Ara Damansara

Source: theMalaysianInsider
By Shamini Darshni

FEB 15 — When the idea of a national health financing mechanism came up in the mid-2000s, the question of how the funding scheme would be implemented caused much concern.

As a journalist then with an interest in public health issues, I followed the arguments made, then observed how the idea of “the rich paying for the poor” disappeared.

Logic suggests that the then-proposed national health financing mechanism — or scheme, as it was also referred to — had gone back to the drawing board. Today, it seems that the same idea has been repackaged under 1 Care.

Rebranding aside, the idea of 1 Care is noble. But the sketchy details are worrying. Why a major announcement is made without being accompanied by proper details boggles me.

And yes, Mr Director-General, Malaysians are sensitive when it comes to parting with their money. How can we not be, when we already contribute to EPF, Socso, income tax, service tax, sin tax and a higher cost of living (my jaw dropped when 10 rolls of toilet paper and three packages of my favourite 3-in-1 coffee chalked up almost RM60)?

The DG had also said that the 11 technical working groups are still studying the 1 Care system and details on the paying mechanism will be revealed in due course. He goes on to say that apart from the RM34 billion set aside, the costs of medical visit and treatments will be borne by a central government agency that will pool contributions by “the government, employer, employee and those self-employed.”

He had said: “Under the idea, we optimise the system, you can choose your doctor and you can go to any clinic, private or government as the costs will be paid by an authority handled by the government… it’s very simple. Say you need to be hospitalised and this system allows you a two-person per ward stay, but if you want one which you don’t want to share, then you have to pay for that option.”

What happens to our insurance commitments? From where I sit, it seems like double payment for a single service. We need answers.

Under the existing two-tier system, there are still Malaysians unable to access even primary healthcare. I shudder to think what happens to the Orang Asli villager who suffers a heart attack, but lives a week away by boat or foot from the nearest hospital. Would 1 Care ensure that people with no access to healthcare in the first place be able to access their human right?

Or is 1 Care just going to be another fund that the government can tap into to provide housing for 20,000 people at our risk?

Would 1 Care include treatment for anti-retrovirals for people living with HIV, methadone replacement for drug users wanting to kick the habit, mental illnesses, and other diseases that insurance companies refuse to cover? Only then would 1 Care be useful.

I would be open to contributing if I knew my fellow Malaysians, irrespective of colour and creed, were getting the medical attention they needed, whatever the condition. But I would need to know that my contributions were safe from corruption and preferential treatment, and would not be a burden to my existing financial commitments.

Access to healthcare is undeniably important. If details on 1 Care were solid facts with proper statistics to show why we need to contribute to this programme instead of the government increasing the overall healthcare budget, perhaps we would be more open to hearing out the idea.

But with the latest move by the government to consider using EPF contributions so others can purchase homes, coupled with the National Feedlot Corp scandal, can we trust the government to protect our interests?
_______________________________________________________________________________________
Shamini served as a news journalist for some years and now works as a media and communications manager at a private university. When she’s not stabbing furiously at her computer, she’s in a bar somewhere drinking in great music or at home devouring her favourite authors. She can be reached at sdkalie7@gmail.com.

* The views expressed here are the personal opinion of the columnist.

Source: theSun Feb 15

PETALING JAYA: The controversial 1Care healthcare scheme may still be in the works, but the plan is full of unresolved obstacles and may be a case of putting the cart before the horse, an authority on healthcare financing said.

United Nations University International Institute of Global Health senior research fellow and health economics professor Datuk Dr. Syed Aljunid told theSun that the 1Care scheme needs to go back to the drawing board.

“Do we need a health financing system in this country? Yes, but 1Care as it is now is not feasible,” he said.

The healthcare financing scheme is aimed at providing quality healthcare for all citizens.

Syed, who is a consultant in healthcare financing for countries like Indonesia, the Philippines, United Arab Emirates and Saudi Arabia, said the scheme cannot work because Malaysia does not have a good healthcare costing framework.

