Two significant announcements on the health sector were made in the Finance Minister’s budget speech in November 2018, i.e. the B40 Health Protection Fund and the nationwide health screening programme, Skim Perlindungan Kesihatan (Peka).
The minister stated that “the Government will pilot a national B40 Health Protection Fund to provide free protection against the top four critical illnesses for up to RM8,000 and up to 14 days of hospitalisation income cover at RM50 per day”.
Since then, it has been announced that the number of illnesses has been increased to 36.
Illness does not recognise classifications into B40, M40 or T20, which is based on a monetary number and does not take into account family size, cost of living at place of residence, etc.
Everyone knows that the same ringgit has different purchasing power in different parts of the country.
Many Malaysians have incurred catastrophic health expenditure (CHE) when there is a critical illness like heart attack, stroke, cancer, etc.
Some households have had to borrow money or sell assets to finance their healthcare; earn less due to deteriorated health condition(s); become impoverished after paying for healthcare services; and become even poorer for those already below the poverty line, due to healthcare expenditures.
The reports of CHE studies in Malaysia are disturbing, to say the least.
An Asean study reported that the proportion of previously solvent patients who experienced economic hardship following a cancer diagnosis was highest in Malaysia (45%) and Indonesia (42%), and lowest in Thailand (16%).
A National Heart Institute (IJN) study concluded that the economic impact of ischaemic heart disease (IHD) in Malaysia “was considerable and the prospect of economic hardship likely to persist over the years due to the long-standing nature of IHD”.
B40 Health Protection Fund
Whether the B40 will benefit from the Health Protection Fund is a moot question when they already have access to virtually free healthcare at public healthcare clinics and hospitals.
Whether consideration has been given to the size of private hospital bills is pertinent.
The total bill for some acute conditions in private hospitals may amount to RM8,000 or less.
However, many private hospital bills exceed RM8,000, particularly in critical illnesses that are chronic in nature, e.g. heart attack, stroke and cancer.
When the insurance or personal financial limit is reached, transfer to a public hospital will almost always be inevitable.
However, the fact that has not been made known is the current practice of the imposition of the First Class treatment charges under the Fees (Medical) (Amendment) Order 2017 on all patients referred from private hospitals.
These First Class treatment charges are considerably higher than those for patients referred from public clinics or hospitals.
Unless the practice is changed, anyone in the B40 Health Protection Fund can end up saddled with hefty bills, i.e. CHE from both private and public hospitals, particularly when there is a chronic condition.
It would be more advantageous for the B40 not to enrol in the Health Protection Fund and continue to access healthcare from public clinics and hospitals as they are doing now.
A little-known fact is that patients who transfer from a private hospital to a public one, as seen in this filepic, have to pay First Class fees.
The other announcement was that the Health Ministry will pilot a nationwide health screening programme, Peka, for 800,000 individuals aged 50 and above in B40 households at a cost of RM100 million.
According to the 2015 National Health and Morbidity Survey (NHMS), about two-thirds of Malaysians have at least one of three non-communicable diseases (NCDs), i.e. diabetes, high blood pressure (hypertension) or high blood lipids (hypercholesterolaemia).
More than one in four (26.3%) have at least two of these NCDs and 7.2% have all three NCDs.
These three NCDs are not confined to the B40, but are also prevalent in the M40 and T20.
The prevalence in those aged more than 18 years of age for:
• high blood pressure was 30.3%.
The condition was diagnosed in 13.1% and undiagnosed in 17.2%, i.e. for every two persons diagnosed with high blood pressure, there were three undiagnosed.
• diabetes was 17.7%.
The condition was diagnosed in 8.3% and undiagnosed in 9.2%, i.e. for every eight persons diagnosed with diabetes, there were nine undiagnosed.
• high blood lipids was 47.7%.
The condition was diagnosed in 9.1% and undiagnosed in 38.6%, i.e. for every one person diagnosed with high blood lipids, there were four undiagnosed.
Of those diagnosed with:
• high blood pressure, only 35.7% had been on treatment, and 9.6% had blood pressure controlled under treatment
• diabetes, only 38% had blood glucose levels within treatment targets (NHMS 2015).
