Its 1Care, NOT “I CARE”

I thought this is a “I CARE” healthcare program that will benefits the rakyat more, land up its another “rent seeking” 1Care for 1Malaysia program that will bring wealth to certain quarters.

Its written clearly in the Concept Paper prepared by Ministry of Health Malaysia back in 11 August 2009 and recent statement in ETP as following:

To understand more, click to down load the presentation paper of Dr Ng Swee Choon, Medical Affairs Committee, FPMPAM.  Healthcare restructuring. Selangor KL healthcare Public Forum. doctors perspective.120112.1

I tried to search in MOH official web site to understand more about the 1Care concept, but failed to get anything, except following statement published on 11 Feb 2012. http://www.moh.gov.my/news/292

KEY MESSAGES ABOUT 1CARE

  • 1Care is a proposal that aims to improve healthcare and make it accessible to every Malaysian.
  • 1Care is still at the concept level.
  • The MOH is still working on the technical issues with various stakeholders.

WHAT IS 1CARE ?
A proposal that aims to improve healthcare and make it accessible to every Malaysian.

WHY 1CARE?

  1. People always complain about;People worry about paying for major treatments of serious illnesses.
    • Long waiting time
    • Overcrowding
    • High cost of healthcare
  2. People worry about increased cost for healthcare as they grow older.

WHAT IS THE VISION OF 1CARE?

  1. Rakyat will have more choices for healthcare either public or private regardless whether they are rich or poor.
  2. Regardless of how old or sick they are, Rakyat will have access to high quality care.
  3. Rakyat will have care nearer to home or work place.
  4. Rakyat will have their own family doctor. They can choose their own family doctor and can change if necessary.
  5. The family doctor will know personally each individual and their family’s health problems, working with them on their long term healthcare needs to continue to stay healthy.
  6. Rakyat don’t have to worry about payment at the point of receiving entitled treatment.
  7. The government will continue to contribute for the poor.
  8. Contributing for healthcare needs will not burden the Rakyat.
  9. Rakyat will not become poor as a result of paying for healthcare treatment.
  • We welcome input and feedback on how to improve our healthcare system.
  • If you have any ideas, feedback or enquiries, please direct it to  Forum1Care@moh.gov.my 

Look like a great concept right?

But why want to fix the system when MOH repeatedly said “Malaysia’s health care system is acknowledged internationally as a successful, modern, government regulated health system that provides effective health services.”.

And how the rakyat give input and feedback on how to improve the healthcare system when we can’t access to the information?

Healthcare is our basic rights and shall not be treated as trade-able goods. Healthcare should not be privatize as other basic needs like water, electricity, transportation system and etc.

You can find more 1Care Documents (including the 1Care concept papers etc) from the following link: http://taknak1care.weebly.com/1care-documents.html

To understand why public object about the system, you can read from following news report (oh, I took all these photos :p):

健保计划迎合一马潮流赚钱
医生抨医疗沦商品本末倒置

Original post : http://www.merdekareview.com/news_v2.php?n=22735

医药界人士认为,“一个马来西亚”健保计划(1Care)美其名让医院享有自主权,实际上是要撤除医药津贴。他们认为,医疗服务是基本人权之一,不应变成商品,有者甚至直抨,政府此举旨在迎合首相纳吉“一个马来西亚”潮流!

马来西亚私人执业医生联合会(Federation of Private Medical Practitioners Associations Malaysia,FPMPAM)属下的医药事务委员会委员黄瑞春(右图)指出,其实我国医疗系统是国际公认成功的,政府只需要拨出约2%国内生产总值的款项,就能修补现有的弱点。

他暗讽道,其实健保计划只是要赶上纳吉的“一个马来西亚”潮流,而且他也引述卫生部长廖中莱的话,指在经济转型计划中,健保被视为“能够制造财富的领域”和“具有无限经济潜能”,致使我国医疗逐渐变成商品。

此外,他认为医药教育不应成为一种商品,反之培养医生应符合国家利益和需求,要不然只是出产一堆医生,却造成供过于求,“然后(他们)就可能成为药剂营业代表(Drug Reps)”,引起观众大笑。