“The reason we read about gross ballpark figures is because the ministry does not have a proper costing framework,” he said.

“That is putting the cart before the horse,” he said.

Syed was referring to Health Ministry officials who have repeatedly said that all the figures which have been reported in various blogs and media were only “ballpark figures” which have been misinterpreted.

Among the figures were 10% compulsory deductions to pay for the social healthcare scheme and limits of six visits to a doctor each year, both of which the ministry has dismissed as misinterpretations of estimated figures.

Syed warned that the scheme would fail if the government does not find a way to consolidate existing resources such as the Employee’s Provident Fund, Social Security Organizations, private healthcare insurance and income tax.

“We need a mechanism to bring these fragmented resources together and pool it into a social insurance, because in social insurance, people’s contribution alone is not enough,” he said.

Syed said the government needs to reorganize its health services before a national healthcare financing scheme can be formulated.

Meanwhile, a senior doctor also said the Health Ministry should make is health services more efficient before implementing a new system.

“The ministry should make itself more efficient, utilize its budget more effectively and trim the fat to improve its services” the doctor, who heads a department in a public hospital told theSun.

Malaysia Medical Association president Dr Mary Suma Cardosa, who is involved in the planning of 1Care, had told theSun previously that of all the unresolved issues plaguing the plan, the most contentious is the management of the funds.

“We will have to ensure there will be transparency and accountability and good governance in place, but many are sceptical and wary about whether this is possible,” she had said.

Source: Ampersand by KW Mak 13 Feb 2012

THERE is a proposal by the Petaling Jaya City Council (MBPJ) to redevelop the PJU1, PJU2, SS and PJS areas of Petaling Jaya (PJ). Details of these proposals are found in the Draft Special Area Plan and the council is invoking Section 16B of the Town and Country Planning Act (TCPA) 1976 for this exercise.

The public has until 29 Feb 2012 to file in their objections. It is very important that they do so because if the SAP is later gazetted, it can be used to justify any development in PJ without the need to consult the public any further. This is because MBPJ will be empowered to approve any development in these areas of PJ without consulting the public if the current plan is approved without public objection to change or abolish it.

If these plans are allowed to go through they will allow for more development and all the issues that come with development. They will help justify projects such as the two proposed elevated highways running through PJ. Thus, residents who are caught in the pathway of these highways have all the more reason to not want to see further development anywhere else within PJ.

Now that I have your attention, let’s examine the books in a little more detail for PJ residents who want to better argue out their objections.

Selangor Structure Plan

From a technical point of view, this Draft Plan is flawed since it does not reference the Selangor Structure Plan (SSP) at all. Under Section 16B(3) of the TCPA, the preparation of a special area plan shall be done in the same manner as the preparation of a local plan.

Section 12(8) of the TCPA, which governs the preparation of a local plan, states:

In formulating its proposals in a draft local plan, the local planning authority shall secure that the proposals conform generally to the structure plan for the State as it stands for the time being, whether or not it has come into effect, and shall have regard to any information and other considerations that appear to it to be relevant, or that may be prescribed, or that the Committee may in any particular case direct it to take into account. (Emphasis mine)

The SSP was gazetted in 2007 and contains numerous policies to ensure that any development within the state would be sustainable. One such policy is the need to identify the carrying capacity of an area to ensure that an area is not overdeveloped and subject to all sorts of traffic and social problems.

There is no mention of what the carrying capacity is for all the areas that the MBPJ has zoned for development. Yet the council has also gone ahead and slapped arbitrary plot ratio numbers of up to 4.0 on numerous empty plots of land. A plot ratio is a calculation that affects the density of a piece of property development. Property developers could thus demand to build their projects according to this unjustified plot ratio if the special area plans are approved and gazetted without objection.

Hidden information

There is a lot of “hidden” information within these books, as not all aspects of the proposal are detailed. Indeed, the worst offender is the Peta Gunatanah & Intensiti Pembangunan with maps devoid of landmarks requiring the reader to cross-reference with another map book to have an idea where the areas are.

