1Care or just “I don’t care”

Malaysian Healthcare system, despite some inadequacies, has been functioning well in comparison to countries of similar living standards. In fact, the facilities of some of our hospitals rival that of the advanced nations.

In certain aspects, our system is even better than many of the advanced nations. Malaysians can have immediate access to medical care and  treatment whenever they feel unwell, unlike in some of the developed countries, where it may take a few days or even weeks to seek an appointment to see a doctor.

Government healthcare cost has been on the rise. Part of this I blame it on piratetisation privatisation as well as leakages and wastage in funding hardware as well as softwares. Billions have been spent on building new hospitals and medical equipment as well as the software system for the operation of such hospitals. But as in other aspects of Malaysian life, leakages and wastage could have amounted to 20-30% of overall spending.

Because of the increasing cost of the healthcare system, government is considering instituting a Health financing system, formerly call the National Health Financing scheme ( i have written a paper on this topic in 2006 – search under the masthead of this blog or see the link at the end of this post). This has now been conveniently renamed 1Care.

Very little is known about this 1Care. As in the Malaysian tradition with regards to policy matters, there is hardly any (or shall we say absolutely no) consultation with the end-users ,  the Rakyat and the consumer groups. Although the ministry is said to be working with the Malaysian Medical Association (MMA), even doctors know very little about this scheme.

What little info that is available hints at a system that will drastically alter our lifestyle. Unlike now, we cannot  no longer choose our own doctors. Apparently under this 1Care system, each individual will be assigned to a doctor, presumably someone who is operating nearby. How this allocation will be done and what criteria will be used are unknown as yet.

Patients assigned to that particular doctor will have a limit as to how many times he or she can consult that particular doctor in a year. Those with chronic diseases like asthma, hypertension and diabetes will not be able to see their doctor  as often as now, compromising their health.

All doctors will have to be in this scheme, and would be allocated patients. Doctors are not allowed to dispense medicine. As a compensation, their consultation fee is set to go up , as high as RM60 per visit. This contrasts with the present system where for a fees of around RM30 – 40, you can consult a doctor and be treated with medications for common ailments.

So who is to fund for this incredible scheme? The end users of course since there is no such thing as a free lunch in this world. From what is known, everyone will have to be in this scheme, and each house hold is supposed to fork out 9 to 10% of their income to a National Health Financial Agency.

For those who are young, hale and hearty, they have to fork out the same amount, which will probably be deducted from their pay as in EPF scheme.  Like all other insurance scheme, this actually works on the  concept of the more healthy subsidising the less.

But for the less healthy, don’t be too happy yet. Apart from the limit on the number of times they can visit their assigned doctors,  they also have to spend extra time and transport cost to get their medical supply from a pharmacy after seeing their doctors.  There will also be certain diseases which will be excluded from this scheme, and out of pocket payments (OOP) will have to be made for these diseases.

Because the doctors are now being paid a higher consultation fees and because extra costs are incurred for medicines to be dispensed by pharmacy, the total healthcare costs will shoot up, as in the experience of many countries which have implemented health financing scheme.

The money eventually comes from the people. When the healthcare cost goes up, the NHFA is going to ask for more money and that will translate to more deduction from the rakyat.

What is ironical is that the present system is efficient and cost effective. Malaysians in fact spend much less on healthcare than their counter parts not only in developed countries but developing nations as well.

The above table ( charted by me using WHO statistics)  shows the percentage of Total Health expenditure of malaysia in 2002 and 2003 compared with many other countries.

Even countries with comparable GDPs in international dollars such as Mexica and Brazil spent much more on health care than Malaysia. Developing countries with lower GDPs such as China and India also spent higher proportion of their GDPs on the health of their citizens.

Malaysia government has a duty to take care of its citizens’  health care. As it is, it is spending much less than the WHO recommendation of 7% of GDP on health care. Our government spends around 6-7% of government  budget on health,  which is much less than our GDP.

