is just like at the immigration office. Instead of queueing up in one line, it would be much faster to open up five lanes. Whatever resources used, we have to get it done as soon as possible to vaccinate the whole population. By 2022, if we don't die of Covid-19, we will definitely die of hunger! - Mkini

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