Beware the perils of health care “liberalisation”


Michael Moore’s must-see documentary, Sicko

And then came the expose of a PR campaign by the private health care industry to discredit Moore’s documentary…

I was reading the latest edition of The Edge – I am interested to see how the business folks think and what motivates them – when I came across a report that private hospitals are full because of the H1N1 alert.

You would think that this would keep these private hospitals busy. But folks in the private hospital industry are actually worried – not because of the H1N1 outbreak – but because these flu patients do not bring high enough revenue yield! “Flu patients could occupy the beds for up to five to six days and yet make less money [for the hospitals] than those that come in for higher-yield procedures such as minor surgeries but who would only occupy the beds for about three days,” an industry observer told The Edge.

But for hospitals that are running below capacity, the pandemic could spell good news for their business, The Edge report reassures the business community. The report was titled ‘Hospitals full, but where’s the money?” These private hospitals are raking in millions of profits – and yet it is never enough.

Nice to know the priorities of some of these private hospitals. They are more interested in “higher-yield” (i.e. more profitable) patients than in your suspected H1N1 fears. Oh, what a nuisance!

Now ‘the in thing’ is “health tourism”, which will further drain human resources from the public health care system.

We know that privatisation of health care began with a vengeance under Mahathir and continues to this day. That was a blow to our underfunded public health care system, which was neglected as specialists, doctors and experienced nurses left for greener pastures. The BN has much to account for in the way it managed – or rather mismanaged – the public health care system.

Of course, the rich and the upper-middle class who can afford medical insurance have no problems with private health care as they can afford it. But as Moore’s movie shows, even those with medical insurance can sometimes be denied claims because of “pre-existing conditions”, not to mention a long list of excluded diseases.

We know how the BN has mismanaged the health care system. But what is the stand of Pakatan on liberalisation of health care? We are so focussed on BN vs Pakatan, we often don’t ask these questions. Can we hope for universal health care as seen in those systems highlighted in Moore’s documentary? It is not impossible if we have the political will. After all, a civilised society is one in which no one should be denied quality health care because of a lack of means. In a civil society operating a universal health care system, the better off would be ready to chip in to help those who are more vulnerable and sickly through a system of cross subsidies. It is only in a callous society that folks tend to think of “me first” and to hell with everyone else.

Or is Pakatan more interested in “business as usual” as evident in the way it is promoting “health tourism” in the states it controls? Is there any difference between the BN and the PR in this respect? Do they not see how “health tourism” could eventually hurt the health care interests of the lower-income group by further entrenching the two-tier health care system – one system of the rich and an inferior system for the poor?

Watch Michael Moore’s documentary. It’s worth the two hours.

And if you have experienced any problems with private hospitals and medical insurance, just drop me a line in the comments below.

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Yow Chuan
15 Sep 2009 3.38am

While we are on this topic, it’s also good to investigate into how the big pharmas are playing an important role in greasing the hands of these doctors and healthcare authorities.

What we have now is ‘Wealthcare’ – where it’s no longer about curing diseases or saving lives.

12 Sep 2009 11.16am

@Wong Ka Wa,

Btw, ayurveda and homoeopathy is NOT BOMOH. Get your facts right :0

12 Sep 2009 11.14am

@Wong Ka Wa,

I do not oppose you because of kbp. I oppose your stand and chest thumping that reason and logic is supreme. Lack of reason and logic is NOT IRRATIONALITY. One day when you understood what this meant you will discern the value of intuition and inspiration over “mindless” objectivity (objectivism according to ayn rand) that seldom ever shed any light on the problem at hand.

You will have to travel the path.

Phua Kai Lit
Phua Kai Lit
11 Sep 2009 10.27am

Dear Anil In my opinion, health tourism will also increase demand for high end medical services (it does not matter what nationality the patient holds). This will raise prices in the short run. As for your comment (“Of course, the rich and the upper-middle class who can afford medical insurance have no problems with private health care as they can afford it”), this is not necessarily the case. A private, fee-for-service system run by profit-maximizers and (marketing/PR guys) can actually be a threat to the health of the upper middle class and the wealthy i.e. provision of medically unnecessary services,… Read more »

Wong Ka Wai
11 Sep 2009 9.27am

Kepada Mist,

sudahlah dengan teori songsang. Jika sesiapa sakit pergilah dapatkan rawatan dan bukan melalui bomoh.