• high blood lipids, only 45% and 37% of those treated at public hospitals and private clinics respectively, had their total blood cholesterol levels controlled.
However, this data from the NHMS 2015 was limited by no distinction between LDL and HDL cholesterol.
In short, the prevalence of undiagnosed high blood pressure, diabetes and high blood lipids was high, and of those who were diagnosed, control was poor.
Everyone whose NCD is diagnosed and well-controlled will benefit from better health and fewer complications.
Consequently, the country’s disease burden and expenditure from secondary and tertiary care will be contained, if not reduced, with early detection and better control.
Better value for money
A reassignment of the allocation for the Health Protection Fund to reduce undiagnosed and poorly-controlled NCDs will ensure that the B40s are not saddled with CHE.
It will also contain and reduce the disease burden of NCDs; and contain the country’s healthcare expenditure in the medium and long-term.
The private registered medical practitioners (RMPs) can play significant roles in this res [...]
LONDON • Prime Minister (PM) Theresa May suggested yesterday that MPs may get to decide whether Britain eventually joins the “backstop” plan to avoid post-Brexit border checks with Ireland.
May told BBC Radio that she was looking at allowing lawmakers a vote on the arrangement, which would keep the country in a customs union with the European Union (EU) after the end of the proposed Brexit transition period in December 2020.
The alternative, according to the deal struck between May and the EU, would be to extend the transition period for up to two years, during which time Britain would largely enjoy the same relationship with the bloc, despite officially leaving on March 29, 2019.
“We’re looking at this question around the backstop and the role of Parliament,” May said.
“The backstop is talked about as if it’s automatic. Actually it’s not automatic. There is a choice.
“The question is do we go into the backstop, do we extend…the transition period? I’m exploring.”
May is drumming up support for her deal, but faces daunting odds with scores of her own MPs set to vote against the government on Dec 11.
The Conservative PM commands a slim working majority in Parliament thanks to a deal with Northern Ireland’s Democratic Unionist Party (DUP), which is fiercely opposed to her plan.
DUP leader Nigel Dodds said his party would vote against the deal, but would not move to bring down May’s government.
“If it (the deal) is defeated, it would be somewhat illogical — having achieved our aim trying to get to a better deal — it would be illogical then to turn around the next day and say ‘let’s vote the government out’,” he told ITV.
“I think then we start on a process to try to get a better deal,” he added.
The backstop issue is the key sticking point, with official legal advice suggesting Britain could get indefinitely stuck in a customs arrangement, having no power to unilaterally withdraw.
According to media reports, May’s office has attempted to win over rebellious backbenchers by suggesting that MPs may even be able to vote on rejecting both options of the deal, but was rebuffed by leading Brexiteers.
Conservative MP Jacob Rees- Mogg, leader of the influential eurosceptic ERG group, told the Daily Mail that such a proposal would mean ripping up the Withdrawal Agreement and renegotiating it entirely, something the EU has ruled out.
MPs were to hold a third day of debates on the deal yesterday, focusing on its economic impacts.
May’s fragile position was laid bare on Tuesday with a stunning series of defeats in parliamentary votes.
MPs backed an amendment that will give them a bigger say in what happens if May’s deal is voted down and also forced her to publish the official legal advice.
A defeat for the PM next week could trigger a no-confidence vote leading to early elections, leaving the Brexit process in chaos.
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var EMOTE_TEXT = ["HAPPY","INDIFFERENT","AMUSED","EXCITED","ANGRY","SAD"]The post May hints at Brexit backstop vote to save ailing deal appeared first on The Malaysian Reserve. [...]
