Malaysiakini Letter

Private healthcare should be curbed

Dr Teh Yik Koon  |  Published:  |  Modified:

As a member of the public, I am very worried about the increasing cost of healthcare, especially when the charges of private hospitals and their doctors are very high. Let's be very realistic and honest. The aim of private hospitals which are run in a business manner is profit. Private doctors are there definitely not for noble and charitable cause as claimed by some doctors. They are also there for the money.

It cannot be denied that they earn many times more than government doctors. This in turn poses strong temptation for many government doctors to leave as soon as they have served their compulsory three years at government hospitals.

Those who did not leave made comparisons between their pay and that of private doctors, and have voiced out strongly that the government should increase their pay to be near the earnings of the private doctors. The government, in trying to prevent them from leaving and also to keep up its duty to provide healthcare to every citizen, tried to accommodate them as best as it could within the limited funds allocated to healthcare.

The latest the government did was to have private wings in the government hospitals. This in turn has been a grave mistake as there have been many cases where government doctors have corruptly abused the system, for example asking their patients to see them in the private wings if they want to have their treatment faster and spending time at the private wing when they should be at the government wing.

Their consultation charges are even higher than those in the private hospitals. As a criminologist, I am not surprised at all. Human nature is such that whenever there are opportunities to abuse the system and commit a crime in the name of profit, they are likely to do it; doctors included.

The private wing has not solved the problem. It may even escalate the problem as once government doctors have a taste of the high earnings, they will be even more tempted to leave government service for the private sector.

With medical tourism being touted as a big business venture, I am even more worried. It is not difficult to imagine the cost of healthcare in the near future. More private hospitals will mushroom and government doctors will be even more tempted to leave government service. In the end, government hospitals will be very short of medical staff and the waiting time for poor patients who cannot afford private healthcare will even be longer as the queue will have lengthened.

This is partly because many professionals earning a decent pay will find it expensive to have private healthcare for themselves and their families unless their bill will be footed by their corporations or if they have insurance. Even with insurance, the premium is usually only renewable until the age of 65 years old. What happens after 65 years old when the insurance no longer cover their medical bills, especially that being the period when medical care is most needed?

With the increase cost in private healthcare, insurance premiums will surely be increased. It cannot be denied that private hospitals and doctors do abuse the insurance system. The first thing the front desk staffs of private hospitals ask when you register is whether you have insurance.

If you have, the private hospitals and doctors will take advantage of the fact and charge the patient to the maximum. As it is, the present practice already shows how much abuse has been taking place at private hospitals. This is even highlighted by the 2005/2006 president of the Association of Specialists in Private Medical Practice, Dato' Dr Abdul Hamid Abdul Kadir, in the assocation's website .

All these abuses by a significant number of private doctors will definitely add up to the cost of healthcare. This, in turn, will escalate the insurance premium. The vicious cycle will go on and on, and the cost of private healthcare will continue to increase further and further. In the end, the government hospitals are going to suffer as their doctors will be leaving by the droves. The government will find it very difficult to keep up with the salary of private medical doctors and to keep to its commitment of accessible healthcare to every citizens.

From the very beginning, our government should have controlled private healthcare instead of letting it go out of control and messing up the noble idea of accessible and affordable healthcare to all. We certainly do not want to end up like China where its rural citizens are dying in huge numbers because they cannot afford to have treatment in the hospitals.

As a citizen of Malaysia, I shudder to think of the near future when I will need to use the medical facilities in our country. For example, patients needing heart bypass operations have complained that they need to wait months for the operation as they cannot afford private healthcare. I feel very sorry and sad for the poor and the marginalised. What sort of access will they have?

Healthcare is a basic human right that the government has a duty to provide. The government should ensure that it is efficient, accessible and affordable to every citizens in the country, especially the poor and marginalised. I hope the government will continue to ensure that this is being complied with. With the present system, there are still lots of room for improvement.

However, with the aggressive commercialisation and the promotion of health tourism in the private sector, I am afraid the government is open to stiff competition to keep its medical doctors and its commitment to its citizens. The government should take back control of the healthcare in the country by limiting private practice.

In fact, the government should not even let private healthcare to flourish in the country to mess up this provision of basic human rights to the public. If the government controls the whole system of healthcare, there will not be private doctors with their high charges to tempt government doctors as all doctors will be subjected to the same salary scales. Cost of treatment could then be reasonable and provisions could be made for those with low incomes and who are poor to have some form of subsidies.

As for health tourism, the government can control the industry with its pool of medical specialists and doctors. The income generated could be used to give medical doctors reasonable salaries and perks, train more medical specialists, upgrade the facilities in government hospitals and provide free treatment to the poor.

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