The last three weeks or so have been abuzz with talks and public debates on the new health insurance scheme soon to be introduced to Malaysians and boringly named 1 Care. And as usual when insufficient information is available thus lacking transparency, people will tend to make their own assumptions and conclusions. And as expected when a new scheme is imposed on the public affecting their income and choices, there will likely be an outcry. The non-mainstream news portals, blogs, social media networks like Facebook and Twitter become an outlet to vent angry oppositions.
To conclude that the health ministry has not done its works on this controversial new health insurance scheme is unfair as they have been working on this healthcare financing scheme for many years as a response to an escalating increase in healthcare cost. Other countries like the UK,Germany, Singapore and Australia have already put in place healthcare schemes which mandate public contribution to ensure its sustainability. Yes, there are countries among these which cap the number of visits to specialists’ care and impose a certain percentage in mandatory personal contribution.
What I see as rather unfortunate (or is it fortunate?) in this 1 Care issue is that it is being leaked out prematurely by some quarters out to create ( inadvertently?) public confusion and subsequent apprehension especially in the months running up to the 13th general election which must be called before March 2013. There must have been some rattlings in the Barisan Nasional (BN) camp as this issue could be used against them in this election. So crucial it is that you may notice that the Minister of health immediately coming out to say that the scheme is not yet finalised, that it is still at the preliminary discussion stage and the public should not be alarmed (typical politician’s garble). And then a junior officer from the same ministry refuted the minister’s statement by saying that the discussions were actually in a very advanced stage here.
Then you have one of the most pathetic responses from a government department in memory. The health director general went on national TV to state that the scheme is not yet cast in stone and that the 10% cut in personal income as a contribution to the scheme is just a proposal and that the scheme will allow patients to choose between a private hospital or a public hospital at no cost ( Dear me! at no extra cost? many of us would surely opt for private hospital with its 5-star facilities. Now how sustainable will this kind of healthcare in Malaysia be?) and that the government will probably decide to settle all the contribution! Lord! What kind of garbage is that? And on national TV too? If the government wants to bear all the cost, then why the heck should there be a new healthcare insurance scheme? We are already having a 98% subsidised public healthcare in Malaysia! Laughable indeed.
To be sustainable, any healthcare insurance scheme in the world will require public contribution. It is the structural payment mechanisms and the shared cost that would need careful considerations/deliberations to ensure relatively smooth implementation.
And so we are left with more questions than answers after that mediocre response from the top civil servant of the health ministry.
As if it is not enough, the following day in the Malaysian Insider, some junior officer contradicted the director general’s remark on the 10% contribution by saying that it was never a proposal but in fact it was a finding in their studies that people spent about 10% of their income on healthcare. Jesus, how could the head and the subordinate say two different things on the same issue? . What is happening to this once fine ministry? You have three different versions , one from the politician (the Minister), the second from a “blur” DG as head of department and the third (most likely the “real” one) is from two junior officers. And don’t forget there is yet another version from an anonymous source, probably from among those members of the so-called 11 technical working groups deliberating on this new scheme!
And today the minister of health Liow Tiong Lai came out again to give another piecemeal information that 1 Care is actually an upgrade of the existing healthcare system and we should expect him to come out yet again with more disjointed information in the coming days as the controversy rages on.
I sure miss Dr Chua Soi Lek, former Malaysian best health Minister. He would be able to give us a clearer picture/narrative of this proposed healthcare insurance scheme. Incidentally, concerns have been raised about the current health DG whose competency in dealing with big issues such as this is found to be wanting.
Any health officer can announce disease statistics or disease outbreaks and rattle off health advice to the public. Nothing is difficult about that routine stuff. A leader, however, will show his true colors as exemplified by the following: leadership,competency,acumen,intelligence,clarity of ideas, confidence, articulateness, strength of character,unsuitability, mediocrity,stupidity, poverty of ideas and weakness of character in time of crisis or controversy and people tend to view this healthcare insurance issue as a form of crisis due to the impending general election.
The issue should therefore be addressed succinctly to allay public fury, fear and anxiety. Contradictory responses/statements are bad news. In short, an incompetent and an inarticulate top public official is not only embarrassing but might also cost the present government dearly at the ballot box.
Does anyone care?