KENYATAAN MEDIA : MEMPERBAIKI SISTEM SEDIA ADA LEBIH BAIK DARIPADA CADANGAN 1CARE

MEMPERBAIKI SISTEM SEDIA ADA LEBIH BAIK DARIPADA CADANGAN 1CARE

Pihak kerajaan tersilap sekiranya mereka memikirkan cadangan skim 1Care merupakan penyelesaian terbaik bagi mengatasi cabaran yang membelenggu sistem kesihatan Malaysia. Menerusi skim ini, rakyat berserta pekerja dan kerajaan akan menyumbang kepada skim pembiayaan kesihatan di mana pihak hospital kerajaan dan swasta akan diintegrasikan.

Di dalam kertas konsep skim ini yang dibentangkan pada 2009, ‘1Care for 1Malaysia: Restructuring the Malaysian Health System’, kerajaan mendakwa dasar baru diperlukan berikutan sistem penyampaian perkhidmatan dan pembiayaan kesihatan yang tidak mapan di negara kita.

Pertubuhan Kesihatan Sedunia (WHO) mengesyorkan agar perbelanjaan kesihatan kerajaan sebagai peratusan kepada Keluaran Dalam Negeri Kasar (KDNK) sepatutnya pada kadar 5 hingga 6 peratus. Jumlah perbelanjaan kesihatan Malaysia pada 2008 merupakan 4.8 peratus namun perbelanjaan kerajaan hanyalah 2.2 peratus. Pada 2004, buat pertama kalinya perbelanjaan kesihatan swasta sebagai peratus KDNK mengatasi perbelanjaan kesihatan kerajaan.

Cadangan bahawa sekitar 10 peratus gaji pekerja dipotong untuk disumbang ke skim pembiayaan kesihatan akan menambah beban yang dipikul rakyat. Pada masa ini, pekerja dibelenggu gaji yang rendah dan berhadapan dengan kos sara hidup yang meningkat. Ditambah pula dengan gejala rasuah dan ketirisan di dalam perbelanjaan kerajaan (termasuk kesihatan) kerajaan seharusnya dapat menjangka kemarahan rakyat terhadap cadangan 1Care ini.

Kami tidak mempertikaikan bahawa wujud cabaran di dalam skim kesihatan negara yang sedia ada. Jurang antara hospital kerajaan dan swasta semakin melebar. Keperluan untuk mengurangkan penghijrahan kepakaran daripada hospital kerajaan ke hospital swasta tidak boleh dinafikan. Rakyat Malaysia tidak boleh terus bergantung kepada bayaran terus daripada kcek mereka bagi rawatan perubatan.

Pun begitu sudah wujud begitu banyak usaha penstrukturan sebelum ini yang dibuat tanpa proses yang betul dan telus yang berakhir dengan masalah yang lebih besar untuk rakyat. Hospital-hospital kerajaan kita menjadi mangsa proses penswastaan perkhidmatan asas yang meningkatkan keuntungan untuk syarikat-syarikat kroni namun merugikan para pembayar cukai dan pesakit. Laporan Kesihatan Sedunia 2010 mengenai Pembiayaan Sistem Kesihatan oleh WHO jelas menyebut antara 20 hingga 40 peratus perbelanjaan kesihatan dibazirkan berikutan kekurangan kecekapan sistem. 1Care bermakna akhirnya rakyat dan kerajaan akan memberi subsidi kepada hospital swasta seperti mana kolej swasta hari ini disubsidikan oleh skim PTPTN.

Kami ingin menegaskan bahawa kami bukannya menentang hospital swasta. Malah, sektor kesihatan swasta menyediakan perkhidmatan yang berguna bagi rakyat Malaysia yang mampu dan sewajarnya dibenarkan meneruskan perkhidmatan tersebut. Walaubagaimanapun integrasi yang disyorkan oleh 1Care akan menyekat hak ini dan tidak mencapai piawai penyeragaman kualiti.

Kami menggesa kerajaan untuk tampil kehadapan secara telus tentang peringkat mana perancangan 1Care buat masa ini. Terdapat terlalu banyak jawapan bercanggah yang tidak memberikan keyakinan kepada semua pihak terbabit di dalam suatu perubahan besar sistem kesihatan negara.