The old saying that “do not try to fix anything that ain’t broken” is apt in this case.

I have written a paper on National Health financial scheme in 2006. In it I have extracted many statistics against implementation of such a scheme and posted them in table forms. This paper was also published  in FOMCA’s publication last year, after obtaining my consent via email. For those who want to know why I oppose such a scheme, and the rationale behind my opposition to such scheme, please read the paper “Malaysian Healthcare- a critical look at National Health Financial Scheme” in this blog:

https://hsudarren.files.wordpress.com/2006/10/malaysian-healthcare-a-critical-look.pdf


32 Comments (+add yours?)

  1. Richard Loh
    Feb 03, 2012 @ 16:29:49

    Waiting for you to write on this 1Care. One question though, what about those doctors in private medical centres & if a patient is already under one specific doctor that looks after his illness, what happen?

    Like

  2. C++
    Feb 03, 2012 @ 18:26:20

    Dear Dr’,

    I’ve eventually know this matter in 1999 when I wrote the first “E-Health Management System” that I submit to Kementerian Kesihatan which is now being copycat by others as been “network based medical management system”. At that time many company were submitted their proposal to MOH to get approval.

    But then.. at that time the idea is to have a centralised database for medical purposes without disband the two tier health management system which 1Care planned to do right now. Now 1Care is very crucial to our National Health Policy whereby in the near future the Government will get his hand freed from managing the right for citizen to get lower cost medical services.

    The problems with this 1Care as what I’m seeing is the rate of the medicine dispense by a pharmacy will be differ between one pharmacy and others. This is because some pharmacy will try to lock or monopolized the markets.

    This will bring problem where some pharmacy (which happen to sell medicine or drugs on lower cost as to monopolizing the markets) bring in the substandard or nearing the lifetime period (near expiry date) medicine/drugs.

    Therefore.. even though the medical cost were became higher, the outcome will be much lower… I myself were against this 1Care scheme.

    I really hope medical people (doctors and pharmacist) will be joining the “Tak Nak 1Care” campaign as our healthcare system is okay right now. Our two tier system were the best.

    Like

  3. Phua Kai Lit
    Feb 04, 2012 @ 07:49:50

    Dear Dr Hsu

    Here are my comments on your article (in capital letters):

    “Government healthcare cost has been on the rise. Part of this I blame it on piratetisation privatisation as well as leakages and wastage in funding hardwares as well as softwares. Billions have been spent on building new hospitals and medical equipment as well as the software system for the opeartion of such hospitals. But as in other aspects of Malaysian life, leakages and wastage could have amounted to 20-30% of overall spending.”

    YES. CLEAN THIS UP FIRST BEFORE IMPOSING MORE TAXES ON THE PEOPLE.

    What little info that is available hints at a system that will drastically alter our lifestyle. Unlike now, we cannot no longer choose our own doctors. Apparently under this 1Care system, each individual will be assigned to a doctor, presumably someone who is operating nearby. How this allocation will be done and what criteria will be used are unknown as yet.

    THIS POLICY UNNECESSARILY ALIENATES PEOPLE.
    MOST PEOPLE ALREADY SEE A GP NEAR THE HOME AND NEAR THE PLACE OF WORK. WHAT THE GOVT SHOULD DO IS ONLY ASSIGN GPs TO PEOPLE WHO DON”T HAVE A REGULAR GP NEAR THE HOME AND NEAR THE PLACE OF WORK.

    Patients assigned to that particular doctor will have a limit as to how many times he or she can consult that particular doctor in a year. Those with chronic diseases like asthma, hypertension and diabetes will not be able to see their doctor as often as now, compromising their health.

    THIS POLICY HAS CLEAR FLAWS. TO DISCOURAGE UNNECESSARY VISITS, THE GOVT ONLY NEEDS TO INCREASE THE CO-PAYMENT DRASTICALLY ABOVE A REASONABLE NUMBER OF VISITS. PEOPLE WITH CHRONIC DISEASES SHOULD HAVE THE BASIC NUMBER OF VISITS PLACED AT A MUCH HIGHER LEVEL (BEFORE THE HIGH CO-PAYMENT KICKS IN) THAN OTHER PATIENTS.

