GST on Medicine: The conflict

There it is again, a time when I was so busy with my work and study and I can't even keep on writing on the story of Doctor in Malaysia for quite some times. I've been working at it, there were so many thing that can be told regarding what we do in our life. Just like pilot, engineer, soldier, teacher, labourer, the story of medical doctor is interesting.

However, this time I want to discuss an issue out of that topic. This maybe a little political but I will try not to be. I just want people out there to understand that there is something wrong with the current health system in Malaysia. I believe everyone already knew about it, yet many do not want to admit it as a problem.

GST (Goods and Service Tax) was implemented in our country for the sake of supporting our economy as the oil price going down everyday. Oil is cheap, and oil is not a good business now compare to years ago where oil was claimed to be a black gold. I am not against GST as many countries in the world are using it to support their economy. Maybe it was just a bad time to announce it in Malaysia few years ago when government was drowning in a lot of corruption and mismanagement of public funds. They still drowning now, still not dead though. However, it is inevitable. Those taxes need to be implemented as soon as possible even though the corruption and mismanagement of funds are still not resolve until today. It was a bad news for us.

So there a few things that was 'exempted' from GST, one of it is medicine. All citizens in Malaysia went crazy if GST is implemented in medicine. This is because everyone are pampered by the free health care system. We do not need to pay even if we should. For us, health is much more important but yet we do not want to pay for it.

I met a doctor few years ago, she was specialised in Palliative Care medicine and she was a very humble and philosophical person. I will never forget what she told me. She said that the purpose of our saved money is to pay for our health. Not for cars, not for handphone, not for our children. But for our health when we were sick. Its true but not many think this way. We always think that we kept our money in the bank just to make sure that we can afford to buy those fancy car or houses. What is a fancy house if we were to live our lives in hospital until we die? Those money in our banks, should be spend to pay for our health cost (yes we can save extra for those fancy house). We should not be cheap in regards of our health. So there is no excuse for us to say I have no money for that scan, I have no money for that medicine, I have no money to pay the hospital bill. This reflect how poor our financial and health planning, which for most people, health is the most important thing.

Not many have such commitment to save money just to spend it when they are sick. That is why we buy insurance. Health insurance not just helping us plan our money, it also help other people who are sick to pay their bills when we are still healthy. But let us leave the discussion about health insurance in the other chapter (maybe).

Let's go back to GST. So people do not want to pay their medical bills. They want free health care. If government ask to pay medical bill, no vote for the government and no vote is bad in politics. Even if they need to sell their soul to the devil, they will do it just to get a vote. The problem happens, when there are no GST in health, this only favour the citizen but not the health system itself. When I say health system, it was no robot or machine, it was real human being, people just like other citizen working inside that system.

To simplified things, citizens do not need to pay GST, hospital cannot charge GST, however hospital need to pay for GST for everything they need to provide for the people. It does not make sense. For example, a patient pay RM1 for all the consultation and medicine he gets, the pharmaceutical company charge GST for that medicine to the hospital, and all the imaging procedure, lab reagent, and many more, everything have GST on them. So all this GST are absorbed by the health system.

This is worse for private hospital and semi private hospital such as University hospital where no money is allocated for them from the government to pay for their expenses. Years by years, all the GST absorbed will be like millions and millions of ringgit. In the end, there are only two things to do. One, increase the price so patient pays more, or second, do nothing, let reagent runs out, medicine runs out, people will received a non optimum treatment.

For government hospital, cheaper cheaper generic medicine is given to patient, reduction in hospital staff allowances, reduction in reagent in lab, everything that will make treatment for patient not the level where it should be. The optimum treatment is expensive. We can't afford that. We can't afford to absorb more and more GST. We were already 20 years behind in regards of health care compare to other developed countries.

There will be days where everything will turn out to be a disaster later. We hope those days will be long before it come. I believe however, government will realise this, at least put aside the political or vote seeker attitude, and think for the real benefit for the people. Something must be done. It must be done fast.

* I remember government trying to implement something like an insurance or something like Obama Care before the last election. People opposed it by threatening not to vote and those proposal disappear. I think it was good, its like you are paying in advance to help those who are sick and when you are sick, other people will help to pay the bills for you. Just like insurance. Who knows this could save our health care system in the future. As for now, it is dying.


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