These maps have the land use and plot ratio numbers slapped on top. So do not be surprised if one day you discover a huge building going up in that empty plot of land in your neighbourhood if you don’t do anything about it now.

On a final note, it is possible to challenge a gazetted plan. However, that would require a lawsuit (and a judgement in your favour), which is not the preferred method since that would be costly and even more time consuming.

Copies of the Draft Special Area Plan are available for purchase at the MBPJ headquarters on Jalan Yong Shook Lin. Call 03-7956 3544 ext 353, 411, 377 or 357 for details.
________________________________________________________________________________________
MBPJ councillor KW Mak has helped several resident groups object to development projects even for areas that have these development plans gazetted, but he is not paid for such work. He would rather not make a career out of this since it involves making enemies out of property developers. He has made quite a few property developers very angry during the three-and-a-half years he has served as councillor.

Doesn’t this park belong to the public of Ara Damansara?  But I’m beginning to get the impression that a certain quarter is claiming ownership of the park as indicated by the continued padlocking of this gate.  Personally, I have no issue if the gates are padlocked during the darkness hours.  But peak hours at the park is mornings and evenings and access to this public facility must be uninhibited no matter how many gates have been installed.  They MUST NOT be padlocked.

Source: the Star Feb 4

PETALING JAYA: The Health Ministry should scrap plans to change the entire healthcare system under the 1Care for 1Malaysia plan, said medical experts and concerned citizen groups.

Also, it is better for Malaysia to improve the current healthcare system instead of shaping the 1Care for 1Malaysia plan after foreign models.

Federation of Private Medical Practitioners Associations Malaysia president Dr Steven Chow said the Malaysian healthcare system had achieved remarkable results despite our relatively low healthcare expenditure.

“Why do we want to totally transform a system that is already working relatively well, with something entirely new that might not suit us at all?” Dr Chow asked at a press briefing recently.

Citing data from international organisations, Dr Chow said that Malaysia’s healthcare system was comparable to countries like the US, Britain and Singapore even though our healthcare spending was lower in GDP terms.

He said the country would only need to address some of the shortcomings of the current system to improve it, such as problem of wastage and under-productivity in the public sector.

Dr T. Jayabalan, the main coordinator of the Citizens’ Healthcare Coalition, said the ministry should talk to local experts, instead of foreign ones, on the best way to improve healthcare.

Voices of dissent against the proposed 1Care for 1Malaysia healthcare reforms have been mounting since members of the Citizens Healthcare Coalition posted “supposed details” of the plan.

These details include the claim that households will have to fork out 10% of their monthly income to fund a Social Health Insu- rance that will be used to finance the new system.

Although the Health Ministry had earlier clarified that the plan was still in its conceptual stage, some parties have claimed that parts of the plan are already being imple-mented.

Source: the Malaysian Insider

By Yow Hong Chieh
February 04, 2012

KUALA LUMPUR, Feb 4 — Putrajaya’s controversial 1 Care scheme, which critics claim will tax citizens and businesses monthly to foot the country’s growing healthcare bill, has already entered its “final stages”, Health Ministry officials told a pharmaceutical seminar last month.

This is despite the ministry’s repeated denials and assurance to the public that it is “too early” to sound warning bells about the scheme, believed to be in phase three of a five-phase implementation plan.

The Malaysian Insider understands that ministry officials had told the Malaysian Pharmaceutical Society (MPS) during a seminar on January 15 that it was already finalising 1 Care proposals and that a Pharmacy Act would be tabled at the next Parliament sitting in March to facilitate the transition to the new insurance scheme.

“The 1 Care transformation proposals are now in the final stages,” the ministry’s health policy and planning deputy director Dr Nordin Saleh had told MPS, according to the minutes of the seminar obtained by this news portal.

The Malaysian Insider understands that Health Ministry pharmacy board deputy director Azman Yahya had also explained that the new Pharmacy Act would see the government outsourcing the dispensing of prescription drugs to pharmacies.

