LETTER | Health system reform doesn't require white paper, it needs action

LETTER | We refer to the Health Ministry statement in Parliament under the heading "White Paper will kickstart national health system reform, says minister" where it was reported that tiering of hospital charges will be imposed and the formation of national health insurance.

We are in the present predicament because of populist politics and the populist strategy continues even with the present government.

The issue at hand is the diminishing financial sustainability of the healthcare system, high national debt, weak ringgit, and low government revenue.

The most appropriate action at this stage is getting commitment in Parliament that the government tax collection system, education system, and healthcare system are not to be used as political fodder. It must be ring-fenced from politics.

Our ringgit is weak because the global financial market sees that Malaysian revenue is dependent on Petronas and politicians now meddling in Petronas' affairs. GST was a fair tax system that was destroyed by politicians and it should be brought back.

The government needs to enhance and diversify its revenue source and show on paper it is not entirely dependent on one source and it can sustain any shocks in the market. Diversifying revenue sources is critical.

Being a trading nation helps immensely. This should be the government's primary focus and the realignment between collection and expenditure.

A tiered hospital charge is a populist policy. There should be one set of charges for all. Hospitals should focus on providing a good service and not focus on determining who should pay more or less. It should be one standard charge for all and allow people with financial problems to get financial problems.

Those who have problems paying hospital bills should explore funding from the National Welfare Department (NWD). The service and financial misalignment that has gone on for years must be corrected.

NWD has a very good network and is in a better position to address individuals' financial positions and decide on the help that they need. We should move away from tiered charges.

Is there a need to table a white paper on the national health system reform? The issue of national health system reform has been going on for ages but we don't even have an entity to operationalise this since it was first mooted in the 90s. We have highlighted previously that a wholesome 360-degree strategy is required.

Healthcare cost inflation needs to be managed and accessibility to primary care and tertiary care services is enhanced. Funding for healthcare services is by the government and Malaysians currently are indirectly insured by the government.

The government's intention is for the citizens to share their financial burden today but has the unwritten aim that it will be fully funded by the citizens in the future. To call it insurance is wrong and inappropriate as from financial modelling, insurance is only present when the risk is uncertain.

In the case of national health system reform, the outgo will be more than the income and this cycle will continue because hospitals have profits and dividend goals, ie the medical claim risk is certain.

Uncontrolled pricing by hospitals will only burden the public and the government in the long run. In commercial health insurance, we are seeing the malady of increasing premiums.

To move forward, we proposed that the government look at the whole healthcare matter holistically. It needs to have appropriate laws and organisations to manage funds collections and healthcare network and cost management as well as benefits management.

These three entities must be separate bodies and the main focus must be on containing and stabilizing healthcare costs using the national health system reform scheme.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.