Widen access to healthcare for the B40
WHILE we applaud the introduction of the mySalam insurance scheme for the B40 group, we would like to know the rationale behind why early cancers diagnosed before Jan 1, 2019 are currently excluded. Is the government saying that patients who were diagnosed earlier are just unlucky to have missed the boat?
We understand that this income replacement payment is the first of its kind to help the B40, but the government surely knows that RM8,000 is certainly not enough to help support patients while they undergo treatment for critical illnesses such as cancer.
Even when a person is using public hospitals, both the cost of treatment and loss of income can be crippling.
In public hospitals, most medicines may be given free or are heavily subsidised. However, advanced drugs such as targeted therapies are either unavailable or will need to be purchased privately by patients. Most likely, this is where the money from mySalam will end up being spent – on expensive medicines necessary for survival.
Even as an income replacement during cancer treatment, it still falls short. B40 households have a monthly income of RM4,000 or less, so that one-time payment is equivalent to two months’ treatment. But most cancer treatments exceed that period, ranging from six months to one year, depending on each case even for early stage cancer patients.
In the case of Sarawak, there is only one Sarawak General Hospital (SGH) in the whole city of Kuching that is equipped with an oncology or cancer unit. Patients who live in other towns or rural areas will have to travel long distances (an 800km drive from Miri to Kuching, for example) to receive treatment in the SGH.
Costs involved in seeking or obtaining treatment include air tickets, accommodation and time off from work. It can be, and is, an expensive exercise.
In most cases, patients would need a primary caregiver to be with them at all times. That would easily double up the cost incurred. Will they get paid for all the leave they take? What if they are dependent solely on wages which are paid daily? The time spent by outstation patients to seek treatment is certainly longer compared to patients residing in Kuching.
It’s now two months since the implementation of the mySalam scheme, but the only news from the Finance Ministry is that out of over 1,000 mySalam applicants so far, only two have successfully received the RM8,000 benefit.
Is the mechanism to review and process applications working well? Why is the success rate so low? How is the application process being tracked to ensure timely disbursement of the fund to benefit the B40 group who are in need of this financial aid?
According to press reports, the Health Ministry’s “Peduli Kesihatan” for the B40 (PeKa B40) is expected to benefit 800,000 Malaysians above the age of 50 beginning March this year.
Considering that PeKa B40 is starting with just RM100mil, it is clear that there will be limits in the programme coverage. We hope to see in 2020 an increased budget to cater for younger Malaysians, including those in their 30s and 40s. Cancer, like many other diseases and illnesses, afflicts people regardless of age.
The government has recruited private facilities to conduct health screenings under the Peka B40 programme. In the long run, we need to ensure that screening and treatment services are made available in most major public hospitals and oncology units across the country. In Sarawak, only the SGH in Kuching has the core cancer screening and treatment facility. No other public healthcare centre has these services.
We hope the government will monitor the implementation of both schemes and take the actions necessary to improve their supporting structures so that they would really bring benefits to the needy in the B40 group.
Lastly, the Health Ministry should also study successful healthcare systems or models used in other countries such as Australia (medical personnel in private clinics see patients and claim from government) and Singapore (through the Central Provident Fund), take the best from each and have what works for us. Thailand and Sri Lanka’s HAQ (Healthcare Access and Quality) index was not much different from where Malaysia was in 2000. Yet, both countries have since improved their ranking, leaving Malaysia behind as per the latest HAQ in 2016. What did these countries do to improve that we didn’t?
If we are to say that we have achieved universal healthcare coverage and apparently have the best healthcare service in the world, surely we can do better and ensure that no one is left behind.
After all, access to health is a human right.
SEW BOON LUI President Society for Cancer Advocacy & AwareNess (SCAN) Kuching