anilnetto.com

18 Responses to “Australian health care consultant shown the door”

1. ewoon on June 20th, 2008 at 12.14am

   How many more of such IMF-types ‘consultants’, whose sole purpose is to recommend schemes or plans that will impoverish the populace and later seize control of the country’s resources and wealth when the nation gets into trouble, that have penetrated deep into key industries and doing their dirty work?

   Congratulations to Penang for sniffing this one out and sending the operative home packing. Comb the various departments and key industries that more can be flushed out before the damage is done.

   Selamat pejuang, Pakatan Rakyat. Syabas!

2. jonathan on June 20th, 2008 at 12.45am

   The problem is not the consultants Karl Karol..but the dungus who hired them. The MOH is just filled with substandard people who cannot think for themselves nor can they fathom what the public or health professionals want.

   This country with its vagaries from Bangsar right till Bekalanag in Sarawak has different needs….the only people who are going to be able to tackle the various issues is not a health consultant from Siberia but Malaysians themselves. Lim Kuan Joo, a Chua appointee, should just leave. And take with him his moronic DG Merican. The current MCA minister appears to mean well…and even has invited private doctors to help see patients….instead the MOH officials come up with a guideline filled with bureacratic red tape that is bound to put off almost all private doctors. Liow Tiong Lai….see for yourself….these are the a**h**** the MOH has…..get rid of this lot and get someone who can put healthcare in this country back on track…..

3. Andrew on June 20th, 2008 at 1.33am

   Not only do we have to compete with nepotism and cronyism, we also have to contend with foreign ‘experts’ who should try harder to sell their ideas in their own countries, rather than come over here and try to rake more than a few bucks off us.

   Western governments know what kind of public reaction to expect with policies that have the slightest hint of regressive taxation.

   Thought we didn’t know that, did you?

4. raj raman666 on June 20th, 2008 at 4.04am

   anil,
   a bit drowsy with all this doctors actually

   1.some goodsoul doctor told me once dont use company doctor if you want a good medicine because the company contract out to them with very minimum fees.(so he have to give basic panadol)
   2.Insurance - money making devil from everyone.
   3.consultant and politician - still blur what they trying to do for medical needs of the poor.

   rajraman-I HAVE A DREAM-can u please ask haris ibrahim

5. iammi on June 20th, 2008 at 8.53am

   All the complaints and ’suggestions’ - why dont we ask ourselves, do we (or MOH) actually know whether the money for healthcare is being spent prudently? Rather than spending more money on grand schemes, why dont start investing a little amount on gathering and analysing the data and processes to determine how to prioritise the use of the money. With the current way of operating the service, even a major increase in funding will not be sufficient as there will always be leakages and inefficiencies. Solve the real problems of cost management, resource sharing and optimisation (including between public and private providers). Healthcare is just not about satisfying the doctors.

6. Phua Kai Lit on June 20th, 2008 at 9.22am

   Dear Anil

   A good article overall. But I would like to comment on some points you raised:

   1. “For instance, he proposed that private general practitioners could act as “gatekeepers” when referring patients to specialists and if they kept below the targeted number of referrals, the doctors would be given a bonus!”

   Having GPs serve as gatekeepers is actually a good thing. This is carried out in the British NHS. The real problem with his proposal is the part about the bonus. Bonus schemes for doctors are a disaster for patients in US “managed care” insurance schemes.

   2. Having a lot of hospital beds (i.e. having a lot of hospitals) is not necessarily a good thing. Hospitals are expensive to run and also need a lot of human resources. The health of people can be improved more effectively in other ways, rather than by simply building more hospitals and increasing the number of hospitals beds.

   You can refer to my article at:

   http://phuakl.tripod.com/healthpolicy.doc

   3. “One senior private hospital doctor told me, “We have to fill page after page of health insurance forms before we can treat patients.” He also complained that certain insurance firms were resorting to unethical practices such as asking private hospitals and their doctors to reduce their fees in return for more patients being channelled to them.”

