What we know so far is this: there is no certainty with regards to the new health care policy. There is only one known document that tells us what it is about. Said document is a PowerPoint presentation. But apparently it is already in its final stages of implementation. Doctors are complaining that they were not consulted. The new system, they say is designed by health economists. Not medical practitioners.

The 1Care proposal has not been well accepted by the medical practitioners. The proponents are of course very happy with the whole idea of ‘bridging the gap’ between public and private healthcare. However, there seem to be a lot of questions left unanswered, which is worrying. How could the government be uncertain on a policy it has been developing for quite some time and not be able to come up with sufficient answers when questioned by the public?

It is not a question of secrecy. This is no submarine nor arms-expenditure issue to be secretive about. The ministry have not given satisfactory answers when approached by certain quarters concerned with the implementation and mechanism of the system. It appears to be more like a scam. A way to take money out of the Rakyat’s pocket when they need it the most, for things the government might not need.

So what else do we know so far?

We know that with the current dual-track system, heath care is provided by both the public sector and private practitioners. So consumers can choose between a variety of care providers. Financing, in the current system is a mix of government subsidies, individual out-of-pocket payment and health insurance companies via contributions by employers as a work benefit.

4.7% of the national GDP is spent on healthcare, with RM15 billion allocated in the 2012 budget for operating expenditure alone. RM1.8 billion is expected to be used for development which among others include the upgrading of hospitals, rural health clinics and setting up 1Malaysia clinics.

We also know that with the implementation of the 1Care policy, the healthcare system will be monopolised by a single authority. Once the funds are pooled (10% of your monthly salary will be deducted to fund this scheme), a National Healthcare Financing Authority will manage it. It is not actually surprising when the concept paper of 1Care itself lists abuse of funds as a threat and a disadvantage to the new system.

The general idea for 1Care apparently is to lessen government expenditure by pooling resources and spreading the stakes. To quote the proposal paper, “Pooled as single fund to promote social solidarity and unity as per 1Malaysia concept”.

This is a backdoor attempt to introduce a financial approach known as Social Health Insurance (SHI), which -according to the proposal- is exactly aimed to pool risks. The SHI gives an avenue for high levels of cross-subsidization, an effort to have the rich subsidize the poor, the economically productive to help the dependants and the healthy to the ill. Sounds very socialist?

The problem with SHI is this: it is a compulsory system based on payments of premium. Which brings about the concern of the 10% deduction from our monthly salary. Liow Tiong Lai, the minister in charge, so far has clarified that the percentage is still a proposition. But he has not denied the fact that there will be a compulsory deduction.

In comparison, the National Health Service in England provides free healthcare for all, based on need, not on ability to pay. One should not have to question the rate of the taxes that the English people pay for the services they are getting. In England, if you do not have enough money to go to the hospital, it is possible for you to get reimbursement for your travel expenses. There is no need whatsoever for you to even bring cash to the hospital.

Whereas our version, the SHI, only covers the contributors with a benefit package that is predetermined. Anything that goes out of the package, well.., naturally the patient will have to just fork out more cash. This raises the big question of ‘why must I pay for things I may not be using?’

The proposed system incorporates the idea of prepaid healthcare, via said monthly deductions. It is no longer a pay-as-you-use basis, but instead you pay regardless of use! Ask yourself; do you normally spend 10% of your monthly income on healthcare? Most of us do not. But the government intends to take that amount anyway.

Has the government spent so much on one off give-aways that it can no longer afford to provide healthcare at the current rate and is struggling to lasso in the private sector to pool resources? Are the national coffers drying up so fast that they need to extort money from the people? – The Rocket

How will it affect you?

• You contribute 10% from your monthly salary, in addition to cuts meant for EPF, SOCSO and taxes.
• You cannot choose your own doctor. The government will assign one doctor for you.
• Your assigned doctor is budgeted to see you only 6 times per year.
• Your assigned doctor can only treat you for one complaint per visit.
• You will only be given the most economical medication (read: cheapest).
• You will not be covered for every other illnesses, especially expensive care.
• If you don’t like your assigned doctor or the medicine given, you will have to pay more from your own pocket to see a different doctor.

Questions you should be asking:

• Won’t the healthcare benefits my company provides be redundant?
• But I already have health insurance, why must I pay more?
• Am I not paying for healthcare already through tax?
• After a few years of healthy living, does the government refund the unused amount?
• If I get paid RM10,000 per month, RM1000 gets deducted? Do I really spend 10% of my income on medical bills every month?
• Aren’t most private hospitals government linked already?
• Prepaid healthcare? Shouldn’t prepaid just be limited to handphones?