Better treatment for full-paying patients; inferior service to the poor
In Ismail Merican's response to P Ramakrishnan's criticism of moves to allow government specialists to provide "private treatment" after working hours, the Health Ministry Director General said that the Aliran president had based his comments on an erroneous inference. Ismail said:
Ismail also said:
To say that the government is subsidising 98 per cent of health services paints a distorted picture. The money is not coming out of the Cabinet's pockets. It is not charity from the government. Rather, the funds are from hard-earned taxpayers' money and it is only right that this money should be used for essential services for the people such as health care. The whole idea of taxation is to provide an element of cross subsidy so that nobody is denied such essential services because they cannot afford to pay.
Right now, the government is only spending a paltry 2 per cent of GDP on health care - well short of the 5 per cent recommended by the World Health Organisation. If the government were to spend more of public funds on such a critical area as health care, it wouldn't need to come up with fanciful ideas and ill-thought-out schemes to raise money to pay its specialists, doctors and other medical personnel. It would have enough funds to pay specialists and doctors higher salaries without taxing patients a second time through higher fees. (Remember, the public have already paid for public health care services the first time through taxation.)
Finally, Ismail may give us all kinds of arguments and assurances that his proposal for "full-paying patients" (to allow specialists to earn more) will not affect the poor. But the fact remains: once government specialists discover which side their bread is buttered, they can be expected to gravitate to the full-paying patients and spend more of their time and energy with them. Gradually, the non-"full-paying patients" will be subjected to second-class service, longer queues, and crowded wards.
This will result in two classes of patients and two types of services. In effect, better treatment from the best specialists will be provided to the rich (full-paying patients) while inferior service will be dished out to poor patients. Specialists will quite naturally devote more of their time and attention and energy to patients who will contribute more to their take-home income and less to those who cannot afford to pay. In the end, it will be the poor who suffer. So how can Ismail say that the poor will not be affected?
But look what the NST had to say on 8 January 2006, in particular the first paragraph of its report. It clearly says that specialists will be allowed to provide "private treatment" after working hours.
...the inference that the Government will extend the working hours of specialists — requiring them to provide "private treatment" after working hours — is erroneous.
Ismail also said:
At present, the Government is subsidising 98 per cent of health services provided by the ministry. In no way will this new scheme jeopardise the provision of patient care for non-full-paying patients.
To say that the government is subsidising 98 per cent of health services paints a distorted picture. The money is not coming out of the Cabinet's pockets. It is not charity from the government. Rather, the funds are from hard-earned taxpayers' money and it is only right that this money should be used for essential services for the people such as health care. The whole idea of taxation is to provide an element of cross subsidy so that nobody is denied such essential services because they cannot afford to pay.
Right now, the government is only spending a paltry 2 per cent of GDP on health care - well short of the 5 per cent recommended by the World Health Organisation. If the government were to spend more of public funds on such a critical area as health care, it wouldn't need to come up with fanciful ideas and ill-thought-out schemes to raise money to pay its specialists, doctors and other medical personnel. It would have enough funds to pay specialists and doctors higher salaries without taxing patients a second time through higher fees. (Remember, the public have already paid for public health care services the first time through taxation.)
Finally, Ismail may give us all kinds of arguments and assurances that his proposal for "full-paying patients" (to allow specialists to earn more) will not affect the poor. But the fact remains: once government specialists discover which side their bread is buttered, they can be expected to gravitate to the full-paying patients and spend more of their time and energy with them. Gradually, the non-"full-paying patients" will be subjected to second-class service, longer queues, and crowded wards.
This will result in two classes of patients and two types of services. In effect, better treatment from the best specialists will be provided to the rich (full-paying patients) while inferior service will be dished out to poor patients. Specialists will quite naturally devote more of their time and attention and energy to patients who will contribute more to their take-home income and less to those who cannot afford to pay. In the end, it will be the poor who suffer. So how can Ismail say that the poor will not be affected?
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