   I don’t think it is unethical for insurance firms to do that. These are called negotiated fee schedules and volume discounts. One good aspect of managed care is that patients who seek care “within the network” (of doctors and hospitals contracted with the insurance company) pay less than those who seek care out of network. This is only possible if the insurance company has negotiated lower fees with the within-network doctors and hospitals.

   Phua Kai Lit

7. Hahaha! on June 20th, 2008 at 10.00am

   Vote in the BN clowns! The aussie will tell you, “She’ll be right, mate.”

8. Ganesh on June 20th, 2008 at 11.30am

   It is vital for a government to give free Education and free Health, not just increase spending on health care. This is a basic necessity. The UK government, with only 60 million people, can give free Health, why can’t we?

   After all, our government gets a lot of revenue from sources that other social state countries like the UK don’t ie like high taxes from cars etc.
   Some writer in Malaysia Today did some calculations and estimated that since the inception of high car taxes, the taxes collected from cars alone would be some RM180 billion to date.

   http://www.malaysia-today.net/2008/content/view/8763/84/

   Malaysia is rich in resources. Infact, many say, Malaysia is one of the richest countries in the world with natural resources, for example, oil, gas, oil palm, rubber, tin, gold. UK does not have all these luxuries.

   For the financial year ended March 31, 2007 (FY07), Petronas alone posted a net profit of RM46.4bil (and that is the old oil price). This year how much lah dei? RM100 billion maybe?

   Revenue from sales tax, stamp duty etc. When you buy a house, say, RM500,000 house, you pay a huge amount of stamp duty. And thousands of Sale and Purchase agreements for properties are done daily.

   Stamp duty alone is this formula

   i) for the 1st RM100,000.000 - 1% i.e. 1/100 x RM100,000.00 = RM1,000.00

   ii)for the next RM400,000.00 or part thereof - 2% i.e. 2/100 x RM400,000.00=RM8,000.00

   iii)above RM500,000.00 - 3% i.e. 3/100 x any sum above RM500,000.00

   Don’t forget income tax. House Assessment and Quit Rent. Road tax.

   All the revenue going where?

   People don’t want hundreds of billions spent on Corridors. People want Education and Health. Two basic necessities.

9. Patricia on June 20th, 2008 at 11.34am

   I know insurance is a bad word in most languages, but as we are not civil servants, how else do we afford going to a private hospital? And please don’t tell me to go to KLH, I’ve knocked years off my life ‘waiting-and-waiting-and-waiting’ with my dad in the years before he died. No complaints about the care, though, they were caring and careful in KLH’s cancer wing.

   But for me and mine, we are stuck with medical insurance. I am in my fifties and imagine that I will be spending more time in and around, than ‘out’ of hospitals. What lies ahead for us? Medical costs just keep spiralling upwards, along with everything else.

   Is it myopic hindsight, or were things so much better eons ago, when I was young?

10. jerrymohan on June 20th, 2008 at 2.17pm

    http://www.jerrymohan.blogspot.com

    While it is true that we may have to rely on drug therapy and hi-tech in acute life-threatening emergencies and trauma, as far as the management of chronic diseases are concerned, we should look to evidenced based, safe and Natural alternatives such as Acupuncture and Homeopathy which are by far cheaper and safer than drugs produced by western countries.

    Countries like India, Pakistan and Bangladesh which uses Homeopathy widely and China which uses Acupuncture are reducing their healthcare costs by leaps and bounds. Many countries in Latin america and Africa (e.g. South Africa) are also following this trend. It is also a good method of prevention of chronic diseases rather than drug therapy.

    By the way, Homeopathy was invented by a brilliant German medical doctor, Samuel Hahnemann.

    http://www.blogspot.com/jerrymohan

11. matt on June 20th, 2008 at 2.44pm

    A doctor friend told me once never show them the money because they[umno] will swoop in like vultures

12. Andrew on June 20th, 2008 at 3.23pm

    Thank you for the financial info, Ganesh. Absolutely, we want education and health. What use will these corridors be when the people do not have the knowledge and well being to utilise them?

