PETALING JAYA (Herald Malaysia): The proposed healthcare reforms under the 1Care for 1Malaysia transformation plan is nothing more than a move to enrich private companies, says a health activist. Dr T Jayabalan, the Citizens Healthcare Coalition spokesman, told a press conference that the government had long been flirting with the prospect of plunging its hand into the services sector and was now pushing ahead in the outsourcing of health services.

He reminded the media of the outsourcing of Malaysia Airlines System’s (MAS) catering system in which a private company made a killing. “It’s very clear that at the end of the day it is all about outsourcing,” Jayabalan said. “There has been no consultation with the public except with pharmacists and selected segments of doctors.”

“Its outsourcing vehicle is the Social Health Insurance (SHI) scheme. I find it fantastic that they use the word ‘social’ when there is nothing social about the scheme.” Under the 1Care, healthcare will be provided by a single entity and each household would be required to contribute almost 10 per cent of gross household income for the SHI which only covers basic healthcare expense.

All clinics and hospitals will be incorporated into an umbrella of 1Care facilities and access to specialist healthcare will have to be through primary healthcare providers who will act as gate-keepers. A National Healthcare Financing Authority will be set up to take charge of 1Care. The coalition expects that this authority will likely be turned into a government-linked company.

According to Jayabalan, the doctors who were consulted over the 1Care were forced to sign a pledge to keep the information confidential. But a few, who disagreed with the plan, had stepped forward to furnish him with the details. “Hushing up the scheme’s details is unacceptable,” Jayabalan stated. “Healthcare is a social issue which affects the country’s progress and productivity.”

No thought for public welfare

The coalition views 1Care as a thinly veiled attempt by the government to turn yet another public services sector into a business without a thought for the people’s welfare. “We have already lost the education sector and we cannot afford to lose the healthcare sector,” he said. “The biggest issue now is that the government wants to transfer part of the cost to the people in what it calls cost-sharing.”

“This is the language of the World Bank which has always promoted the removal of subsidies. And the government’s claim that it is illequipped to bear the cost of healthcare doesn’t hold water as it doesn’t fork out much anyway.” Jayabalan also pointed out an alarming discrepancy in the Health Minister’s words and actions pertaining to 1Care. He said that despite the ministry assuring the public that the plan was only at the conceptual stage, it has already begun nationwide roadshows to promote the plan.

“I daresay that it is already at the final stages of implementation,” he said. “The government is also separating the pharmacists and doctors and this tactic of division is the best way to push a plan through.” But he still believed that it is not too late for citizens to push back (the plan), especially with the general election around the corner. Noting that 1Care could be an unpopular move, he said that the government might backtrack if the dissent was strong enough.

Jayabalan also rattled off a list of alternatives to these proposed healthcare reforms. The first is to retain the current healthcare system with reforms aimed at improving public healthcare as well as increasing government funding for this sector. “The government could include the pooling of risks… with the poor being subsidised by the rich,” he said. “But the country will be headed for disaster if we dispense the current system for an American one.” -- By Stephanie Sta Maria, FMT Hat tip: Catholic Herald