Manifestations of reorientation
The shift away from the universal welfare model of public health care has been manifested in a number of policy decisions. These have included moves to generate greater income from co-payments, the promotion of private insurance and savings for health care costs, and the encouragement of health service provision as a benevolent act by non-government organizations, charitable bodies and firms. Other manifestations have been the corporatization of some hospitals, the privatization of some services and the active fostering of the commercial private health care sector. For some years the government has indicated its intention to overhaul its policies on subsidies for health care in public institutions. The government is concerned that only about 5% of hospital operating costs are met through co-payments and that many of the patients enjoying heavily subsidized treatment can afford to pay a greater share of the costs. Moves to increase charges in public hospitals and government health clinics have been supported by the Malaysian Medical Association which wants such charges to be the same in both the public and private sectors.To date, however, substantial fee increases have not been introduced for Malaysians, although some haemodialysis services have been transferred to private providers with an attendant rise in fees. Among the schemes for financing health care recently articulated in public policy have been savings, private insurance and employer-funded private coverage. In order to enable patients to be able to pay a greater share of the costs of their treatment in public hospitals, or to seek treatment in private hospitals, the
government instituted reforms to the Employees Provident Fund (EPF), Malaysia’s compulsory retirement fund in which 23% of an employee’s wages are held. In 1994 a scheme was introduced allowing up to 10% of an individual’s EPF balance to be drawn upon to pay for medical treatment of critical conditions such as heart diseases, kidney failure and cancer. In keeping with the government’s desire to promote a family-based welfare system, the scheme can also be used to pay for the medical care of members of the immediate family of the fund-holder. In the 1996 Budget, tax relief for approved pension funds and life insurance premiums were increased by RM 2000 to a total of RM 7000 in order to encourage savings for health and health insurance coverage [17]. The government has also stated its intention to require all larger companies to provide free or subsidized health care to their workers as part of their terms of employment [18]. These comparatively minor policy changes have occurred despite the government’s oft-stated intention ultimately to introduce some form of national health insurance system.
ลักษณะของ reorientationThe shift away from the universal welfare model of public health care has been manifested in a number of policy decisions. These have included moves to generate greater income from co-payments, the promotion of private insurance and savings for health care costs, and the encouragement of health service provision as a benevolent act by non-government organizations, charitable bodies and firms. Other manifestations have been the corporatization of some hospitals, the privatization of some services and the active fostering of the commercial private health care sector. For some years the government has indicated its intention to overhaul its policies on subsidies for health care in public institutions. The government is concerned that only about 5% of hospital operating costs are met through co-payments and that many of the patients enjoying heavily subsidized treatment can afford to pay a greater share of the costs. Moves to increase charges in public hospitals and government health clinics have been supported by the Malaysian Medical Association which wants such charges to be the same in both the public and private sectors.To date, however, substantial fee increases have not been introduced for Malaysians, although some haemodialysis services have been transferred to private providers with an attendant rise in fees. Among the schemes for financing health care recently articulated in public policy have been savings, private insurance and employer-funded private coverage. In order to enable patients to be able to pay a greater share of the costs of their treatment in public hospitals, or to seek treatment in private hospitals, theรัฐบาลโลกเพื่อพนักงานสำรองเลี้ยงชีพกองทุน (EPF), กองทุนเกษียณอายุภาคบังคับของมาเลเซียมีขึ้น 23% ของค่าจ้างของพนักงานซึ่งการปฏิรูป ในปี 1994 แผนถูกนำให้ถึง 10% ของยอดดุล EPF ของแต่ละที่จะใช้เมื่อชำระค่ารักษาพยาบาลของเงื่อนไขสำคัญเช่นไตล้มเหลว โรคหัวใจ และมะเร็ง เพื่อความต้องการของรัฐบาลเพื่อส่งเสริมระบบสวัสดิการพื้นฐานครอบครัว โครงร่างยังสามารถใช้ชำระค่ารักษาดูแลสมาชิกของครอบครัวของผู้กอง ในงบประมาณปี 1996 บรรเทาภาษีเงินบำนาญที่ได้รับอนุมัติทุนและเบี้ยประกันชีวิตได้เพิ่มขึ้น โดย RM 2000 จำนวน RM 7000 เพื่อสร้างเสริมให้สำหรับสุขภาพและประกันสุขภาพครอบคลุม [17] รัฐบาลได้ระบุเจตนารมณ์ต้องการบริษัทขนาดใหญ่ทั้งหมดให้ฟรี หรือทดแทนกันได้ดูแลสุขภาพของแรงงานเป็นส่วนหนึ่งของเงื่อนไขของการจ้างงาน [18] เปลี่ยนแปลงนโยบายที่ดีอย่างหนึ่งรองเหล่านี้เกิดขึ้นแม้ความตั้งใจของรัฐบาลระบุ oft สุดแนะนำรูปแบบของระบบประกันสุขภาพแห่งชาติ
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