    All doctors will have to be in this scheme, and would be allocated patients. Doctors are not allowed to dispense medicine. As a compensation, their consultation fee is set to go up , as high as RM60 per visit. This contrasts with the present system where for a fees of around RM30 – 40, you can consult a doctor and be treated with medications for common ailments.

    ALTHOUGH THE POLICY OF NOT ALLOWING DOCTORS TO DISPENSE MEDICINE WILL MAKE DOCTORS UNHAPPY, I DO SUPPORT THIS POLICY.

    So who is to fund for this incredible scheme? The end users of course since there is no such thing as a free lunch in this world. From what is known, everyone will have to be in this scheme, and each house hold is supposed to fork out 9 to 10% of their income to a National Health Financial Agency.

    10% EARMARKED TAX IS TOO HIGH! IT SHOULD BE MUCH LOWER.
    NOBODY SHOULD BE EXEMPTED — AND THIS INCLUDES CIVIL SERVANTS.
    AND AS I SAID BEFORE, BEFORE IMPOSING NEW TAXES, TAX ACTION TO
    END WASTAGE OF AVAILABLE FUNDS BY ENDING CRONY CONTRACTS FIRST

    What is ironical is that the present system is efficient and cost effective. Malaysians in fact spend much less on heathcare than their counter parts not only in developed countries but developing nations as well.

    GP CARE IS NOT A PROBLEM IN MALAYSIA. PRIVATE SECTOR GP CARE IS EFFICIENT AND AFFORDABLE. THE POOR CAN SEEK CARE AT KLINIK KESIHATAN. THE MAJOR PROBLEM IS HOSPITAL CARE (ESPECIALLY IN THE EXPENSIVE PRIVATE SECTOR)
    1CARE SHOULD PROTECT CITIZENS AGAINST “CATASTROPHIC HEALTHCARE BILLS”. IF IT COVERS ONLY BASIC OR PRIMARY CARE, THEN IT IS USELESS.

    The above table ( charted by me using WHO statistics) shows the percentage of Total Health expenditure of malaysia in 2002 and 2003 compared with many other countries.

    Even countries with comparables GDPs in international dollars such as Mexica and Brazil spent much more on health care than Malaysia. Developing countries with lower GDPs such as China and India also spent higher proportion of their GDPs on the health of their citizens.

    YES! TOTALLY CORRECT !

    Like

  4. Phua Kai Lit
    Feb 04, 2012 @ 07:58:44

  5. Dr Hsu
    Feb 04, 2012 @ 10:24:51

    Since the consultation will be drastically increased, a visit to the doctor and subsequently to the pharmacy to fill up the prescription will cost more than RM 80-100 for a normal cough and cold treatment in my estimate ( this includes the consultation of RM60, and the medicine costs in Pharmacy, the costs of which will include the pharmcist’s professional fee and his overhead).

    This contrasts greatly with the present median charge of RM 35 (This is what is being paid by most Health management company like ING to doctors for single visitation+treatment).

    Ultimately, this will translate to a higher premium for the contributors, and this premium will form a big portion of a worker’s salary, and make the little disposable income even less.

    I dont see any savings for hospitalisation too. Unlike now when the poor can be hospitalised in government hospitals for free, under this scheme, even public hospitals will charge fees and get reimbursed from NHFA, thus drastically icnrease healthcare cost per capital. Visitations to government clinics will also be charged accordingly and reimbursed from the scheme.

    Take the case of Taiwan, healthcare cost escalated in 1995 when they implemented a financial health scheme in 1994. So much so that the health authority has to force everyone to increase contribution (increased premium) in 2002 to avoid bankruptcy.

