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Malaysian Healthcare - The Way Ahead!!

Dear Colleagues,

2011 has started with an air of expectation in the healthcare fraternity. We are all so excited with so much talk of impending change and increased doctors’ professional fees that we forget what the basic issue is all about.

We are told that national healthcare reforms are on-track and that 1-Care will be the future tagline for all healthcare in Malaysia. Patients will be able to access healthcare in both private and public sectors. Already the major private hospitals are now GLC-owned and the nation’s private GP and primary care clinics are now been asked to re-look at their business model.

All this sounds good and new on paper, but our question has always been “What’s wrong with our present system?” It does sound very much like the “new-car syndrome” i.e., if a family wants to buy a new car they will find countless things wrong with the old one.

Bits and pieces of information on this so-called 1-Care have seeped out of the many meetings that have been held for the past two years. Technical working groups have been formed and various lobbyists are furiously pushing their own agenda to be included in the final product. However the true substance and form are yet to be revealed and discussed in total. International consultants and experts have been called in to write glowing reports and to explain why drastic changes, reforms and transformation will be needed.

At the end of the day, how much will all this 1-Care cost us and the future generation of Malaysians?

We envisage the 1-Care will cost the patients and the rakyat more and not less than what they are paying for now.

The claim that future patients need not pay is certainly not correct for at the end of the day it is still the patient and the rakyat that will have to foot the final bill. Increased taxes in one form or another will have to pay for this. Already healthcare costs have escalated way above what the average family can afford. This started the moment the policy decision was made to commercialize healthcare with the entry of MCOs, public listing of private hospitals, other associated healthcare services and their likes. RM100K hospitalization bills are no longer rarities today. We expect to see more and more families going bankrupt as a result of massive hospital bills for major illnesses.

Make no mistake, we are well on our way down the American model of commercialized healthcare and there seems no turning back. Paradoxically, the Americans, under Barack Obama have come to their senses and are looking at ways to turn back the clock. We, on the other hand are happily marching down this well-trodden commercial path.

Perhaps ten years down the road, our leaders of the day will have to sit down and see how to make reform on the reforms made today.

Our stand has been for the consolidation of the existing system by minimizing wastage and improving the productivity of key sectors of the public healthcare system rather than total reform or transformation.

Our call for a public referendum on this very important development for healthcare reforms and transformation have not taken heed. There is big money to be made in commercialized healthcare and the big boys are there pushing and shoving. You can
see them waiting daily in the corridors of power.We as doctors are irrelevant. Our simple dictum, “to cure sometimes, to comfort always and never to harm” is now replaced by corporate call for billion ringgit turnover, RoIs and buoyant profits to satisfy the demands of shareholders.

Eventually, the rakyat will find it expedient to express their support these reforms or otherwise in the form of their vote at the ballot box .

It is thus pertinent for us as doctors to talk to all our patients whenever we can with regards to the future healthcare system. Explain to them how it would impact their care. It is your duty to inform the patients and their families that the previous social contract model of healthcare may in future, be replaced by a business contract when they see you. Do ask them if this is what they want. Ask them if they prefer this present one-stop medical care at your clinic or they rather go a couple of miles down the busy main road with their sick child in tow to pick up their medications at a pharmacist. Ask them if they and their future generations are prepared to foot massive bill for the increased cost.

We in your Federation would like your feedback as well as the views of your patients and their families. Do write to us soon.


With best wishes,

Steven KW Chow
23.3.2011

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