Saturday, May 14, 2011

The Star: Government plan for better health care system.... by DATUK DR HASAN ABDUL RAHMAN, Director General of Health, Malaysia.

Government plan for better health care system

Director General of Health, Malaysia.

The Star, Friday May 13, 2011

RECENTLY, there have been a number of articles and comments regarding the Government’s efforts to improve our health system, ‘MMA: Talk to Stakeholders (The Star, April 18), ‘Provide Adequate Healthcare’ (The Star, April 26) and ‘Government healthcare plan must be carefully studied’ (The Star, May 1).

I am responding in view of the misconception and inaccuracy of the information as the Health Ministry (MOH) and government want readers to receive the correct picture.

The Government and the MOH are still in the planning process and have been consulting widely to get input into the blueprint that is being developed over these two years. Absolutely no decision has been made on the details of the transformation.

To date, MOH has also conducted more than 100 sessions of the discussions, dialogues, forums, focus group discussion and meetings involving at least 62 stakeholders, including the Malaysian Medical Association (MMA).

Ten Technical Working Groups (TWGs) have been created to study and suggest relevant options for the new system.

Representatives from various stakeholder groups such as professional bodies and external agencies, including MMA are members in these TWGs.

Under 1Care, patients will have the choice to register with any qualified primary health care provider (PHCP) who will be their personal doctor.

Yet, the public is allowed to change their provider if they want. These measurements are to improve the quality and responsiveness of the health care system.

If the patient needs referral to a specialist or for hospitalisation, arrangements will be made through their family physician to either a public or private facility.

Globally, this is a proven mechanism to facilitate appropriate access to higher level care. At the same time, the patient is free to choose additional services through their own funding as they do currently.

Therefore, contrary to setting up monopolies, 1Care is designed to improve efficiency through provision of greater choice and better control on cost of health care delivery.

Funding for 1Care 1Malaysia is based on the principles of social health insurance where the risk of falling sick and paying for health care is shared across the whole population.

Therefore, the rich support the poor, the healthy support the sick and the economically productive support dependents.

In contrast, private health insurance is individually risk-related to each person’s pre-existing condition, age, health history and other factors.

The MOH has always stated that the financial management of 1Care will be handled by a not-for-profit government statutory body accountable to the MOH, and should not be privatised.

I reiterate again that the invitation of the MOH and government for stakeholders to participate selflessly and constructively in the planning process for health system improvement.

It is a legacy we will provide to our nation for years to come and we should work together to develop a blueprint that will provide the rakyat with a health system that meets the needs of the population.


francis ngu said...

Suggest MMA holds MOH/government to the reported promises:

1. The national health insurance company will be non-profit and will not be privatised.

2. Patients/public will have choice of provider, and change of providers.

Suggest also that the dozens of private health insurance enterprises should be merged into larger entities to provide economy of scale (like banks)and observe the following:

1. their policies should be population/community rated and not individual risks and morbidity rated, but scale of private premiums may be set according to age of subscription, to encourage buying policies young.
2. premium set and increases will be negotiated with government and health consumer bodies;
2. policy exclusions should be similarly negotiated and approved.


PS. In Australia, there is only one large private health insurance, Medibank Private; Malaysia with much smaller market, has dozens of private health insurers.

Dr D Quek said...

So far we have not been informed formally to attend any of the TWGs. The invite for TWG for primary care was made through the invitation of Academy Family Physicians Malaysia, and then we were told that only GPs can attend.

What about other stakeholders? What about the current or later leadership? What about other doctor groups who would be affected in no small manner such as hospital physicians, specialists, etc?

There are some dozen or so other TWGs, but MMA has not be notified of any need to participate thus far. Are we being penalised for being too vocal? Aren't we being sidelined?

We are still very concerned that soon GPs and all other doctors would become under the gatekeeping powers of a few govt trained family physicians, totally deciding on who should be paid what and how much, and who to refer to...

francis ngu said...

It is irresponsible not to include MMA in the CWG. Cont..

francis ngu said...

It is unthinkable that MMA is not included as a principal dialogue partner in what is touted as a major health care reform initiative.

Is MMA not the sole entity, which includes among its membership the whole diverse spectrum of medical professions?

Is not MMA the peak medical professional body which is best able to articulate and mitigate any competing interests between medical professional groups on the one hand and between professional and wider public interests on the other ?

In principle the development of the family physician specialist field is desirable for the growth of primary care. However, the future long term role of the specialty in the scheme of things need to be trashed out between stake holders.
Thus, would only some doctors be specially trained as such specialists, to provide another level of gate-keeping, which Dr. Quek is rightly concerned about ? Would such additional clinical (and bureaucratic!) level of gate-keeping not impair patient care process?

Or would all doctors in future going into private GP practice need to be trained and qualified as specialist primary care physicians?

Clearly, the MOH/DG may not have worked through major issues critical to the success of any reforms. The dialogue with stake -holders would be so much deficient without the essential participation of MMA reps.