Malaysia

1 Care a ‘done deal’ despite ministry assurances, source says

By Yow Hong Chieh
February 10, 2012

KUALA LUMPUR, Feb 10 — The controversial 1 Care healthcare scheme is at a “very, very advanced” stage of planning and is not as preliminary as the Health Ministry has made it out to be, a source said.

The source closely involved in talks over the proposed healthcare revamp told The Malaysian Insider the ministry will also likely use its stakeholder briefings later as proof of consultation, despite coming to the table with a “done deal”.

Characterising this approach as the “usual sleight-of-hand”, he said the ministry would present 1 Care when it was too late to make any changes before appealing to stakeholders to give the government’s proposals a chance.

He pointed out that the World Health Organisation (WHO) and United Nations Development Programme’s (UNDP) recent attempt to recruit a representative to take part in talks as proof that the consultation process was just for show.

The WHO and UNDP technical consultant’s presence would then be used by the ministry as proof of endorsement by the two international bodies even if the government does ahead with its original plans, he said.

The source also expressed concern over the 1 Care model which, he said, would eliminate patients’ right to choose their doctor, increase cost and lead to poorer quality of and access to healthcare.

He noted that doctors will be pressured to see huge numbers of patients under the scheme, which he predicted would occur once the government cuts fixed payment to doctors for per consultation fees.

The Malaysian Insider reported yesterday that the national healthcare proposal will be made mandatory for all Malaysians, in an admission that is likely to fuel further controversy.

Despite the ministry insisting this past week that the proposal was still at an early stage, the deputy director of the National Health Financing unit Dr Rozita Halina Hussein said 1 Care would have to be made mandatory.

However, she said private healthcare providers would be given a choice on whether to participate in the new healthcare system that has seen stiff opposition from stakeholder groups.

She also denied rumours that the ministry had finalised a decision to force Malaysians to contribute 10 per cent of their salaries to finance the scheme.

There were also no plans to cap the number of medical consultations, she said.

The ministry told the Malaysian Pharmaceutical Society (MPS) at a seminar on January 15 it was finalising 1 Care proposals and that a Pharmacy Act would be tabled at the next Parliament sitting to facilitate the transition to the new insurance scheme.

According to the minutes of the seminar, the ministry’s health policy and planning deputy director, Dr Nordin Saleh, told MPS then: “The 1 Care transformation proposals are now in the final stages.”

It is believed that the five-phase scheme has already entered its third phase, and the full initiative — post-engagement with doctors and pharmacists nationwide — is due to be presented to the Cabinet by March.

Health Minister Datuk Seri Liow Tiong Lai, however, has stressed that 1 Care was still in its “infancy” and the widest possible consultation with stakeholders would be conducted before proposals are firmed up.

1 Care has come under fire from healthcare practitioners and the public, who claim that individuals and businesses will be forced to hand over 10 per cent of their earnings each month to the government-run insurance fund.

The scheme is expected to replace the current two-tier healthcare system with one which integrates both private and government hospitals in the hope of ensuring more equitable healthcare for Malaysians of all classes.

Under the present system, patients can choose to seek treatment at either private clinics or hospitals and pay out of their own pockets or opt for government clinics or hospitals instead, where they will pay a nominal fee for basic, federally subsidised healthcare.

The ministry has assured critics that the 1 Care scheme will not burden the public with undue costs, saying that talks on the financial arrangements that will be made available and their impact on the government and taxpayers were ongoing.