Healthcare or sickcare?

WHEN was the last time you read or heard Health Ministry officials or the minister talking about the need for Malaysians to stay healthy and the ways to achieve it?

As far as I am concerned, it's been such a long time or a rare occasion that such a thing has happened.

What have been frequently promoted or announced are matters like the government is building more clinics and hospitals or upgrading existing facilities to give the people a higher standard of healthcare.

We as citizens are always grateful for this because Malaysia is recognised internationally as having one of the world's best public healthcare services and certainly the cheapest. And treatment is provided virtually free in government hospitals and clinics in every nook and corner of the country.

But from the public relations point of view, news of more healthcare facilities being made available – though necessary – only indicates that the number of people falling sick is always on the rise and even outstripping in percentage terms the increase in population.

Just look at the congestion in government hospitals where there is a very long queue for beds. At times patients are turned away unless they require emergency treatment.

And at the outpatient sections at these hospitals people start arriving early in the morning to get their queue numbers.

When do most Malaysians visit a healthcare practitioner? When they are sick. So by right we should tag it as sickcare and not healthcare.

By and large, Malaysia still adopts a fire-fighting mentality when it comes to health. We only address health problems when we get there.

Visit our healthcare centres from government clinics right up to tertiary referral centres and you will see patients being prescribed drug after drug.

This begs the question as to whether dependency on drugs is a permanent solution for our healthcare?

In other words, we are focusing on improvement of healthcare centres at the expense of preventive measures, which are not only better but cheaper.

The Health Ministry must invest a fraction of its multi-billion ringgit annual budget on health education. The rationale for this is that sickcare is eating into our economy.

For example, childhood obesity is rising at an alarming rate and 80% of obese children, according to findings, will go on to become obese adults.

Medical experts say childhood obesity if not addressed early will be a medical timebomb if not now surely in the near future. And this would mean an obese and diseased, and by extension unproductive population.

And one thing is certain – the cost of sickcare will rise exponentially as our population is poorly educated about healthcare but overly dependent on sickcare.
What is the way out?

Dr Prashant Subramanian, who has a Masters in Preventive Health and Wellness, said to begin with, the health and education ministries must collaborate to have healthcare and nutritional classes in all schools.

"Go back to basics for healthcare. Educate the masses and engage them from the grassroots level. And educate the heathcare practitioners not to be trigger-happy and dispense drugs freely. Instead, judiciously approach every patient and wholesomely treat the individual," he told me.

He advocated a promotional blitz on preventive health as a mainstream subject as well as creating specialists in this field.

As Prashant put it: "Make prevention glamorous. Not just plastic surgeons or physicians are made to sound and look sexy."

He said a specific budget ought to be allocated for grassroots preventive programmes while introducing a key performance indicator (KPI) for the country's 1.6 million civil servants to "force" them to maintain a healthy body mass index (BMI) for job promotions. BMI refers to the ratio of weight to height that indicates relative obesity.

Health Minister Datuk Seri Dr S. Subramaniam revealed recently that it cost the government about RM2 billion annually just to pay for medicines for its 1.6 million civil servants! And if you add the costs of their hospitalisation and after-care, the amount can be mind-boggling.

Repeat business for the pharmaceutical industry, said Prashant, should not be the order of the day, just as there should not be a lifelong dependency on sickcare.

This also means a lifelong dependency on drugs which will only lead to reduced efficiency of our society and a huge burden on the economy as costs become unsustainable.

Prashant proposed a lifelong healthcare approach where all levels of society are encouraged to stay healthy and given tax breaks as incentives for a healthy BMI.

Another step is to increase tax on the 24-hour eateries and by increasing the price of food sold after midnight to discourage people from sacrificing their sleeping hours by eating the night away which is a health hazard.

Malaysians love two things – eating and public holidays. On this score, Prashant said: "Why don't we eat right and spend our public holidays healthily instead of working towards the 'Sickcare Trap'."