We applaud the launching of the mySalam critical illness scheme for the Bottom 40 group. However, we question the rationale behind the exclusion of early cancers diagnosed before Jan 1, 2019. Is the government saying that patients who were diagnosed earlier are just unlucky to have missed the boat?
While we understand that this income replacement payment is the first of its kind to help the B40, the government surely understands that RM8,000 is not enough to help support patients while they undergo treatment for critical illnesses such as cancer. Even when a person is using public hospitals, both the cost of treatment and loss of income can be crippling.
In public hospitals, most medication may be given free or is heavily subsidised. However, advanced drugs such as targeted therapies are either unavailable or will need to be purchased privately by patients. Most likely, this is where the money from mySalam will end up being spent – on expensive medication necessary for survival.
Even as an income replacement during cancer treatment, it falls short. B40 households have a monthly income of RM4,000 or less, so this one-time payment is equivalent to two months’ income. Most cancer treatments exceed that length, ranging from six months to one year depending on each case, even for early stage cancer patients.
In the case of Sarawak, there is only one general hospital (the Sarawak General Hospital or SGH) in the whole of Kuching that is equipped with an oncological or cancer unit. Patients who reside in other towns or rural areas will have to travel long distances, for example, an 800km drive from Miri to Kuching, to receive treatment at the Sarawak General Hospital.
The cost involved in seeking or obtaining treatment includes air tickets, accommodation, and time-off from work. It is expensive.
In most cases, patients would need a primary caregiver to be with them at all times. That could easily double the cost incurred. Will they get paid for all the leave taken? What if they are dependent solely on wages which are paid daily? The time outstation patients spend seeking treatment is certainly longer than patients residing in Kuching.
It has now been two months after the implementation of the mySalam scheme. The only news from the finance ministry is that out of over 1,000 mySalam applicants so far, only two successfully received the RM8,000 benefit.
Is the mechanism to review and process applications working well? Why is the success rate so low? How is the application process being tracked to ensure timely disbursement of the fund to benefit the B40 group who are in need of this financial aid?
According to reports, the health ministry’s “Peduli Kesihatan” for the B40 (Peka B40) is expected to benefit 800,000 Malaysians above the age of 50 beginning in March this year.
Considering Peka B40 is starting with funding of just RM100 million, it is clear that there will be limits to the programme’s coverage. We hope to see in 2020, an increased budget to cater to younger Malaysians, including those in their 30s and 40s. Cancer, like many other diseases and illnesses, afflicts all, regardless of age.
The government has recruited private facilities to conduct health screenings under the Peka B40 programme. In the long run, we need to ensure that screening and treatment services are made available in most major public hospitals and oncological units across the country.
Unfortunately in Sarawak, only the Sarawak General Hospital in Kuching has the core cancer screening and treatment facility. No other public healthcare centre has those services.
We hope the government will monitor implementation of both schemes and take action necessary for the enhancement and supporting structure to ensure that they really work to benefit the needy in the B40 group.
Lastly, the health ministry should also study successful healthcare systems or models used in other countries such as Australia (private clinics see patients and claim from government) and Singapore (through Central Provident Fund) and take the best from each to use in Malaysia.
Thailand and Sri Lanka’s HAQ (Healthcare Access and Quality) index were not much different from that of Malaysia in 2000. Yet, both countries have since improved their ranking leaving Malaysia behind as per the latest HQA in 2016. What did they do to improve that we didn’t?
Surely, we can do better and ensure that no one is left behind. After all, access to health is a human right.
Sew Boon Lui is president of the Society for Cancer Advocacy & AwareNess (SCAN), Kuching
The views expressed by the writer do not necessarily reflect those of FMT.