    Initially we may be forced to pay 9-10% of our salary, but once in place, there is no going back, and if healthcare costs increase drastically, the premium each has to pay may go up to as high as 15-20%.

    When the present system is working well, why should it be changed? And once the dice is cast, it cannot be undone. So i urge everyone to think carefully about a scheme which will drastically affect our lifestyles, our children. we will be effectively paying more for the same or even less.

    Like

  6. Kenny
    Feb 04, 2012 @ 10:43:22

    Everything the BN govt proposes is rotten because everything is done with profit in mind. The main criteria is not how it will benefit the people but how much they and their cronies can make out it. It’s a very rotten state of affairs which can only be cleaned by replacing BN as the govt. This comes from never changing the govt for 50+ years.

    Like

  7. mcfan
    Feb 04, 2012 @ 10:56:19

    It sounds like, those who can pay may opt to pay for private GP/specialist (unless this private healthcare system is totally disallowed) and yet still require to contribute ?10% from their earning to this 1care system (on top of their annual taxes).

    Like

  8. Dr Hsu
    Feb 04, 2012 @ 11:44:21

    Richard Loh and mcfan

    Exactly. If you don’t like the doctor assigned to you, you can visit your own doctor but pay OOP( Out of pocket payment)under the scheme.

    If you want to see a specialist but your assigned doctor does not want to refer you, you can still consult the specialist but pay OOP again. If you are already under the care of a specialist, and if you don’t have the referal from your assigned doctor, you pay OOP.

    I suspect many urban Malaysians will still see their own doctor and payOOP after paying their share of contribution to the FUND.

    The fund will be huge and those in power could probably tap into the fund in case of need to fund for certain things, like using the EPF now.

    Like

  9. Kenny
    Feb 04, 2012 @ 12:12:24

    Why is it necessary to assign a doctor? There is nothing wrong with letting patients choose whichever doctor they want. They should also be allowed to change doctors. If a patient has lost confidence in a doctor not being able to change can be devastating for treatment as there is no more patient-doctor trust and no placebo effect.

    This harebrain scheme should not be implemented in the first place. It can be a big election issue if the govt tries to ram it through. Deducting 10% from wage earners’ pay is not a small thing on top of the EPF deduction. I don’t think any urbanite will support it. Sadly this is a govt elected by uneducated and semi-literate rural voters with overweight constituencies.

    Like

  10. Trackback: 1Care or just “I don’t care”
  11. Ahamed
    Feb 04, 2012 @ 13:00:42

    I am in tandem with the view that the 1Care does not seem to be a holistic plan. While the Govt (through my reliable sources) are looking towards emulating the National Health Care Reform as how the UK did it for over 100 years, which had laid out very comprehensive supporting laws (ie national health insurance laws even before the health reform laws), retrospective studies and views show that the “reform” may not have achieved its objective as well as it had envisioned. Mind you that this is actually from a developed country who has the experience and know how that started it when we in this country were still farming potatos….

    Through its course of premium calculations, the 1Care scheme has hit many snags but it being a brainchild project of top politicians and children of past politicians, the show must go on. A premium of 10% of a person’s wage is considred low bearing in mind that this is social health insurance. Meaning to say that the risks involved like in any other scheme will have to be bourne by the policyholders.

    In other words, why insurance company can be lower is because everyone who pays gets a share of benefit, and the pool of money paid to the insurance company is used to pool the risks of contributors…..meaning to say if the working class wants insurance, they pay; if babies want insurance, another policy is taken; if the old wants insurance, another policy has to be taken; if the DISABLED wants insurance, they also need to take out a policy…hope you can see where i’m going….

    Suffice to say….the Govt will lobby for support not from people who pay… But from people who DON’T have to pay (ie, the poor or those earning below a certain capita, the disabled, the elderly, the young, RELA members, national heroes, oh wait did I say RELA members?? Hmmmm latest statistics show they have more than 2.6 million members)

    So why 10% of our pay? Because these “privileged” people who are going to pay need to pool the money and risks for people who will be subsidised by the government…..so hence, those who pay will make out to be the minority voice, and those who will reap the benefits through subsidy will be the majority voice. So if the majority is happy….who gives two hoots to the minority who have to pay….