PETALING JAYA: News that RM2 million has already been pledged towards the ‘Save Seafield Temple Fund’ so far, brought some cheer to the management and devotees gathered at the Sri Maha Mariamman Hindu temple in USJ 25 today.The news was greeted with loud applause when Berjaya Group Founder Tan Sri Vincent Tan announced that the amount had been reached with a RM500,000 donation pledged by businessman Datuk Anathkumar Alagu.Another RM1.5 million had been pledged by Tan, who started the ball rolling by pledging RM500,000 on Friday, and was almost immediately joined by Tan Sri Barry Goh who previously headed MCT Bhd and Nirvana Group founder Tan Sri David Kong, both of whom had matched his donation.Tan, who had mooted the crowdfunding initiative to buy the land on which the temple stands from the landowner, visited the temple this evening.Speaking at a press conference together with Water, Land and Natural Resources Dr Xavier Jayakumar, Tan said he decided to step in to raise funds and assist in the negotiations, as he was disturbed by the hostility and violence that followed a court order on the temple’s relocation.“This should not be happening in our peaceful country Malaysia. We of all different races have co-existed for so long.“The landowner and majority shareholder is a Philippines based company called Ayala Corporation. They own 66% of the land. They are a very respectable company and I understand are very charitable and do a lot of CSR (corporate social responsibility) projects.“So when the bosses know the situation is like this, I am sure they will come up with some good solutions. We will discuss matters with them and wait for their decision. Perhaps they will give us a discount on the sale of the land or even give it away,“ he added.Tan also pledged to donate RM50,000 to the 24-year-old fireman Muhammad Adib Mohd Kassim, who was severely injured after being assaulted by protestors at the temple early on Monday last week.“I hope they will forgive the people responsible, and God willing, Adib will fully recover with time and medical treatment and be able to resume his duties as a fireman,“ he said, adding he was relieved that to hear that Muhammad Adib had regained consciousness and was showing positive signs of recovery.“Please don’t quarrel or fight. Why do we need to fight? Malaysia is our country. It’s a good country. We are under a new government now and have a great prime minister who works so hard at the age of 93,“ he said after meeting with the temple’s task force committee on the relocation.Meanwhile, Xavier said the rule of law still applies to the case and that there was a court order on the eviction of the temple.“The court order still stands and this should not set a precedence to other temples in a similar situation in future. We will be enacting laws on this.“Only Ayala is in a position to drop the court case. As for now, the temple will not be touched,“ he added.However, he said discussions will be held with the landowner, who are prepared to hear out proposals and suggestions.“We are in touch with them and there are some technicalities to be sorted out,“ said Xavier, who lauded the initiative of Tan and other wellwishers to purchase the land to keep the temple as it is.Pertubuhan Pusat Aduan Rakyat Malaysia President Datuk A. Chandrakumanan, who is a member of the temple’s task force, expressed the hope that more people will come forward to contribute towards the fund so that the temple will remain at its current location for good. [...]
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The tiny Pacific island nation of Palau will ban “reef-toxic” sunscreens from 2020 in what it claims is a world-first initiative to stop chemical pollution killing its famed corals.
Palau, which lies in the western Pacific about halfway between Australia and Japan, is regarded as one of the world’s best diving destinations, but the government is concerned its popularity is coming at a cost.
A spokesman for President Tommy Remengesau said there was scientific evidence that the chemicals found in most sunscreens are toxic to corals, even in minute doses.
He said Palau’s dive sites typically hosted about four boats an hour packed with tourists, leading to concerns a build-up of chemicals could see the reefs reach tipping point.
“On any given day that equates to gallons of sunscreen going into the ocean in Palau’s famous dive spots and snorkelling places,” he said.
“We’re just looking at what we can do to prevent pollution getting into the environment.”
The government has passed a law banning “reef-toxic” sunscreen from Jan 1, 2020.
Anyone importing or selling banned sunscreen from that date faces a US$1,000 (RM4,180) fine, while tourists who bring it into the country will have it confiscated.
“The power to confiscate sunscreens should be enough to deter their non-commercial use, and these provisions walk a smart balance between educating tourists and scaring them away,” Remengesau told parliament after the bill passed last week.
The US state of Hawaii announced a ban on reef toxic sunscreens in May this year, but it does not come into force until 2021, a year after Palau’s.
The Palau ban relates to sunscreens containing chemicals including oxybenzone, octocrylene and parabens, which covers most major brands.
Palau has long been a pioneer in marine protection, introducing the world’s first shark sanctuary in 2009, in a move that has been widely imitated.
