Asia Times: Malaysian people power wins health care back-down



	August 24, 1999	atimes.com

Southeast Asia

Malaysian people power wins health care back-down
By Anil Netto

PENANG, Malaysia - The Malaysian government's back-down on a controversial plan to ''corporatize'' government hospitals is a landmark victory for a citizens' campaign that had been gathering pace ahead of a looming general election.

The cabinet's recent decision that government hospitals would not be privatized came after months of intense public pressure marshalled by the Penang-based Citizen's Health Initiative (CHI), a loose network of 55 concerned groups launched in March 1998.

Though it would be easy to claim victory, activists are not letting down their guard, with many of them seeing the decision to abandon corporatization as an attempt to remove the issue from public debate ahead of the election. Many think the plan could yet be resurrected and steamrolled through if the ruling coalition wins the election.

The government decision came a week after a letter was sent to all political parties spelling out the CHI's demands. The turning point came when the Malaysian Trades Union Congress, an umbrella outfit for the country's various trade unions, delivered 10,000 signatures to the health minister in the early weeks of a high-profile CHI signature campaign.

''We welcome the decision but the timing makes us rather cautious,'' says epidemiologist Dr Chan Chee Khoon, the CHI co-ordinator, referring to the impending general election. ''We are now asking for firm actions that demonstrate commitment to meaningful changes to health care financing policy.''

The signature campaign began in late May when doctors at a state-run general hospital in Ipoh city, 170km south of here, circulated a letter to the health minister expressing concern over the privatization of general hospitals. Within a couple of weeks, more than 80 doctors at the city's hospital had endorsed the letter. Another 80 doctors attending the Malaysian Medical Association's annual general meeting in Penang in May added their signatures to the petition.

Instrumental in launching the campaign among doctors in Ipoh was consultant physician Dr Jeyakumar Devaraj, a Malaysian Medical Association award winner for his exemplary community health care service. But here's the catch: Devaraj has since been notified that he is to be uprooted from the Ipoh General Hospital, where he heads the respiratory unit, and posted to distant Sarawak state in north Borneo.

The MMA itself called for a moratorium on corporatization, a move endorsed by its members, who represent 80 percent of the nation's doctors. It joined the Malayan Nurses' Union, representing government service nurses, and the Estates Hospital Assistants Association of Malaysia in openly declaring skepticism and apprehension about the benefits of corporatization.

Government officials had said that corporatization was necessary to improve efficiency and relieve the burden of health care spending from the government. But activists argued that the government spends way too little - only 3 percent of GDP - to fund the public health care system. A marginal increase in funding, they said, would lead to tremendous improvements.

In an August 5 editorial of the New England Journal of Medicine, Dr Steffie Woolhandler and Dr David Himmelstein of Harvard Medical School reviewed extensive evidence revealing the human costs and institutional and systemic wastefulness and inefficiencies of investor-led, market-driven health care in the United States.

The evidence has long been clear to all but the most obtuse and dogmatic of pro-market fundamentalists, says Chan. The US health care system consumes 14 percent of GDP - double the Western European/Japanese average. Yet, it leaves 43 million residents without health insurance cover, including 10 million uninsured children - one out of every seven. Many more have inadequate cover for critical illness. The US has state-of-the-art medical technology, but its infant mortality rate is the second highest after Portugal among the 22 OECD countries.

Chan is alarmed at ''the multitude of US-based health care consultants purveying their wares in Malaysia, eagerly anticipating opportunities from a privatized 'sunrise' service industry with enticing growth potential''. He is now calling for an independent commission of inquiry to report on the necessary reforms needed for the organization, staffing and financing of public sector health care. He also wants the government to set up a permanent National Health Council with ''clearcut advisory and policy-setting powers in which the lay public through their civic representatives are effectively, adequately, and credibly represented''.

''There are many weaknesses within the existing system, and an open discussion of these is in order,'' says the senior physician quoted earlier. Health care costs have already been pushed up by the piecemeal privatization of hospital support services, he adds. ''Our call for an impartial evaluation of the cost benefits of these privatized services still remains relevant.''

Still, the cabinet's decision is good news for those who feel that an essential public service such as health care should remain the state's responsibility.

(Inter Press Service)

back to the top

©1999 Asia Times Online Co., Ltd.

Southeast Asia Sex News | Asian Sex Gazette