The Malaysian healthcare system has metamorphosed into a disaster as successive government and ministry brass have failed to take into account the rising economic costs of treatment.

Malaysia's 5 percent - which was even raised to 20 percent of the national budget allocated for healthcare - will not suffice as there is a real possibility that 10 percent of it will crawl its way out into the coffers of politicians or other 'in betweens' and into the ministry’s bureaucratic abyss.

The system arising from the current governance of healthcare resources has become a nightmare for both patients and medical personnel.

You can allocate as much money as you want, but a substantial portion of taxpayers money will leak away, which any Malaysian prime minister, who has to come to terms with an intransigent civil service determined and pandered by political forces, will soon realise.

How do you make a system efficient so that every cent you pump into the system counts? Dr Mahathir Mohamad's solution to privatise the highways produced results but his methodology in awarding the contracts and concessions riled Malaysians.

Healthcare in Malaysia faces the same grim reality. Right from the type of undergraduate and postgraduate students to the medical schools they graduate from, the primary healthcare policies, new healthcare enactments, the building and location of new hospital infrastructure put in place appears to be all coloured heavily by pork barrel politics and financially debilitating cronyism. And this does not benefit anyone let alone patients.

Being pragmatic is essential if the Malaysian healthcare system is to be helped. And some sort of ‘highway privatisation mechanism’ that will provide an efficacious healthcare system would need to be devised to reverse the current disaster. And that will require a leadership with great political and administrative will.

Maybe you don’t need to be cruel all the time to be kind. In Malaysia the greater challenge is to incentivise the delivery system to provide a better service. Every healthcare system needs to be individualised to its own needs and people. And Malaysia has to endeavour to find a scheme that works for it.

It is increasingly becoming evident that healthcare policies may have to be handled by someone who has had greater exposure to the reality of private healthcare economics rather then someone in government dishing out policies subsidised by taxpayers which ultimately hold no one accountable.

Until such a leader is put in place, there will still be paraquat poisonings being treated on a 40 bedded open ward with two staff nurses and an attendant rather then a one-to-one nursing environment of a critical care ICU.

Malaysia’s appointment of yet another politician as health minister after 50 years of independence is not the right choice to correct all the attendant and emergent problems in healthcare today.

It will require a savvy and experienced health commissioner. Prime Minister Abdullah Ahmad Badawi’s decision to appoint such a minister from a political party that has already lost all confidence in the recent elections is only reflective of his intransigence to continue ‘business as usual’ in a service sector that has a direct bearing on the country’s populace.

As both Health Minister Liow Tiong Lai and the Health Director-General Ismail Merican become increasingly embroiled in the Anwar Ibrahim affair, it is apparent that healthcare delivery and economics are in the hands of politicians or potential politicians who will not be able to focus fully on the service.

Liow, for instance, is further involved in the upcoming murky MCA elections. This lack of focus will have a ‘trickle down’ effect and affect healthcare delivery to Malaysians especially in these trying economic times.

Perhaps the ministerial post for health needs to be abolished and replaced by a health commissioner or secretary which comes directly under the prime minister or ministry of finance.

Until then, Malaysians will have to put up with dodgy answers pertaining to why patients need to drive to a healthcare clinic 5km away when they are living right opposite a general hospital.

And why another RM140 million is needed for a heart centre in Kota Kinabalu to appease political frogs from jumping although the health minister himself has pronounced that these heart hospitals are vacant as a result of lack of specialised staff.

Mistakes in clinical medicine cost lives. Mistakes in healthcare policies appear to be costing Malaysia - both billions and lives.