    The standard of education today is deplorable. We have sales people who need to use calculators for the most basic sums, grammatical errors strewn all over speech and written communications and a population with little general knowledge. We have the nouveau riche who visit other parts of the world, not to learn anything from their travel experiences, but so that they can brag to others about it.

    Education means empowerment. An ignorant populace is much easier to govern than one which is knowledgable.

13. KK on June 20th, 2008 at 5.12pm

    Yes, Anil, Malaysian civil society should continue to be vigilant on this very important issue and make the case as Dr Jeyakumar has been making: health care is and should always be an essential or basic service for everyone, not just the rich.

    This message cannot be promoted enough in the light of the dominance of neo-liberal economics with their mantra of privatisation and commoditisation of everything under the sun. This is the economics that comes with the capitalist (as opposed to people-oriented) ideology that market forces will deliver efficient, affordable services to all. But it has shown to be a lie.

    Just look at the systemic crisis in health care in the US that has adopted the privatisation policy all along, despite a slightly larger amount of taxpayers’ money being spent on it. And now, all the US apologists for the system could say is their system offers the best kind of health care service, while ignoring the fact that even if that true, it is only for those who can afford it, i.e., the rich.

    The neo-liberal approach that has led to a major crisis in US health care service as its health insurance has made it out of reach of many in the US. No wonder this has been a constant issue of politicians running in the past few US presidential elections.

    Meanwhile, many Americans like to ridicule or slam the health care system of the Canadians, who have resisted the neo-liberal ideology as much as possible by trying not to take their system down the same sorry path as the US even though they know their system can still perform better in the interests of truly providing affordable “universal” health care.

    Back in the 1970s, economics textbooks clearly stated that certain basic services/goods should not be privatised or commoditised but should be provided by the government using taxpayers money (after all, isn’t that a main purpose of taxation?). These basic services included utilities (like water and electricity), public transportation and, of course, health care.

    There were several strong reasons for the thinking. More coordinated implementation of such services by a centralised entity in the form of the government was one and making such services affordable to as many people as possible was another.

    Then came the 1980s and the neo-liberal ideology was promoted all corners of the world from the US and UK led by its demagogues President Ronald Reagan and Prime Minister Margaret Thatcher respectively. Suddenly, all those basic services could be privatised and commoditised, after all. And many economists like to champion econ as a science subject! And so, for neo-liberalists, everything under the sun has become fair game for privatisation and commoditisation.

    Here in Malaysia in the 1980s, PM Mahathir was happy to privatise all kinds of utilities, public transportation, and even health care for two main reasons. One was that privately run services were touted to be more efficiently provided as they would involve less bureaucratic delays than publicly/state run services. The other was publicly owned and run services could be privatised to his cronies without going through open-tender the better to shore up his/Mahathir’s political support.

    Well, we all know very well now that privately run services have not really proved to be more efficient. Meanwhile, what is happening to Singapore’s highly efficient civil service shows that government or state run services do not, by definition, operate inefficiently or are not necessarily riddled with bureaucratic delays. They can actually operate highly efficiently. Even the Immigration Department here in Malaysia has recently shown to be fast and efficient in renewing passports within only hours of their application.

    Also, the privatisation of basic services are becoming more and more an economic burden on ordinary Malaysians as private companies owning and offering these services are driven more by the bottom line of profits. This is clearly shown by the increasing toll charges on the many privatised highways unlike the relatively inexpensive tolls, even on low income wage earners, on highways built by the state/government in US before 1980s.

    Furthermore, the bottom-line mentality of private corporations has little if any concern about environmental degradation. This is a negative impact stemming from their profit-driven mentality but instead of assuming full responsibility for it, including using some of the corporate profits to deal with the impact, neo-liberal economists called it an externality. In so doing, they go around promoting the impact as everyone’s problem in order to get the government to set aside more taxpayers’ money to help deal with it.