    Anyway…just some fuel for your fire, bullets for your guns…..

    Like

  12. AcHoo!
    Feb 04, 2012 @ 14:05:22

    The chart also could mean that that privatisation of health schemes in those countries only make health care more expensive. Because insurance companies and private hospitals and doctors operate like a business and only look out for themselves.
    Since you rightly said our healthcare system is functioning well, it should only be improved. Every year we are producing a lot of doctors and these could be recruited for our government hospitals. Their scheme of service could be improved and they could have incentives like quarters and attractive housing loans and opportunity to upgrade their skills,

    Like

  13. CYC
    Feb 04, 2012 @ 14:15:41

    This is another step towards communist state where everything is determined by the govt. Good, bad and lousy doctors will be earning almost the same. It kills meritocracy and competency.

    More and more slogans, portraits of “dear leader” and “regulations were seen in the last couple of years in our country. We are going to be a real communist country soon.

    Like

  14. cardiprin
    Feb 04, 2012 @ 14:22:31

    Dr Hsu, what about it’s effect on doctors?

    Under the 1Care scheme, since every hospital, regardless government or private will be managed by corporate companies and hence they will have a major say in the number of doctors to be hired and how much to pay them. With many doctors are bonded with the government (JPA, MARA scholars), plus graduates from the local IPTAs, priority is given to them. I doubt the entire selection process will be transparent.

    Like

  15. cardiprin
    Feb 04, 2012 @ 14:28:40

    Perhaps unemployment is soon-to-be reality for doctors.

    Like

  16. JKhoo
    Feb 04, 2012 @ 14:59:49

    Dear Dr. Hsu,

    Thank you for your enlightening piece on the 1Care Health system which seems to be on its way to be implemented whether we like it or not. Your article has indeed given awareness to a lot of people who are still in the dark about the proposed ‘re-engineering’ of our healthcare system. However, I would like to offer my view to a point that you have made with regards to software systems.

    While I agree with you that leakages does happen, having a general statement like paying billions for software gives the impression that there are no benefits using such systems. Let me present to you my argument.

    For e.g., the PACS software which replaces film based system. If you were to make a comparison as to the cost of films and related consumables as well as storage, spending on a system like this will give you a return on investments and additional savings. This is proven to be true. Many do not know – films used in traditional x-rays, MRIs, etc are very expensive. With a PACS, there are no films, no physical storage and certainly no chemicals needed as there is no need for processing. All this will lead to cost reduction and eventually savings.

    With an efficient computer system, patient’s treatment are faster as access to records are quicker and more complete – thereby enhancing patient safety issues. This reduces accidents which may cost more money to fix such insurance claims, court cases etc from giving wrong drugs/incorrect dosages, leaving physical items in a patient after surgery, etc – just to name a few.

    Another example, is the Pharmacy system where drugs can easily be controlled and wastage reduced such as ensuring the dispensing of drugs that has a shelf life.

    If you really look into it, the cost of such system does not go into the billions. But apparently it did, so how did this happen then? I believe it has all to do with the procurement system where too many layers are added onto the chain without explicit values being added.

    Unfortunately, this is the end result. If at all, the software systems should be in place but a total revamp of acquiring such systems should be done. That should be how that point should be made. The blame is not on the software/systems but the way how things are done.