“现在有35间大专院校提供医药课程,出产许多毕业生,你知道吗?有些甚至招收满额学生。”

根据他呈现的报告,一马健保计划的目标是达致“公平、有效率、有品质的健康保险”和“减少人才外流”。

引述卫生部概念书证明观点

身为医生及消费者,黄瑞春自嘲自己有“利益冲突”,为了保护自己而非假造事实,他是“有根有据”地引述资料来源,“而且是你(观众)的责任从事实中寻找真相”。

他在演讲中,常常加入些会心爆笑的言语,而且常常以暗地讽刺性言语批评一马健保计划。

在他看来,我国公共医疗制度已经接近完善,而且90%的人口居住在固定的医疗服务站,平均每州都有十所医院,“就连在大汉山出事,都能够通过一层层,找到适合的医疗服务”。

虽然卫生部总监声明一马健保的“强制性是媒体使用的字眼”,但是黄瑞春不同意,并指出在卫生部2009年概念计划书(Concept Paper)里第45段落,列明全部马来西亚人“没有选择不参与(健保)系统”。

他再次发挥冷面笑匠的本事:“这些全部在书本里面,除非你告诉我这本概念书只是用来玩的啦!”,再次引起哄堂大笑。

卫生部总监哈山阿都拉曼在上周指出,强制性健保只是媒体使用的字眼,扣除国人10%薪资投保“1Care”保健计划仍处于建议阶段,是否落实取决于政府决定。【点击:强制扣10%薪资仅是建议 卫生部总监:由政府决定】

他也表示,概念书有强调9.5%的缴纳率,只是可能由政府、雇主和雇员一同承担,而且健保计划只是估计涵盖“病人的每年享有六次初级看病权”。

政府无力负担医疗成本?

另外一名主讲人雪兰莪州行政议员塞维尔(Xavier Jeyakumar)则质疑为何我国公共医疗开支在2004年后就开始落后于私人医疗开支。

他指出,有许多医院扩建和新工程都停止了,“政府是计划性停止建立还是不能负担成本?”

他表示,就连落后于我国的泰国,每个医院手术,不管是什么,甚至是心脏绕道手术,只需要马币3000元,然而有些马来西亚的贫穷人士却因无法负荷区区马币200元的白内障手术而瞎眼。

也是一名医生的塞维尔(右图右)认为,政府应该向公共医院注入拨款,以恢复以往的良好服务,“以前最高元首去公共医院接受治疗,不过现在飞去新加坡”。

对于发展医药旅游,他并不反对,但不应该建立在牺牲公共医院的条件上,因为我国有70%人口是依赖公共医院寻求治疗的。

此外,他也指政府应该采取透明和开放投标政策,不能只是以私营化来解决一切为题。

他举例,垄断政府医院药物供应的私人公司Pharmaniaga 和 Fomema,造成政府必须“以25分钱的成本来买市场售卖5分钱的药物”,以致浪费公款。

政府外包医疗服务

积极倡议反对一马健保计划的病理学家嘉亚巴兰(T. Jayabalan,下图)表示,该计划美其名让医院有自主权,实际上就是撤除医药津贴。

他指出,公共医院在没获得拨款下,必须要提高收费,来维持操作,而这对消费者,尤其是低收入者,更是不公平。

他认为政府此举,乃是外包医疗服务至市场,由市场决定一切价格,实际上医疗服务是基本人权之一,不能够随意让市场剥夺。

在该计划下,他指称普通开业医生(General Practitioner)必须要每三年,向马来西亚健康品质局(Malaysia Society for Quality Health,MSQH)缴纳马币一万会费,而如果开业医生不参与该计划,那么医疗费用就不会获得一马健保津贴,而会导致医生无法生存。

他表示,卫生部实行该计划根本没有与专业医生进行咨询,而且是在偷偷摸摸下进行,根本是不透明化。

这场论坛是由人民医疗保健联盟(Citizens’ Healthcare Coalition)、雪隆私人医生公会(Private Medical Practitioners Association Selangor/KL)和马来西亚私人执业医生联合会(Federation of Private Medical Practitioners Associations Malaysia,FPMPAM)联合主办。

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