Is there any ideal health care system in the world?
Arguably, some would point to the single payer system which is nationally controlled or directed, such as those being practiced in the UK, Canada, or even in communist Cuba.
The recent acrimonious debate about the now aborted sale of IJN (our National Heart Institute) is symbolic of our political masters' ambiguity with regards health care.
On the one hand, there is this push toward more open and freer market-driven trade and services as demanded in the globalised world. On the other, there is this overarching concern for our citizens' right to universal access to health, which at the present moment appears piecemeal and disjointed.
Cost and affordability issues continue to plaque the system which has as its backbone, a dichotomous two-tiered private-public sector, seemingly at odds with its premise to provide efficient, excellent yet affordable health care to the Malaysian rakyat.
Yet, when compared with most of the third world countries, our healthcare service has been touted as noteworthy of emulation--particularly our rural health service and primary care. The concept of having a healthcare facility within a radius of 5 km, is clearly one very remarkable service which has enhanced the reputation and stature of our health service. UNDP and WHO has endorsed this system which has been copied by many other developing nations.
Lately, due to the expansion of our private healthcare services, tertiary (specialist) medical care has also grown in stature, such that we are now attracting medical tourists not only from our neighbours such as Indonesia, Bangladesh, Vietnam, Myanmar, but also from Singapore, Australia and even the UK and USA.
The irony is that while such superlative care seems readily available for the well-to-do and foreign medical tourists, the converse is not true. Thus, for some of our poorer rakyat, this service appears to be out of reach for them, and this has brought on some understandable resentment, and complaints of social injustice--loudly echoed by consumer associations and other social pressure groups. Clearly, there must be some mechanism to address such an inequity in access.
At the same time, it must also be borne in mind that in every healthcare system of the world some degree of rationing, delay and waiting times exist. Some of these shortcomings may be more apparent for some patients, for various reasons, but often because of financial constraints.
Thus, excellence in healthcare unfortunately comes at a cost, and with newer advances, this is inevitably going to be even costlier. To be better than good and to excel implies willingness to compete and the drive to be the best. Human skills development are needed to encourage greater motivation to become the best, to attain standards which matches or even exceeds international norms.
With the recent drive to attain JCI ["Joint Commission International"; JCI is a subsidiary of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)] recognition, many of Malaysia's better medical centres will be even better acclaimed and accredited--hence possibly gaining even greater exposure as medical tourism attractions. With greater attention to detail and systemic error-reducing protocols, health care can attain standards which will benefit every one, including our own Malaysians who still form the bulk of the private sector clientele (or patients if we wish to remain purists). Higher standards will also have a knock on effect, which raises the level of care all round, and which will also uplift even the harried overloaded public healthcare sector. Such is the win-win scenario that is espoused by every stakeholder in healthcare.