    Regards,

    JK

    Like

  17. CYC
    Feb 04, 2012 @ 15:08:14

    AcHoo,

    Yes, we are producing more doctors and nurses but the aiming is solely to enrich the education institutions which are well connected with the govt of the day. Look at Masterskill, its recruitment is guaranteed in a way as all intakes were fully funded (either by scholarship or govt loan). Where the hell in this world u can get this type of business model. So, they keep producing more and more nurses irrespective of employability or competency. Now, we have thousands of unemployed “nurses”. Who cares. The govt of the day also set up medical college in collaboration Newcastle in Iskandar region but please where were the intake came from and how all they funded? 1st batch about 100 students, 95% bumiputras under govt scholarship/loan, 5% non Malay. We simply having all these simply for the fun of having it. Nothing more. My friend simply refused to send his straight As son to enroll there even with the name Newcastle attached and perhaps much cheaper than going overseas.

    Like

  18. Jong
    Feb 04, 2012 @ 16:12:51

    Another national rip-off! If we fail to stand up and oppose this, we only have ourselves to blame.
    Time to change government come GE-13, ..Anything But UMNO – ABU!

    Like

  19. Dr Hsu
    Feb 04, 2012 @ 18:36:10

    JKhoo,

    Thanks for your comments.
    i am not against money spent on hardware and software, but rather I am against the inflated cost of acquiring such hardware and software. I am sorry if the article appeared to have conveyed such meaning.

    New technology and softwares are necessary. But we must be prudent when making such acqusition, and the leakages and wastage must be plugged, and if we can do so, we can save 20-30% which will amount to hundreds of millions dollars, if not billion.

    Like

  20. Phua Kai Lit
    Feb 04, 2012 @ 22:02:50

    Primary care (GP care) is fine in Malaysia.

    It is our hospital care that is getting more and more screwed up by
    privatisation and promotion of medical tourism.
    More and more experienced specialists leaving the govt hospitals for private sector hospitals. Corporatised govt-owned hospitals acting like profit-maximising
    private hospitals. “Private sectors hospitals” that are actually owned by Khazanah and Johor Corporation.

    Like

  21. Msian
    Feb 05, 2012 @ 15:16:43

    I have these nagging questions:
    – This 10 p cent cut, is it for the salaried worker alone, or is it for his whole family – children, babies aged parents?
    – A popular and busy doctor may lose out in terms of income if he is allotted a certain no. of patients!
    – What happens if a person is allotted a certain doc and he doesn’t like him, and he can’t afford to go back to his regular doc as he has to pay from his own pocket. He might end up being his own doc and buy his own med.

    Like

  22. CYC
    Feb 05, 2012 @ 16:25:41

    To find out more 1Care, you may attend this forum:

    Selangor/KL Healthcare Public Forum
    Date : 12/2/12 Sunday Time : 4-6pm
    Venue : Global Business and Convention Centre, Section 19 PJ
    Speakers : Dr Ng Swee Choon, Dr Xavier Jayakumar, Dr Jayabalan etc.
    Moderator : Philip Koh

    Like

  23. Tim Wong
    Feb 05, 2012 @ 17:03:51

    Dr Hsu,

    I have a simple question. Does a self employed road side nasi lemak seller contribute to this scheme ? How does he/she contribute the 10% of his income when he may not pay income tax ?

    Like

  24. Dr Hsu
    Feb 06, 2012 @ 08:59:07

    Tim Wong and other readers

    We are in the dark as to how the deduction will work. The government has been saying that the poor would not be burdened, so presumably those under certain category ( eg earning less than certain amount) may be exempted from paying or pay a lesser rate (this is of course my own conjecture). If so, then it will go according to income declared to the income tax department. Those petty traders who dont report income may then be under the ‘poor’ income group. I repeat this is my presumption and I actually do not have any info as to how the deduction is going to work.

    That is why I am asking the government to have more transparency and be more open on this 1care. If the government is genuine in its in its intention to care for rakyat, then it should be more open and have discussion with the rakyat.

    Now people are getting suspicious because one moment the Ministry says the whole plan is only preliminary , then next moment news reports have it that a high official was saying at a pharmacy gathering that the whole plan is in final stages.. It cannot blame us to become suspicious when they are behaving in such an inconsistent manner.