Doctors, on the other hand, would only prescribe drugs identified in a standard list, which will be covered by 1 Care’s National Health Financing Scheme (NHFS), while patients will have to pay “out of pocket” for medicines not included in the list.

A drug pricing system may also be introduced once the standard list has been compiled and pharmacies will be reimbursed for all prescriptions, which will comprise mainly generic drugs whenever possible.

The proposed 1 Care scheme, which is fast turning into a political hot potato, is expected to replace the current two-tier healthcare system and force citizens and businesses to contributed nearly 10 per cent of their monthly earnings to a government-run insurance fund.

Under the current system, patients can choose to seek treatment at either private clinics or hospitals and pay out of their own pockets or opt for government clinics or hospitals instead, where they will pay a nominal fee for basic, federally subsidised healthcare.

Already, public outrage is fast growing over the prospect of additional taxes under Putrajaya’s bid to restructure Malaysia’s healthcare system, despite talk that the new scheme would ensure more equitable healthcare for Malaysians of all classes.

Leading the charge is the Citizens’ Healthcare Coalition (CHC), a group comprising medical practitioners and consumer associations that has taken its cause online.

The pact, which started off with some 17 associations, kicked off its “Tak Nak 1 Care” campaign last December using social media tools like Facebook, Twitter, blogs and YouTube to spread information about the scheme and gain wider public support.

The Health Ministry, however, yesterday assured critics that the 1 Care scheme will not burden the public with undue costs.

Its director-general, Datuk Seri Dr Hasan Abdul Rahman, said discussions on the types of financial arrangements that will be made available and their implication to the government as well as taxpayers were ongoing to ensure an acceptable healthcare financing model.

“Any assumption or conjecture on the mode of financial impact for the individual taxpayer is very premature at this stage as discussions are being held at the moment to ensure a positive and workable model,” he had said in a statement.

Dr Hasan added that the ministry was taking proactive steps to ensure that Malaysians would not be burdened by healthcare costs, even as they continued to spiral upwards.

Source: theSun Feb 3

PETALING JAYA: The Health Ministry yesterday sought to engage various quarters which have slung criticisms against 1Care for 1Malaysia, the national healthcare insurance scheme proposed by the ministry.

In a statement last night, Health Director-General Datuk Seri Hasan Abdul Rahman urged critics to engage the ministry through “face-to-face” briefings over the proposed programme.

” The ministry hopes that these groups will seek to understand Malaysia’s current healthcare transformation process for better health for all citizens,” he said, adding that the programme is still in its infancy.

“The programme is still at a drafting stage and it will be some time before the plan can be implemented.”

The 1Care programme, which was proposed by the ministry as early as 2009, is aimed at providing quality healthcare for all citizens regardless of financial ability, and to narrow the gap between the rich and the poor in terms of access to healthcare services.

It has come under fire from various groups, especially the “Tak Nak 1Care” (Don’t Want 1Care) Facebook group. Group administrators , who are anonymous, claim that the programme will deduct 10% from an individual’s monthly salary, and limit the number of visits allowed to a doctor to just six a year.

To do so, a national social health insurance will be set up, under a not-for-profit body within the ministry called the National Healthcare Financing Authority (NHFA).

“What the ministry wants is for all Malaysians to have more choices for healthcare, and to not worry about payment as the cost is paid by a central government agency (the NHRA) that pools contributions from the government, employers, employees and the self-employed,” Hasan said.

However, the Malaysian Medical Association (MMA) yesterday said the uncertainty surrounding the scheme has led to a lot of resistance and wariness towards it.

MMA president Dr Mary Suma Cardosa said that based on meetings with the ministry on 1Care, the plan is for the ministry to focus on legislation, governance, stewardship and public health, training and research, while health services will be provided through an autonomous healthcare delivery system (the NHFA).

The funding will come from a social health insurance together with a government contribution.

However, there has yet to be confirmed details of how much contribution is to be made, either by the government or the individuals.

Cardosa said that the most contentious aspect of the programme is the proposal to have social health insurance. “The biggest question is, how will this publicly pooled fund be managed, especially since it will run into billions of ringgit?”

