The provision of public health care in Malaysia need not be completely overhauled but merely revamped to improve it towards excellence. The DAP believes ensuring the proper allocation of funds without any leakages or hanky panky can not only ensure the public’s right to provision of a standard health care but also improve public health delivery.
The DAP calls for the Prime Minister Datuk Seri Najib Minister to intervene and scrap 1Care for 1Malaysia proposal following the failure of of Health Minister Datuk Seri Liow Tiong Lai, to fully examine the adverse consequences of this compulsory Health Insurance scheme. In replacement, the Ministry of Health should conduct a thorough public consultation process involving key stakeholders to ensure that the provision of basic healthcare as a public good and human right is protected and not auctioned off so that well connected individuals and companies can profit from the people.
Using the lack of financing and funding as not sustainable in the long-term is not an acceptable excuse for dumping public health care in favour of a privatised from 1Care for 1Malaysia. If government spending on health has ballooned, why has government spending on health remained relatively stagnant at 2.1% to 2.5% of GDP since 2001. This is less than half the 5-6% of GDP recommended by the World Health Organisation.
The DAP stands firmly in solidarity with the people of Malaysia who have expressed their deep concern and anger over the ‘cloak and dagger’ approach of the Ministry of Health in designing and implementing the 1Care for 1Malaysia health insurance scheme.
Instead of reacting defensively to the outpouring of criticisms against this rehashed scheme, Liow should instead address the very valid concerns raised by various quarters including:
(i) Why should this scheme be forced upon all Malaysia by making it compulsory
(ii) How much will this scheme cost to the individual, the organization he or she works for and the state and federal governments.
(iii) How much will this scheme add to the Federal Debt, which will exceed 55% of the Debt to GDP ratio in a very near future
(iv) Whether General Practitioners will be assigned to every individual instead of allowing the individual to choose
(v) Whether the number of hospital visits will be limited
(vi) Whether a National Healthcare Financing Authority (NHFA) will be set up to collect these insurance premiums
In addition, the DAP calls for Liow to exercise oversight over his officials at the Ministry of Health, some of whom have indicated that the 1Care for 1Malaysia proposals are already in the final stages and that this would be made mandatory, in contrast to Liow’s own assertions that this proposal is only at the ‘discussion’ level. These kinds of contradictory statements only add further fuel to the fire that the Minister himself does not have full control over this process.
Malaysians have become too familiar with past and current efforts of the BN government to introduce market mechanisms and pseudo privatization schemes where profits are privatized for the gain of well connected cronies but losses are socialized at the expense of the average taxpayer. Nothing that the Minister has and has not said have reassured the public that this 1Care for 1Malaysia scheme is nothing more than a smokescreen to extract economic rent and benefit political cronies.
In light of the outpouring of questions and concerns over this proposal and in view of past experiences of ‘piratization’ through the abuse of similar schemes, the DAP calls on the Minister to immediately assign this proposal to the scrapheap. Public interest should be paramount as public healthcare is the basic duty of any government. To carry out this obligation to the public, accountability, complete disclosure and full consultation must be practiced for the benefit of 28 million Malaysians.
How can 1Care for 1Malaysis serve the public good or take care of our health when it does not address the important question why 70% of health professionals are serving in the private sector where they treat only 30% of the population? Leaving the remaining 30% of health professionals to serve 70% of the population is not just a gross mismatch of resources but also guarantees a continued decline of quality public healthcare services.
1Care for 1Malaysia should be rejected for failing these tests. Instead, the Health Ministry should start from scratch by having a transparent and inclusive stakeholder consultation process and put in place iron clad safeguards to ensure that public healthcare remains a public good that is affordable to all, especially those in the lower income bracket.
Lim Guan Eng
—-Mandarin Translation —
民主行动党秘书长兼峇眼区国会议员林冠英于2012年2月17日在吉隆坡发表声明：
首相应该要取消1马健保计划，以保障作为公共物品的医疗服务不会被剥削，导致亏损社会化，利益私有化。
马来西亚的公共医疗服务不需要完全改头换面，而是稍微整顿，让它变得更好。行动党相信，如果公共资金能够妥当地分配，没有疏漏或不正当的作业，我们才不只可以保障公众享有高水平医疗服务的权利，还可以改善公共医疗服务。
行动党促请首相拿督斯里纳吉介入并取消1马健保计划的提议，这是因为卫生部长拿督斯里廖中莱无法全面探讨强制性健保计划的反面后果。此外，卫生部应该要进行涉及所有利益相关者、全面的公共咨询，让做为公共物品及人权的医疗服务获得保障及利益不会被典当，一些有良好联系的个人及公司从人民身上榨取利益。
当局以缺乏资金、无法持续长期拨款 的理由，提议推行1马健保计划、放弃公共医疗政策，是无法被接受的。如果政府在医疗的开销方面增加，为什么自2001年起，政府在医疗方面的开销一直只占国民生产总值的2.1%至2.5%？连世界卫生组织所推介的国民生产总值占有率5-6%的一半都没有。
卫生部秘密地设计并推行1马健保计划，民主行动党与全体对此表达关注及气愤的人民站在同一阵线。
与其对排山倒海的批评进行自卫性的辩护，廖中莱应该回应人们对医疗改革所关注的问题，包括：
(i) 为什么要强制性规定每一名马来西亚人参与？
(ii) 每个人或他/她所工作的单位、州政府、联邦政府在这项计划中需承担多少费用。
(iii) 这项计划将导致联邦债务增加多少？不久的将来，联邦债务对国民生产总值的比率将达55%.
(iv) 每个人都会被指派普通医生，还是人们可以选择自己的医生。
(v) 到医院看病的次数会不会被限制？
(vi) 是否会设立国家健保融资机构（NHFA）来征收保费？
此外，行动党呼吁廖中莱监督好他在卫生部的官员，一些官员已经说明1马健保计划的提议已经进行最后阶段，而这将成为强制性政策。这与廖中莱所强调地“还在讨论阶段”是自相矛盾的。这些言论不只是火上添油，也说明部长在整个过程中没有全面的控制权。
马来西亚人已经太熟悉国阵政府了，从过去及最近的各种例子可以看出，每当他们推介市场机制、假借“私营化” 名义时，往往就是将利益“私有化”，让一些朋党谋利，最后牺牲纳税人的利益，将亏损“社会化”。部长所有的言论都无法让人放心相信，1马健保计划不是用来经济寻租、让朋党赚钱的烟幕。
有鉴于这项计划招来许多批评，加上以往国阵通过滥用类似计划“强盗化” 的经验，行动党促请部长马上下令取消这项计划。公共医疗服务是任何政府的基本义务，公共利益必须被放在首位。为了2800万马来西亚人的利益，政府必须对公众负责，透明化、公布所有资讯及全面咨询。
如果1马健保计划不能回答一个主要的问题：为什么70%的医疗专业人士都在私人界服务，他们只照顾30%的人口？这项计划如何可以为民服务、照顾我们的健康？让30%的医疗专业人士来服务70%人口，不只是资源的错配，也将最终导致公共医疗服务的素质走下坡。
1马健保计划无法通过公众的拷问，它就应该被拒绝。卫生部应该重零开始，进行更透明、涵盖范围更广的咨询工作，确保公共医疗服务这项公共物品继续让全民受惠，特别是低收入的一群。
林冠英