    Like

  25. mmc
    Feb 06, 2012 @ 12:54:31

    simple answer to Icare is to get rid of this corrupt gov which sprayed tear gas into a hospital and denied by the Minister of Health.

    Like

  26. winston
    Feb 08, 2012 @ 17:12:54

    Dr Hsu,
    Let me get one thing very, very clear.
    This government is pushing up the health care costs.
    Seeing a GP for RM60?
    Well, I can consult a specialist for RM70; one with a FRCS to his name.
    And it was only recently and at a private hospital to boot!!!
    Under the present system in public health care facilities, there is no restriction on the patient on the number of consultations and just by paying a mere RM1 for registration.
    If this nominal amount is insufficient, perhaps it can be increased to RM2 or even RM3 in future.
    Still it is affordable, even for the poor.
    Foreigners as I understand it are recently made to pay more than citizens whereas even in the recent past, they were paying the same; this shows the stupidity of those who are in the government!
    They obviously don’t give a damn about what’s going on in their ministry!!!
    Also, the fools who run the Health Ministry have been wrangling with the so-called National Health Insurance Scheme for more than 25 years!!
    Yes, more than a quarter of a century and it looks like they have given up and copy carte blanche from the NHS of the UK!!!
    This, after spending so much time and perhaps large amounts of taxpayers’ money to employ specialists to study the NHFS before abandoning it.
    Undoubtedly 1Care is another scheme (scam?) to benefit cronies.
    The people must vigorously oppose it and bring about its demise, now and forever.
    Make sure it is not resurrected in future on the sly.
    In the final analysis, what is needed is the allocation of more, much more than the 3% or so of GDP for healthcare that it has been doing for so long as, I understand the amount needed for a workable healthcare system, is around 6 or 7%.
    As are a resource rich country, do so will not cause us any toothache, isn’t it?

    Like

  27. Winston
    Feb 09, 2012 @ 09:29:49

    Well MMC you’re right!
    The government is run by people without any moral fiber at all.
    None whatsoever!!!!

    Like

  28. Dr Hsu
    Feb 09, 2012 @ 10:57:25

    Hi Winston
    The government has indeed pushed up health cost, or at least the medicine costs. They have made it mandatory for drugs to be packed in blisters or strips, and that evey packet of the drug must have a hologram; this hologram producing company is run by a well connetced. So drugs come in a smaller , blisters pack size. The costs have gone up tremendously since it gives the drug companies an excuse to icnreae price.

    Govt has also restricted the import of certain ingredients in cold medication, called pseudoephedrine. Their reason being that some of the people turned this into designer drugs like ‘ice’ and so on. BUt those who abuse the drugs are only a small category , my estimate is less than 0.01%, in nite clubs and so on), majority using it are genuine sick patients. what should be done is better enforcement and catch those who abuse it in niteclubs, karaoke places and so on. Because of the drastic restriction on the import of this ingredients, cold medications have gone up, in certain cases, 300% in costs. Plus the smaller packings, it has made common drugs 2 to 3 tines the price of just few years ago.

    this happens when the people sitting in ivory towers do not know the actual situation on the grounds.

    Of course, some of the local drug companies run by warloards can now sell their products much higher to the government/MOH. This translates to better profits.

    Like

  29. A true Malaysia
    Feb 09, 2012 @ 17:09:56

    Government’s coffer is running dry. Income tax base is small, GST plan cannot proceed to widen the tax base, existing tax payers paying lesser taxes due to bad economy, and they need money to continue with their lifestyle, or at least his wife’s boros way of spending.

    So, they come out with 1Care, where they put it as everyone is mandatory to participate, even though no concrete plan yet. 1Care, they are the 1 they care.

    Like

  30. Winston
    Feb 12, 2012 @ 21:06:46

    What’s the best way to prevent the government from ramming 1Care down our throats?

    Like

  31. Dr Hsu
    Feb 13, 2012 @ 11:28:13

    Winston,
    put pressure on your MPs. Those who can write well write to the press.

    Like

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