It has also banned commercial fishing from its waters and last year introduced the “Palau Pledge” requiring international visitors to sign a promise stamped into their passport that they will respect the environment.
Craig Downs, executive director at the Haereticus Environ-mental Laboratory in Hawaii, said other nations would be watching Palau’s move closely.
“It’s the first country to ban these chemicals from tourism. I think it’s great, they’re being proactive,” he said.
“They don’t want to be like Thailand, the Philippines and Indonesia, where they’ve had to shut down beaches. The coral reefs around those beaches have died.”
Downs said there were numerous scientific papers pointing to a link between sunscreen chemicals and coral reef degradation.
“What we’re saying is that where there are lots of tourists getting in the water, sunscreen pollution can have a detrimental effect on nearby coral reefs, as far as 5km away,” he said.
Downs called on sunscreen manufacturers to “step up and innovate”, saying the chemicals used for UV protection had been largely unchanged for 50 years.
He said there were some sunscreens containing zinc oxide and titanium dioxide that were not reef toxic but added: “The other alternative we’ve been pushing is sunwear – cover up, wear a sunshirt.” – AFP Relaxnews [...]
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(From left to right) European Commissioner for Economic and Financial Affairs, Taxation and Customs Pierre Moscovici, France’s Finance Minister Bruno Le Maire, European Commissioner for Euro and Social Dialogue Valdis Dombrovskis and Spain’s Finance Minister Nadia Calvino speak as they attend the Eurogroup Finance ministers meeting, in Brussels, on November 5. — AFP photo
BRUSSELS: France said it is prepared to delay an EU-wide tax on high-tech giants in order to save a proposal that faces opposition from Ireland and Nordic countries.
Paris has been urging its European Union partners to impose a new tax to ensure that global tech platforms like Facebook and Google pay their fair share.
But Finance Minister Bruno Le Maire said France now agrees with Germany that once approved, the levy could be delayed and used as an incentive towards forging an international solution, including with the US and China.
On Monday, Le Maire’s German counterpart Olaf Scholz backed a European tax, but only if a broader solution was not found by summer 2020.
Arriving at a meeting of EU finance ministers in Brussels, Le Maire told AFP the draft EU law “is due to be adopted in December 2018 … but we are open to postponing the entry into force to allow time for the OECD to make a more comprehensive proposal.”
“There is no disagreement with Mr Scholz on this. We share the same analysis, there are technical difficulties to solve and we must solve them within the next four weeks,” said Le Maire.
The change of tack comes after France and the European Commission first advocated a provisional bloc-wide solution until an international scheme is found at the Organisation for Economic Cooperation and Development, which groups major world economies.
France, backed by EU-presidency holder Austria, wants a law proposal by the end of the year leaving little time to get opponents on side as European tax rules require unanimous backing by all EU members.
Paris argues the measure would be a vote-winning accomplishment for mainstream EU politicians ahead of the European Parliament elections next May, in which anti-Brussels populists could do well.
But Ireland, which hosts the European headquarters of several US tech giants, leads a small group of otherwise mostly Nordic countries that argue the tax will also punish European companies and stoke Washington’s anger.
“We cannot support the proposed directive … I see no government in Sweden that would have any other opinion on this issue,” said Sweden’s Magdalena Andersson.”
Irish Finance Minister Paschal Donohoe stressed the potential reaction from countries targeted, mainly the US.
“What kind of reaction would this bring if this was a model that was imposed on us?” Donohoe asked his fellow ministers in a public session.
Given the way that the tax “has been framed as aiming at US companies, of course there will be a reaction from the United States,” added Danish Finance Minister Kristian Jensen.
The EU proposal is also intended to stop other countries going it alone with their own digital tax and creating a patchwork of schemes across the continent.
Some EU member states such as Britain, Spain and Italy are working on national versions of a digital tax, with Singapore and India also planning their own schemes.
“If we do nothing, the EU will be split up like a puzzle and our European businesses will be the first to suffer,” EU Economics Commissioner Pierre Moscovici told the ministers. — AFP [...]
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