Friday, February 05, 2010

1CARE for 1Malaysia, RESTRUCTURING OF THE MALAYSIAN HEALTH SYSTEM

I spend this Tuesday ( 2-3 rd Feb 2010 ) and Wednesday at the Holiday Villa Subang Jaya attending a MOH seminar on " 1CARE for 1Malaysia " 10th Malaysia Plan restructuring of the Malaysian Healthcare system. I would like to keep all Malaysians informed of the plans and what is coming ahead. I suspect that there maybe a snap election soon ( if the climate is right ), and should the present government win convincingly, they will push the plans. Otherwise, the plans may be shelved. So, in that sense, it is up to us. There again, it is not quite up to us ( if you know what I mean ). Anyway, lets roll on. I was invited as a representative of the Federation of Private Medical Practitioners Association of Malaysia.
At the meeting, it was well acknowledged that the present healthcare system that we are having, though there are problems, is by and large a good system that have served the country well. We spend a relatively ( 3.6% of GDP ) small amount and achieved almost world standard healthcare indices. But the powers that be, have decided that we must be " transformed into a high income economy", so the healthcare system must be " transformed and restructured". We were there o give our input ( sounds so nice, but it looks like their mind has been made up and we are there to window dress.
The MOH is proposing that basically we socialise healthcare. They are proposing that we create a social health insurance ( SHI ) scheme. All of us, citizens, will contribute. The government will contribute the majority ( the money from our direct taxation will go towards the National Health Insurance funds ) share. The rest, about 7% will be contributed by us. The employers maybe 4.5% and the employees, maybe 2.5%. ( the exact quantum has yet to be decided, but the employer/employee portion will be about 7% total ). This money will be administered by either the Ministry of Health or the Central Bank, and use to pay for healthcare. The GPs will be upgraded to Primary Care Physicians and they will be the frontliner and gatekeeper of the whole scheme. Local Primary Care Trust ( PCT ) will be set up in each locality. They will employ the Primary Care Physician and pay them. All of us will be registered with a Primary Care Physician. Anyone requiring medical help, will first be seen by his/her Primary Care Physician, who will assess and treat and only when necessary, refer for secondary care. All consult and treatment will be paid through the fund although some treatment may require co-payments.
This system proposed is very much like the UK NHS. The story goes that so and so went to UK and was very impressed with the NHS system, and felt that we should embrace it.
There is still much details to be iron out, but this is basically the gist of it. we were also told that all these nice plan will probably cosy the country about 6.2% of GDP.
Of course, our argument has always been that we have a good system, why change it. Why fix the furniture when it aint broken? Yes, there are problems with the present system, like long waiting list, inadequate coverage etc., but nothing that increasing the healthcare budget cannot fixed. If only they will retain our present good system, raise the healthcare budget to 6.2%. I believe that that will be better then all these socialised medicine, transformation and re-structuring.
At last, the powers that be must transform, and re-structure. The why always escapes us. Poor GPs, more problems on the way.

1 comment:

Spinosum said...

In your opinion, will this move favour the current GPs?

What I gather from my DFM mentor, was that there will be a quota system whereby a GP will be allocated with a fixed amt of patients, and if the current GP holds more patients than the quota, then he or she must "release" the excess patients to the neighbouring GPs.
(and I take that as a fair-share basis scheme)

Also, GPs will be "ensured" a reasonable amt of salary per month; and dispensing power will be channeled to pharmacies.

Are these all true as well?