She urged that a body consisting all stakeholders be set up to manage the fund and ensure transparency and openness.

A senior doctor, who declined to be named, however said the ministry should look into making itself more efficient before setting out to create a new healthcare system.

“As the single largest healthcare provider in the country, with over 100 hospitals and 14,000 clinics, the ministry should manage its services more efficiently and utilize the funds better.” he said.

Existing tunnel near Kelana Idaman

Source: theSun

PETALING JAYA (Jan 31, 2012) : A new bypass and tunnel will be built to ease the traffic congestion near Ara Damansara and Taman Kelana Idaman in Kelana Jaya.

Petaling Jaya Mayor Datuk Mohamad Roslan Sakiman said the project was to divert the traffic flow away from Jalan PJU 1a/4f leading to Taman Kelana Idaman.

Roslan said the RM21 million project, headed by the Petaling Jaya City Council (MBPJ), was to make sure road users do not end up clogging the tunnel which connects the Damansara-Puchong Highway (LDP) to the Subang Airport Road.

“We already have consultants working on the land acquisition and we expect it to be completed in 2013,” he said while explaining the plans to the media today with MBPJ Engineering Department director Cheremi Tarman.

The project is expected to start in a few months’ time.

Cheremi said the new tunnel will be parallel with the existing FAS tunnel that will lead to a new bypass to divert traffic to the Subang Airport Road without traversing any residential area.

The residents of Taman Kelana Idaman have been complaining about the heavy flow of traffic that goes through their neighbourhood as the FAS tunnel is the main access road for residents in Ara Damansara, Crimson Damansara, Taman Mayang, Taman Megah Mas and Taman Emas.

It is also the main access for road users from Petaling Jaya who use the LDP to go to Subang Jaya, USJ, Sungai Buloh, Kampung Melayu Subang and Shah Alam via the Subang Airport Road.

Another tunnel, the Megah Mas, was converted to one-way in August last year and is used by the residents to get to LDP.
MBPJ councillor Khairul Anuar Zainuddin told theSun the residents were aware of the plans but hoped for a solution while waiting for the construction to start.

Khairul said one of the suggestions was to build a slip road at Jalan 1A/4D leading into the compound of the PPR flats, effectively turning the whole road network into a one-way ring road but this turned down by the MBPJ infrastructure committee on Jan 12.

Source: Star Jan 31

PETALING JAYA: Protests by a Facebook group called #taknak1care has prompted the Health Ministry to take on some of the group’s claims against the ministry’s proposed healthcare reforms under the 1Care for 1Malaysia system.

Health deputy director-general (Medical) Datuk Dr Noor Hisham Abdullah, who joined the discussion on the group’s wall, said the plan was still at a conceptual stage.

“Nothing has been decided and the rakyat will be the first to know,” wrote Dr Noor Hisham in one of his first responses.

He added that speculation and assumptions were not going to help and people must give the new system a chance to be developed.

The Facebook group, citing ministry sources and some public documents, claimed the new healthcare system would be funded by the public through a compulsory contribution of 10% of their monthly income.

It had also claimed that the public would only be allowed to see their designated general practitioner a maximum of six times a year.

Dr Noor Hisham, in response to those claims, reiterated that it was premature to speculate and make an assumption on something the ministry had not studied in detail.

He, however, implied that the scheme might be, in part, funded by employees’ wages as he wrote “your salary goes to the scheme”.

Dr Noor Hisham also said the ministry had only started the first stage of transformation, which is the strengthening of existing healthcare services.

He noted that the Health Ministry would be assisted by the World Health Organisation and experts in healthcare reform when it proceeds to the second stage, which is to study various healthcare models.

According to an earlier article in The Star by Health director-general Datuk Seri Dr Hasan Abdul Rahman, the concept paper on 1Care for 1Malaysia had been presented to Prime Minister Datuk Seri Najib Tun Razak and members of the Economic Council in August 2009.

Consequently, the Health Mi­­nistry had received the mandate to develop the 1Care blueprint.