OCT 21 — The write up by Dr. Jeyakumar in the online media "Harapan’s health insurance scheme could disadvantage the B40” is good insight from theoretical perspective but unfortunately not supported by facts.

National Healthcare Insurance (NHI) must not be looked from purely the healthcare perspective. It need to be looked from economic impact, foreign direct investment in the healthcare sector, exporting medical services and improving public access and financial structure realignment.

Unverified sources says that the government plans to about RM3 billion on providing goodies to a segment within the B40 in the form of providing medical equipments, public transport to medical facility, a certain budget per family for healthcare expenditure (like Selangor SPS program) and health screening program. These are political populist program with no clear long-term goal. It is sad if this is true as there is  many ways we can spent RM3 billion for the healthcare benefit of the people. The SPS program has shown to be only benefitting the private GP’s without real health benefits to the poor. The family expenditure data on the SPS shows a very negative an alarming trend.

We need to look at things with a wider perspective. The NHI agenda must not be seen as purely MOH agenda. It must be a national agenda and must be driven a from a high level multi ministry committee. For efficiency sake, the vehicle driving this must be a private company owned by the government free from interference from various ministry to ensure that decisions are executed in an expeditious manner. Alignment of interest can be done at board level. We should learn from other countries on how they have executed this from zero to almost a flawless system. Abu Dhabi government project is a good example to emulate.

Rather than spending RM3 billion on a segment of B40 on a populist program, it is better to provide the B40 group with a proper insurance scheme that can provide necessary cover for ambulance, purchase of support equipment and treatment. For a start, the financial and service alignment must be done within the government infrastructure. All government medical facilities must be place under a corporate government company. This government assets are worth trillions and with proper fund raising mechanism like sukuk and bonds, money raised could be used to expand and improve the network of providers. MOH must reposition itself in terms of function.

Government must take away the foreign worker insurance scheme which is currently within the private sector. It has a value of RM200 mill premium a year with only 30% claims. Most of the claims are arising from the  treatment provided by the government hospital. As such it make sense for the government NHI company to take over the scheme.

With a clear execution plan and roll out program by stages (Foreign workers, B40, Government Servant, Employer Employee Group, Self employed etc etc) the corporatization of government medical networks and expansion of medical providers and introducing the necessary laws to support the NHI schemes, it will benefit the country and the people especially the B40 group. It will force the private hospitals to revisit their costing to ensure that their cost is competitive. It will encourage medical tourism and FDI in the healthcare sector. The B40 will have access to wider government hospital network and we would have the financial structure in place. Eventually the population health status will improved.

Truly, we need to look at a wider perspective.

*This is the personal opinion of the writer and does not necessarily represent the views of Malay Mail.