    It is high time Malaysians were wary of the neo-liberal ideology and not be fooled by its lies about the beauty of privatising health care. There are other models we can look into for implementing the service besides that of the US, which is exemplary of the neo-liberal approach as well as its many ills. Many Americans, through ignorance and/or arrogance, like to make fun of the Canadian model, but even the Canadian model is more affordable, ethical and caring. In the final analysis, neo-liberalism has shown to be doing more harm to more people and the environment than good.

14. esgreat on June 20th, 2008 at 6.21pm

    I believe in free trade, and I do believe that freeing up the market does bring reduced cost and higher quality…unfortunately this is not implementable due to huge government intervention all around the world (even the proponents) as each country wants to benefit from the growth and yet shield themselves when it doesn’t suits them.

    The problem with true free trade is that no one accepts the damages caused by wrong investments. The so-called ‘privatized’ companies in Malaysia took over critical utilities as a monopoly; most of the management had political connections; they had a race quota; there was an implicit understanding that they were too important to fail and the government will bail them out…these factors make them run no more efficiently than a typical government agency. Worse, it also promoted greed and corruption. Since that is the case those companies are better off managed by government.

    However, understand that failure was due to government links and not privatization per se. When Singapore created Singapore Airlines, the government after setting up the company told them that they would be totally hands off: “if you fail we won’t rescue you”. Look at how good they are now.

    However ‘free’ you think of the US, it’s no longer a really free country economically. The US government has been corrupted by lobbies and politicians promising the world to the citizens sot hat they can get elected.

    And they fund these programs with more tax (and monetary inflation), destroying the manufacturing base and will ultimately ruin the quality of life in the US. Perhaps these are the faults of the ‘neo-liberals’ KK talked about.

    The best way to deal with ‘bad’ private companies is not by having more rules, licenses, etc. It’s by having transparency, and no political (hence corruption) connection. It’s by having strong laws and quick investigation and prosecution whenever a violation in fraud, environment, human well being are done.

    Sadly, in the end of the day I’ll have to agree with KK. It’s totally inefficient to implement free economy and privatization in such an environment. You can have ideals but you need to know what is the most practical way to implement something.

    All the good that could have been derived from free trade was destroyed by politicians who had more self-interest in mind.

    I hope that whatever government comes to rule, help the people in their most basic necessities but don’t err into becoming a nanny state.

15. Ganesh on June 20th, 2008 at 9.00pm

    Andrew, the teacher in the school itself cannot speak proper English, so what do you expect of the standard of English of the students?

    And the best part, the teacher that cannot speak good English, what does he or she teach? Shockingly, and its not a joke, the teacher teaches the English subject!

16. Andrew on June 21st, 2008 at 2.46am

    I took Economics as one of my A level subjects. At the beginning of the Mahathir era, I was convinced I’d been wasting my time. Thatcherism was de rigueur. I still remember the accolades heaped on both Mahathir and Anwar by Thatcher during her visit to Malaysia, when the BBC was quick to point out that Thatcher’s husband’s name was spelt incorrectly during an official dinner function ( Denise as opposed to Dennis). There’s one for you, Ganesh.

    Thatcherism might have been the best medicine to wake up the Brits from their colonial dreams that the world still owed them a living, but as Jonathan pointed out, each country has its own characteristics and to borrow, wholesale, ideas suitable for one country is, shall we say, very telling.

    The problem is that we’re still doing it after all these years. When are we going to move out of the eighties? Let’s give Anwar a call.

17. Andrew on June 21st, 2008 at 8.09am

    Ganesh, according to one English tuition teacher, you may substitute the word city with the Big Apple. I don’t think Parisians or Londoners would be too happy that their cities may be referred to as that.

18. Jerry Mohan on July 18th, 2008 at 6.39pm

    http://www.delhihomeo.com/paperberlin.html

Leave a Reply