Transcript A Discourse on Politics and Current Issues in Health Care System in

A Discourse on Politics and
Current Issues in Healthcare
System in Malaysia.
Hariz Iskandar Hassan
Chapter 1: Politics in
Medicine
The Constitution
Every medical practitioner in Malaysia must be
fully registered with Malaysian Medical Council
(MMC).
 Medical Act 1971
 Ministry of Health - led by the Minister of Health
 Minister of Health appointed by the Prime
Minister after General Election (held every 5
years) – appointment of officers at all levels.

Extent of Power
Administration
 Development of new healthcare services
e.g hospitals, clinics, vaccination, etc.
 Appointment – Dismissal
 Budget
 Etc…

Politicians vs. Physicians
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Very few politicians are medically oriented.
Implementation of new system.
Small number of medical representatives in the
parliament.
Politicians have a greater power.
They have no experience or direct contact.
Personal agenda.
Not all physicians are united –
societies/associations registered but not active.
When Do Problems Arise?
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Politicians and physicians do not agree on the
new system (either proposed or have been
implemented).
Current example: Alternative Medicine.
Money wasted.
Rigid regulations
Unnecessary examinations for physicians e.g
endless tests on patriotism, patriotic camps for
every promotion etc.
Corruption at all levels/ Institutional corruption.
Worldwide Corruption Perceptions
published by Transparency
International
The higher the index – more transparent,
less corrupt.
 In 2007:
 Malaysia – 43rd, 5.1%
 Czech Republic – 41st, 5.2%
 The most transparent country is Denmark.
 The least transparent country is Somalia.
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Consequences
The public who suffer.
 Prolong development of healthcare
system.
 Physicians are not able to work efficiently.
 Research programs are not fully funded.
 Lack of understanding and cooperation.
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Proposed Solutions
A separate body which is independent of any
political party or political agenda must be
formed in regulating any health issues that
matter.
 Minimize corruption – new laws and regulations.
 Leave the medical practice to those who are
qualified – only get involved when it is needed.
 Unnecessary implementation of new system
must be reviewed by those who are qualified.

Chapter 2: Public Service
vs. Private Service
Healthcare Services
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The percentage of GDP spent by Malaysia on
healthcare services is below 5%.
In 2003 - total expenditure 3.8% of GDP
2.2% - Public Sector
1.6% - Private Sector
(In the US, >14% of GDP spent on healthcare
services)
Human Development Report in 2006 by UNDP
Percentage of GDP spent on Healthcare
Services
1.60%
2.20%
Healthcare Services
2004 – Private sector in Malaysia only
accounted for 20% of the country’s
hospital beds.
 It employed almost 54% of the doctors in
Malaysia.
 1990-2004  70 Physicians for 100000
patients.
 70% of specialists are in private sector.
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Problems
Imparity between public service and
private service.
 Lack of quality in public service:
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– Understaffed
– physicians working long hours
– quality of treatment
– long waiting list

The use of advanced treatment in private
service.
Problems
Private sector appeals more to the
physicians due to higher salaries and
better working environment – stiff
competition.
 Current implementations of healthcare
service like medical hub in SEA, alternative
medicine, health tourism are not effective!
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Consequences to the Public
Not everyone can afford private service.
 People in Malaysia are not exposed to the
importance of health insurance – very few
are covered.
 Danger in treating patients as there is a
lack of medical practitioners including
nurses.
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Proposed Solutions
A better scheme should be introduced to
attract more physicians to stay in the
government service e.g higher salary,
opportunity of research and further
training.
 Money should be spent wisely – improve
the service for the public -> the ministers
should take note.
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Chapter 3: The Influence of
Religious and Cultural Belief
in Medical Practice.
Problems
Extreme religious group of physicians exist
in Malaysia (especially when they come
back from overseas).
 Narrow minded thinking.
 Against a few ideas in medicine e.g direct
contact between men and women.
 Superstitious ideas of treatment and cure.
 Alternative medicine which has not been
proven by scientific research.
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Alternative Medicine
Not all alternative medicines have been proven
effective – no cross reactions tests and chemical
analysis.
 1997 - Americans spent USD 3.24 billion on
herbal products and herbal medication whereas
Malaysians spent USD 2 billion.
 Each American spent about RM45 on herbals,
each Malaysian spent RM91, which is twice as
much, taking into account populations of 273
million and 22 million respectively.
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Alternative Medicine
Alternative medical practice is based on the
influence of culture and religion.
 It is also a ‘promising’ business with high profits.
 Some doctors are against it but some have been
supportive especially in Malaysia.
 Prime Minister announced in Oct 2007 –
Malaysia will invest more than RM200mil
(~USD90mil).
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Prejudice
HIV/AIDS patients have to pay twice the service
fee in some hospitals in Malaysia e.g HUKM.
 Sexual Transmitted Diseases and Sexual
Education are considered taboo.
 But sex before marriage is high regardless of
religions and races – people are in denial.
 Homosexuality – discrimination due to
misunderstanding and lack of knowledge.
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Solutions
Education
 Physicians must be open minded – no
discrimination.
 Every delicate issue must be handled
professionally.
 Not just medically oriented but all
rounded.
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References
http://www.pmo.gov.my/WebNotesApp/PastPM.nsf/a310
590c7cafaaae48256db4001773ea/e59bbd5eccda3c3b482
5674a002235e5?OpenDocument
 http://msia-indians.blogspot.com/2007/02/overview-ofmalaysias-healthcare-system_17.html
 http://www.annals.edu.sg/pdf/35VolNo1200601/V35N1p
60.pdf
 http://www.mma.org.my
 http://www.hospitals-malaysia.org
 http://www.mmc.gov.my
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