I refer to the letter PKR's promises look good on paper but ... by Rajan Rishyakaran's which is against free healthcare.

Personally, I think universal healthcare is something that we should all aspire to, as access to appropriate healthcare facilities is a fundamental human right. The basis of free healthcare should be one that is free at the point of delivery but is bound by rules that are governed by health economics, as is the principle behind the UK's National Health Service (NHS). Regulatory bodies play a role in ascertaining the need and viability of treatment options, and each case is tailor-made to suit the niche that it is meant to provide for.

The NHS was established by the post-World War II Labour government not as a socialist tool, but rather for its economical advantages. The argument is as follows: public spending will boost productivity, leading to more inward investment by the government and attracting greater FDI to a healthier and more contented workforce. Economical benefits may also be accrued by the higher purchasing power of an entity that caters to millions of individuals.

Rajan states that: 'Universal to universal free healthcare systems are long waiting lines, declining healthcare standards and medical productivity'. While one cannot deny the issue of longer waiting times as compared to those in the private sector, I do not think it is fair to lump an entire healthcare ideology as one in which declining healthcare and medical productivity are rampant and unchecked.

One might argue the opposite there are numerous examples of individuals who rise above the challenge and financial restrictions imposed on them to provide services that are exemplary. This may not be as evident in areas of research, but even then notable achievements have been made, sometimes with private-sector collaboration.

Limited resources need not lead to a decline in standards. Instead of looking at the glass as half empty, one should look at maximising efficiency. One only needs to look at the NHS' balance sheet this past fiscal year to see that it is possible (from being billions of pounds in the red, it is currently in surplus) especially with sufficient political pressure. Naturally, this will need the participation and openness of all parties involved, especially with reference to contracts meted out for healthcare facilities and the provision of services and medication. The onus is on any political party (that claims to want to implement free healthcare services) to justify and clarify their plans based on sound fiscal policies.

Rajan also states that: 'When a morbidly obese person, who drinks and smokes, for example, has the same access to free healthcare as one who eats right and exercises regularly, there is less incentive for that morbidly obese person to change'.

Perhaps these individuals should be targeted in the primary healthcare setting? Educational awareness is a potent weapon, and one must bear in mind that not everyone who drinks or eats him/herself to death is aware of his/her folly. The chap who consumes a 'nasi lemak' every other morning might be clogging up his arteries without realising it, not to mention the gullibility of impressionable young minds when it comes to taking up smoking. And in a setting in which genetics and the environment also play dynamic roles in disease aetiology, who are we to have the moral authority to decide which individual should or should not receive free healthcare?

Ethical consideration must also be practiced when one considers the growing inequity between the haves and the have-nots with regards to healthcare access and provision. If one were to leave things to the market, one would be left with a system that caters for the middle and upper strands of society, at the expense of individuals who can't even afford insurance, let alone expensive private surgery.

Perhaps it can be argued that only the poorest strata be given free healthcare, but even then, where does one draw the line? Any classification will be arbitrary at best, and discriminatory at worst. We have a choice of either improving ourselves and striving for a healthcare system that is fair (and advantageous both from a socialist and capitalist point of view) or we can go the American way and get ourselves entrenched in a debacle that is similar to the Medicare quagmire.