Money Talks : Transforming and restructuring healthcare to save cost – does it work?

The often given reason to transform and re-structure is money. It is often said that we are spending too much on health (3.6% of GDP in 2007 and 7% of total country expenditure). So we must cut down. For some reason, the rationale for this escapes me. We are hoping to spend even less and hoping to get better or equivalent healthcare. In others words, we wish to live longer and better while cutting down expenditure. I suppose the only way is to cut down the “leakages” in the system.

Anyway, the Government is looking at cutting down healthcare expenditure, saying that it can no longer afford to spend so much on healthcare. It is almost universal that when governments look to save healthcare cost, they turn to organisations to manage medical care for an agreed sum of money. So the government will set aside a certain amount of money (let’s say RM30bil), and ask the business managers to control healthcare spending.



What is the worldwide experience with SHIO?

In one simple word, BAD. In the US, some MCOs have, after collecting the money, defaulted and declared bankruptcy. MCOs have not done much good in the US. They are about to reform to come nearer to our system, if politics allow, with a public option. The UK-NHS system is full of shortcomings. There is still a waiting-list. Ask Singapore’s Minister Mentor about his experience when his wife fell ill in UK. That is why many from the UK and US come over to Thailand, India, South Africa, Singapore, and some to Malaysia, to get healthcare (medical tourism).