Friday, July 14, 2006

Emergency Room Friday

This blog spoke about emergency rooms a couple of weeks back. We mentioned

The cost of care in ER is very high and one can almost never make money on ER services. Therefore the recent USA study that shows more medical centers closing their emergency room, is very worrying, as you can never predict emergencies and so ERs are going to have to be always on a standby. The Ministry of Health, Malaysia, expressed a premise not so long ago, about treating "true medical emergencies" without first asking for terms of payment and this must be carefully thought over. Right at the outset we must ensure that true emergencies are better defined.

It is vindicating that the health minister sees things the way we do about healthcare

“However, foreigners using our hospitals bring a lot of problems with them such as non-payment of bills, use of fake identification documents and pregnancy complications because most of them do not undergo antenatal treatment,” he said after a briefing by Sabah Medical and Health Services Department officials here.

The health minister appears to be telling us that folks who don't have to furnish proof of payment or proof of identification are a big headache even for government hospitals. Bear in mind that government hospitals don't necessarily run solely for profit, there is a social responsibility element to it too. However, the private sector needs profits to keep on providing care to the public.

When the government hospital runs out of funds and needs more ringgits to buy gloves or syringes, the government can allocate funds from the tax payer coffers. When a private hospital has spent its last ringgit and needs a few more ringgit to buy another box of gloves, there are no taxpayer coffers standing behind them. I somehow doubt the hospital administrator will stand at the roadside with a cup in hand to ask passing members of the public for funds.

The government clearly understands that to treat first without asking the simple questions "Who are you?" and "Can you pay?" is a disaster; yet this is the burden that private healthcare is asked to bear.

Bear in mind that presently, even without forcing us to "treat first, ask later", there isn't an epidemic of Malaysians dropping dead. We are attempting to fix a non-problem while real problems like that of foreign workers without health insurance run rampage over our public sector brethren.

The healthcare sector in Malaysia has been commendably responsible. We only ask that you tell us who you are so that we can follow up on your care. We only ask if you can pay so that we can channel our resources best to cover those who truly cannot pay and are at the greatest amount of risk.

It's great that the minister sees this quite clearly. Now if only it would make it into the law books.

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