The proposed 1Care for 1Malaysia healthcare transformation plan is a hot topic of discussion in the public.

It is said that a certain percentage of monthly income is to be contributed by the employees and the employers towards the plan, although the details are still on the drawing board.

First of all, we must distinguish the difference between healthcare and medical care. Healthcare is associated with hygiene, proper diet, exercise, and lifestyle.

What the government could do to improve healthcare is to proliferate the awareness through formal education at the schools and informal education through various means.

The key performance indexes may include the level of awareness among the general public on what is healthy food and what is not, how much food is not considered overeating, how much exercise is essential and practical, how much sleep is sufficient, the level of commitment and habitual changes towards healthcare practices, the reduction of obesity among the public, and the reduction of government spending on subsidised medical care.

Medical care is a poor substitute for healthcare. Free or subsidised medical care gives the people false sense of security and misleads them into neglecting their health until it is too late to find out that even modern medical science is not magic.

There is no free lunch. Ultimately, who pay the bills? Who get the biggest slice of the allocation? Could it be pharmaceutical companies, medical care industries, insurance corporations, bankers, and politicians?

Under the 1Care scheme, if the people are forced to pay and forced to accept a doctor assigned by the government, it is repressive. Many people, whether they are rich or not, do not seek treatment at government hospitals due to the perceived poor service quality, irrespective of the true nature of the services.

After all, it is not the responsibility of the public to grant their trust but for the other party to gain the trust of the public. The tax payers are already subsidising the medical cost of those who use the services of government hospitals.

Even if the 1Care scheme only requires monthly contribution of RM10, it does not give any value to those not using the services and it is not fair. Some people receive medical benefits from their employers, while others subscribe to additional insurance for critical illnesses coverage.

They pay for their misfortune or "misconduct" of not looking after their health.

They have the dignity of not depending on generosity from anybody except their family. The 1Care scheme, no matter how little is the mandatory contribution, will incur double expenses for medical care if they still want to go to private hospitals for treatment.

Mandatory contributions by employers will increase the cost of doing business and it won't help to attract investors to create jobs for Malaysians.

We must learn from the experiences of the advanced countries. The Medicare and Medicaid schemes in the US have been criticised by many.

They have become under-funded due to escalating medical costs and a decreasing younger population to carry the burden of subsidising the increasing retirement population.

When the government tries to limit the expenses, the medical care contractors would decrease the quality of services to patients who are covered by the schemes.

Because the public will wants to maximise the benefit out of their monthly contributions, they will increase the utilisation of the hospitals, the length of hospital stays, the number of medical procedures and preventative care much more than necessary.

These further impact the cost and quality of services. Hospitals start to report better-than-actual health conditions of the patients in order to limit the number of patients they need to treat, due to funding constraints and logistic considerations.

In a free market, medical costs should be expected to fall, like the cost of most technology. How much does a cell-phone cost today compared to 10 years ago? Why did the medical cost increases multifold? Government intervention is one of the major reasons.

Medical costs start to escalate around 1970's when the advanced countries become rich again after World War II.

They wanted to have unlimited pleasure and were afraid to die young. With the magic of medical R&D, they were not afraid to become sick as long as their health could be restored.

The governments pumped in a lot of money on medical R&D to fulfill the wish of the voters. Swelling demand for new drugs and medical devices as well as specialists caused the prices of medical care to increase.

Beautiful and comfortable hospitals as extravagant as luxurious hotels were built in the name of improving customer satisfaction. Pharmaceutical companies lobbied the governments to impose mandatory vaccinations even before the procedures were proven to be necessary.

The wealth of nations was transferred to the big corporations and share market speculators with prior knowledge of the contracts.

Technologies damaged the environment and create more business opportunities for new technologies to be innovated to repair the old damage and make new damage.

Synthetic medicines kill some germs but create more dangerous mutated germs for newer medicines to be innovated to kill the increasing variants of germs and provide businesses to pharmaceutical companies and the related industries, including bankers and insurance corporations. It is a vicious cycle.

We benefited from technologies but we also sacrifice a lot of things. It is a zero-sum game. It is better to be moderate.

Another mechanism where government intervention causes medical costs to go up, is mandatory contribution for medical care insurance.

The government, having to satisfy the expectations of the voters, will always pay medical care contractors not to agitate the patients covered by the scheme into venting dissatisfaction and frustration to the government.

Knowing the government will always pay, pharmaceutical companies and doctors will increase charges with excuses of rising costs and "mandatory" immunisations, justified by ever innovatively fabricated facts, and they will always get their way.

By raising the prices of new drugs and devices literally tenfold, government-funded medical benefit probably kills more people every year than those who are saved.

We are living in an interconnected globalised world. The rising prices in the advanced countries will no doubt affect us as well because we import the drugs and devices from them.

However, by reducing the needs for these drugs and devices through proper healthcare practices by the public and reducing the demand for medical services, coupled with minimum wastage, the simple economic theory of supply-and-demand will curb the increase of medical cost.

It is good for everybody, including pharmaceutical companies, medical care industries, and insurance corporations.

Rising medical cost may bring more profit to certain people in the short term but the prices of other goods and services will also rise in order to secure the necessary fund to consume the medical care. Inflation affects everybody, so are wealth inequality and social injustice.

It is in everybody's self-interest not to take too much from society.

The crisis in the US and European countries should serve as a negative example to us. How did their astronomical national debts ever come about?

Of course it is due to various government spending, and not just on subsidised medical care, for the purpose of pleasing the voters.

Basic economic theory tells us that going against free-market system always create more problems than benefits.

We must not just look at the short-term effects. It is better to have a vision to empower most people to become middle-income with few very rich and few very poor.

Making an assumption that the people will continue to be poor forever and require tax payers' subsidy for medical care will degrade the commitment and determination to achieve the greatest success for the nation.

Making the people dependent upon government generosity degrades them rather than elevating their social status.

This generosity must decrease rather than increase every year. It is more prudent to emphasise people relating to each other voluntarily to get any assistance they need through the free markets.