Perubatan Barat dan juga TCM diiktiraf di Malaysia.

Saya ini kaum Cina tahulah kebolehan herba dalam perubatan.

Saja nak tentang saya kerana komen saya terhadap Kg Buah Pala. Kesian.

Sila senyum selalu.

10 Sep 2009 10.45pm

I thought a complete list of relevant issues on allopathic medicine could be found at :

It is basically an organisation that is against fraudulent research in medicine.

10 Sep 2009 8.51pm

Appended are 3 documents that is really an eye opener. Like Wong Ka wai I had great trust and confidence in development, modern technology and science. I was very forward looking and always looking forward to new discoveries. Then one day I had a chronic condition of a trigger fingger. Modern medicine was unable to relieve or cure it. I went on a tour of india and by chance we visited an ayurvedic clinic and I decided to consult the doctor on my condition. Within 3 days I was cured. The remedies consisted of mostly what we used in our… Read more »

10 Sep 2009 3.48am

It’s 3.30am and I’ve finally watched Sicko. Thanks, Anil, for prompting me to watch it since the link’s already in front of me. Might pay for it tomorrow tho. When he was visiting UK & France, I was thinking to myself – I wonder if he’ll visit Cuba. That would be funny! AND he does even better! He ends the film with a visit to Cuba!! (I won’t say much more coz don’t want too much of a spoiler). Haha! Couldn’t make a better ending!! I’ve watched films on Cuba’s foreign medical aid and also attended forum on how society… Read more »

10 Sep 2009 12.39am

Oh btw, people focus on lack of doctors and infrastructure, but another problem needs to be addressed urgently – NURSES. They are too badly supported and we are too reliant on “imports”.

The nursing profession is like teaching. It’s a thankless and under-appreciated/under-rewarded job, so no one wants to do it and all we have left are…..

10 Sep 2009 12.31am

Hi Anil, I’m sure everyone in Malaysia knows at least one person who passed on because of insufficient/inappropriate care in our healtcare system (public/private), someone who has suffered because he/she could not afford adequate care, someone who was left to wait/die in the corridors of a public (or even “private”) hospital. I know at least 1 in each of the above scenarios. Additionally, I was with my mum when she was sick with cancer and know that even in Penang and even if you have the money, there is insufficient infrastructure and expertise to be sick. We HAD TO go… Read more »

9 Sep 2009 6.25pm

Thanks for sharing this movie.

Ong Eu Soon
9 Sep 2009 6.12pm

In the hungry ghost month, to have the hospital’s beds fully occupied is a blessing for the hospital. Normally within the hungry ghost month, the Chinese will shy away from hospital’s bed afraid to witness the invisible one. But due to the media hype and hysteria over H1N1, one might be admitted to the hospital and waited to be (wrongly diagnosed) by our doctors who simply treat anyone with fever as influenza-like illness.

Wong Ka Wai
9 Sep 2009 4.02pm

Sebenarnya dalam isu pembukaan dan penswastaan, beberapa industri mesti dikecualikan atau setidak-tidak pihak kerajaan mesti terlibat sebagai salah satu pengusaha. Sebagai contoh, jika pembukaan industri kesihatan dilakukan, pihak kerajaan juga perlu terlibat dalam bentuk hospital kerajaan tetapi membenarkan hospital swasta beroperasi. Secara ideal, industri pendidikan dari pra-sekolah hingga ijazah pertama perlu diberi percuma. Keperluan asas seperti air, bekalan elektrik, telefon, dan akses internet juga perlu diberi percuma dengan bersyarat. Syarat ini memastikan tiada pembaziran dan hanya cukup mengikut keperluan asas. Sebagai contoh: kesihatan = wujudkan dana bagi penyakit kronik. Rawatan percuma sebanyak, sebagai contoh RM300 setahun air = cukup bagi… Read more »

9 Sep 2009 3.08pm

Anil, Don’t say that people always focus on KBP issue. Frankly speaking, it’s overated. There are plenty issues required urgent attention. Health issue is very touchy one. Nationalisation of Health Care would lead to big hole on the Treasury purse. As evident in UK. It’s running out of control. Cost & infrastructure wise. Whether you like it or not, these folks in the private sector would still be earning tons of money even if you try to do a JBJ on the health care system Anil, There is no direct solution to the problem. Or let me put it this… Read more »