There can’t be meaningful reform of public institutions under BN, according to Jeyakumar.
Commenting on the recently proposed 1Care healthcare scheme, Dr Michael D Jeyakumar, a member of the PSM central committee, said he agreed that it was not the right way to go about reforming the healthcare system. “But I say, change the government,” he said in an interview with FMT.
Jeyakumar, who is the MP for Sungai Siput, is a physician well known for his social work.
He said Malaysians could not rely on the BN government to be objective in its reform proposals. “We can’t have any meaningful reform of public institutions. It usually leads to cronyism.”
He criticised the rationale behind making 1Care a privatised and market-driven entity, saying it was flawed. “It’s a mistake. In PSM , we think it is based on the wrong premise, modelled on financial incentives. That is the wrong way to go about healthcare.”
The government is yet to release the complete details of its proposal, but opponents have claimed that every household will be required to contribute nearly 10% of its gross household income for the insurance, which will cover only basic healthcare expenses.
All clinics and hospitals will be placed under the 1Care umbrella and access to specialist healthcare will to be through primary healthcare providers, who will act as gate-keepers.
Last November, Health Minister Liow Tiong Lai said 1Care was aimed at ensuring that healthcare costs would be effectively managed and their affordability would be sustainable.
However, the proposal has provoked widespread anger, including from consumer activists and healthcare professionals, with some describing it as a scheme that seeks to profit from the sick.
Plenty of weaknesses
According to doctors and activists, the scheme has plenty of weaknesses. Among other things, they say, it imposes unfair conditions on patients, such as the following:
- You cannot pick your own doctor. The government will choose a doctor for you. If you choose your own doctor, you have to pay.
- You cannot consult your assigned doctor more than six times a year.
- You can only see the doctor for only one problem at a time.
- You get only cheap generic medicine.
“I think details are still too sketchy; we are not really sure what they are going to do,” said Jeyakumar.
He said privatisation would be detrimental to the quality of healthcare and would give rise to “all kinds of quirky behaviour”.
For example, he said, a general practitioner might choose not to refer a patient to a specialist so that he would benefit from incentives offered under the scheme.
“If a general practitioner is given a 5,000 patient quota, he may try his best to keep the majority of those patients even though it would be in the patients’ interests to be referred to other specialists,” he added.
“This is what will happen if you use money to regulate clinical behaviour.”
He said public hospitals would be corporatised and would essentially manage themselves as private hospitals.
“This would cause more and more cases of over-diagnosis, over-investigation, and over-treatment.”
Citizens’ Healthcare Coalition, a group opposed to 1Care, has started a campaign against it that is fast gaining attention on the Internet.