SEVERAL concerns have been raised over the national health plans, Peduli Kesihatan B40 (PeKa B40) and MySalam insurance scheme, for the B40 (low income) group.
My primary concern is the national healthcare agenda. Are we compromising or complementing this agenda with the introduction of PeKa B40? The Malaysian Medical Association (MMA), one of the key stakeholders in the nation’s healthcare agenda, has remained silent on this issue so far. This is troubling because the plans have serious strategic implications on the national healthcare objectives.
PeKa B40 is about health screening for non-communicable diseases (NCDs) for the B40 sub-segment above the age of 50 years. Does it mean the government is not interested in reducing NCDs among the Middle 40% (M40) and Top 20% (T20) of the population? While those in these groups may be able to finance their healthcare costs, the fact remains that many are ignorant about NCDs. Therefore, these two groups should not be neglected from the national agenda on reducing NCDs.
As for the B40, a subset of this group are government servants, private sector employees and the unemployed as well as self-employed. For the employed, Socso offers screening benefits for NCDs to those aged 40 years and above. The Health Ministry also provides free health screening at its major centres for them. However, these screening programmes do not have a high take-up rate. While Socso does not publish its statistics, a statement from a group of doctors suggests that 40% of the targeted group have not taken up the offer.
This leaves the self-employed and unemployed categories. According to figures released by the Health Ministry, 800,000 are the target group for PeKa B40. Since no further details have been provided, it can be assumed that there is an overlapping target group that is screened by Socso, the Health Ministry and PeKa B40. Clearly, there have been no strategic discussions among the various agencies involved.
As a responsible government that wants to make a difference, the necessary political branding can still be achieved if all of the screening programmes are integrated, coordinated and centralised to the Health Ministry. What is needed is an improvement in the processes. Furthermore, the data collected would be useful for a subsequent strategy involving resource and disease management.
The Health Ministry has also been doing a lot of work over the last 30 years on a national health financing (NHF) plan. Will MySalam, which cover 36 critical illnesses, complement the NHF plan?
Seen from the NHF perspective, it is a low-quality programme that does not bring the necessary desired value towards achieving the agenda of national health financing.
For those in the dark about the NHF agenda, the aim is to bridge the financial access to meet healthcare costs both in the public and private sector.
Malaysia has many excellent technical resources in the healthcare sector and also numerous good public and private hospitals. The main issues confronting public hospitals are assets utilisation, efficiency and financial management. With NHF, public hospitals could be improved significantly and more services could be provided.
More importantly, the people would have the financial means to receive treatment for all diseases. Giving a few thousand ringgit to someone who meets the critical illness definition certainly does not fulfil the NHF agenda.
Political agendas and manifestos must be aligned with the five-year Malaysia Plan. And it is not morally right to spend RM2bil for MySalam and ignore the NHF.
I urge the government to revisit the PeKa B40 and MySalam programmes to make sure that we get maximum benefits for our money and that these are aligned with the Malaysia national healthcare plan.
DR MOHAMED RAFICK KHAN