LETTER | First off, I would like to thank whoever is managing the Ministry of Health twitter account for answering the simplistic questions in such a passive aggressive way without explaining anything to the Malaysian public other than to portray itself as a pompous jackass.
That being said, while an insurance plan for the Bottom 40 income group might seem like a good idea in a country like the US with their “Obamacare”, we are a nation that has practised universal health care similar to the UK National Health Services (NHS).
As such, we do need to ask just why a public healthcare service under the ministry would need an additional plan to cater for the Bottom 40 when it is supposed to be affordable to the lowest of the low-income groups as well as provide ample coverage for everyone regardless of income.
Thus, my first question – is the government reneging on this policy of catering for everyone? Has the public healthcare system been unable to cater to the policy of affordability, leading the government to need further subsidisation for only 12.8 million out of 32 million Malaysians?
And while the consultation fees will be maintained at RM1 for general practitioners and RM5 for specialists, I understand that the cost of further treatment and medication can get expensive. However, I was also informed that each hospital has a “welfare desk” where those having problems paying their fees can get it waived all the way down to a token RM50.
Is this what the Ministry of Health trying to cut down?
My second question is on administering the insurance plan. Who will be appointed to administer the information and records, as well as the implementation of such a plan? Will the government be appointing a private insurer to handle this programme? If so, will there be an open tender? Also, what safeguards do we have on the privacy of the data?
The last time, data of such a scale from telcos was leaked by a data centre with no action taken against anyone.
Or, will the government opt to handle this in-house by establishing yet another government department? And will bureaucracy cause slowdowns in the handling of claims to the point that the B40 will be waiting a week, even three months, for their claims to go through or approved before treatment?
My third question would be on the financials – the minister Dr Dzulkefly Ahmad has said that the coverage would be RM10,000 to RM20,000 per pax, totalling RM128 billion to RM256 billion respectively. How exactly is this going to be guaranteed by the government? Is it not a very large liability for the government to handle at this current time, let alone in 2019?
Will they be setting parameters for those insured to lower the numbers? After all, I’ve been constantly informed of budget cuts for projects as well as how this country has no money to the point of going bankrupt.
The Ministry of Health on Twitter says that this amount will not be collected from taxpayers, so I would like the government to explain just where exactly are they going to get this cash? Will it come from the sales and service tax or even some austerity from the government or are we going to get a soft loan from Japan?
My fourth question is a matter of usage – would this insurance plan for the B40 allow them to be admitted to private healthcare facilities as well as public healthcare? If so, is this not basically the government spending taxpayer ringgit to profit-based agencies rather than spend on better public healthcare reach?
Is this an outsourcing of the Ministry of Health’s ability to cater to the Malaysian public to the profit of the private hospitals, clinics, as well as whichever insurance company is appointed?
And my final question is this – if the Ministry of Health and this government is looking to spend RM128 billion to RM256 billion for the B40, why not just build hospitals and clinics and expand mobile first responder units and increase their ability to reach the Bottom 40, the Middle 40 and even the Top 20 rather than have them find their own way to these facilities?
It would allow the recruitment of paramedic crews, doctors, medical assistants, pharmacists and even cater to the future increase of an ageing population not just for the Bottom 40, but also the Middle 40 and Top 20 without favour. This is what universal healthcare is about.
To single out the Bottom 40 as needing further subsidies while telling the Middle 40 and Top 20 that consultation fees are about to be raised threefold, goes to show that this government particularly the Ministry of Health is purely playing to the public gallery without a shred of specific information rather than harp that “it is for the poor”.
I look forward to the snarky reply from Dr Dzulkefly Ahmad or the Ministry of Health’s twitter account for proper and specific answers to these questions.
The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.