Sebagaimana komitmen kami di dalam buku jingga, Pakatan Rakyat berjanji untuk memelihara kesihatan sebagai satu hak untuk semua rakyat Malaysia. Kami percaya penyelasaiannya bukanlah 1Care, sebaliknya peningkatan peratusan perbelanjaan kerajaan untuk kesihatan dalam tempoh beberapa tahun bagi melebarkan kekuatan infrastruktur asas kesihatan yang ada di Malaysia hari ini.

Pakatan Rakyat akan membentuk Suruhanjaya Perkhidmatan Kesihatan bagi meningkatkan mutu perkhidmatan, meningkatan pendapatan pekerja sektor kesihatan, menjamin perlantikan berasaskan kelayakan, meastikan perbekalan yang telus dan mengkaji semula perkhidmatan yang diswastakan di hospital-hospital kerajaan.

DATO SERI DR WAN AZIZAH WAN ISMAIL

PRESIDEN

PARTI KEADILAN RAKYAT

IMPROVING PRESENT SYSTEM BETTER THAN 1CARE PROPOSAL

The government is mistaken if it thinks that the proposed 1Care healthcare policy will be the best way to overcome the challenges plaguing Malaysia’s healthcare system. Under the proposal, the rakyat as well as both employers and the government are expected to contribute to a health financing scheme in which private and public healthcare providers will be integrated.

In the 2009 concept paper for the scheme, ‘1Care for 1Malaysia: Restructuring the Malaysian Health System’, it was claimed that the new policy is needed due to the unsustainable nature of healthcare delivery and financing in Malaysia.

The World Health Organisation recommends that government expenditure for health as a percentage for GDP should be between 5 to 6 per cent. Malaysia’s total health expenditure in 2008 was 4.8 per cent but government expenditure was only 2.2 per cent. In 2004, private health expenditure as a percentage for GDP overtook government health expenditure for the first time.

The proposal that approximately 10 per cent of workers’ salaries would be contributed to the health financing scheme will further burden the rakyat. At present, they are stuck in the middle income trap of low wages and rising costs. This situation will be further exacerbated when the government introduces a goods and services tax soon. Combine this with the endemic corruption and leakages that plague government expenditure (including health) it should not surprise the government if the rakyat rise up in anger at the 1Care proposal.

We do not dispute that there are challenges under the present healthcare system in the country. There is a growing gap between government and private hospitals. There is a need to stem the tide of migration from government to private hospitals. Malaysians cannot continue to rely on out-of pocket treatments for their healthcare.

Yet there have been many restructuring attempts in the past where decisions taken without a proper and transparent consultation process ended with bigger problems for the rakyat. Our government hospitals have not been spared from the privatisation of essential services that have increased profits for select-few companies at the expense of the taxpayers and patients. The 2010 World Health Report on Health Systems Financing by WHO clearly states that 20 to 40 per cent of health expenditure is wasted due to inefficiency. 1Care ultimately means that the rakyat and government will be subsidising private hospitals in a manner similar to that of private colleges today under the PTPTN scheme.

It is important to note that we are not against private hospitals. In fact, we believe they provide a useful service particularly to Malaysians who can afford them and should continue to do so. The integration proposed by 1Care however will deny the choice for a segment of Malaysians and do not hold up to any quality standardisation.

We call upon the government to be transparent regarding the stage at which 1Care is at the moment. There have been conflicting answers that do not increase the confidence of stakeholders in a major shake-up of the nation’s healthcare system.

Pakatan Rakyat, as underlined in our Buku Jingga, is committed to protecting healthcare as a right for all Malaysians. We believe that rather than implementing this new 1Care proposal, the government should increase the percentage of government expenditure for health over a span of a few years to leverage on the good basic health infrastructure available in the country.

We would look into the formation of a Health Service Commission that is committed to improve the quality of service, increase the remuneration of health personnel, guarantee appointments based on merit, ensure transparent procurement and re-examine privatised services in government hospitals.

DATO SERI DR WAN AZIZAH WAN ISMAIL

PRESIDENT

PARTI KEADILAN RAKYAT

About wanazizahblog

President of Parti keADILan
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