Our medical care — public or private?

IT was Benjamin Franklin who had famously said: “Nothing is certain in life but death and taxes.”

What he forgot to mention was the certain grey areas in between – of sickness and disabilities.

Disability and sickness impact all of us at one time or another during our time on this Earth. It is any condition of the body or mind that makes it more difficult for us to do certain activities that we would normally be able to do so as to interact with the world around us.

At times like this, we are at the mercy of the facilities that are available within a reasonable distance to help us – for emergency cases, for immediate treatment, or for follow-up healing and rehabilitation.

Not just facilities, but the level of skilled medical practitioners, specialists, equipment, as well as the latest available pharmaceuticals, that are necessary to render us the maximum care over an optimum period.

It all sounds extremely challenging – and for a long time, it has been.

However, it is my personal opinion based on statistical facts and my personal experience that over the past decade or so, the state of all that has been mentioned has been achieved here in beloved Sarawak.

It has gone beyond just this achievement as it is now possible for us to make a choice for ourselves whether to opt for the medical services that we require at the public level – at any of our 21 government-funded hospitals, clinics and specialist centres throughout the state; or to go for private consultation and treatment at the many privately-incorporated hospitals.

I know what you are likely to say next.

Obviously if one has sufficient funds and is able to afford to pay for it, or if one has a comprehensive health insurance scheme one would opt to go private rather than public.

But is this still true?

The level of skilled physicians, doctors, surgeons and others in their own specialised fields in recent years have risen in such numbers as to be able to face the growing demand for the various ailments, diseases and calamities that we encounter.

These specialists work in both the public and private sectors and their skills, experience and expertise are world-class and are on the same level as any of their peers elsewhere, be it Singapore, Kuala Lumpur, London or New York.

The equipment and facilities now available at both private and public operating rooms (OR), as well as the drugs and devices on hand are the latest and the most up-to-date and efficient.

We have certainly reached an era where there are no insurmountable obstacles to overcome in so far as the procurement of equipment and drugs due to accessibility or cost is concerned.

In the public sector, the state government has spared no expense in enabling the Ministry of Public Health, Housing and Local Government to attain its optimum level to be expected of a caring government.

In the private sector, their ever-increasing profits have ensured that their medical facilities are constantly being updated and upgraded with the latest equipment to enable them to attract future customers (patients).

So what is the difference between deciding to go for a public healthcare service like a polyclinic or a government-funded hospital, versus seeking private care at a private hospital?

Obviously if you are a Malaysian citizen with a Sarawak MyKad (those bearing a prefix of the letter ‘K’), any visit to any government medical facility is free of charge for consultation, treatment and the prescription of medications.

There are certain nominal token charges for certain specific treatments, drugs and procedures depending on the nature, urgency of need and additional exception which the attending doctor will advise way ahead of the procedure.

At any point, the choice would always be left to the patient to decide.

If there is any deterrent, it has to be the time element – the queuing period and the waiting time for a slot or a schedule for an appointment for consultation, also for the actual procedure, and then the post-op of recuperative follow up and rehab.

Most of the time, all these three segments can be tediously lengthy.

The expectation of a paying customer at a private hospital is a lot higher.

As he is paying for virtually everything, from the minute he steps into the private hospital to the moment he pays his invoice at the cashier’s counter, the ever-present imaginary ringgit counter would start.

With public-listed companies owning almost all of the private hospitals these days, the foremost mission is to make profits first, ‘Hippocratic Oath’ second.

Sometime in the distant past one could, and actually did, receive the optimally-satisfactory services at the private facilities – fast, efficient and caring treatment. I believe this has changed somewhat these days.

The waiting queues at the respective specialist clinics within the private hospitals are now almost as long as those at the public clinics; one reason being that patients from our closest neighbour Indonesia have been flocking over the border to seek treatment here, in addition to the locals.

This is called ‘medical tourism’ to the happy statistics counters at the Tourism Ministry.

This has been due to the more favourable exchange rate that that in their previous go-to in Singapore; the overall lower cost of living (if they were to stay longer as per the need to care for their loved ones under treatment); and apparently there is also quite a sizeable number of Indonesian students and domestic maids in Sarawak.

I have no doubt that the standard of the skills and the care, pre- and post-procedures if any, as well as the treatments rendered to each and every patient in both the public and private sector would be identically world-class.

Such treatments would be based on the respective specialists’ years of working experience. They would be some of the best-trained talents and their treatment would be based on their never-ending quest and search for ‘a cure’, or the ‘latest drug’ in aiding and healing the sick and afflicted, in all the cases that they handle.

Many other factors would come into play before one finally makes a decision. One big factor is the human touch.

Many would prefer to go to someone who is either familiar or has been referred by someone close, a family member or a good friend who has either been treated or have heard about a specific doctor.

Word-of-mouth referrals often work in small and tight communities and within certain cliques, groups or closed circles. They can also be a double-edged sword as it cuts both ways; a tendency to shun or avoid those with any negative ratings, for instance.

Without either a referral or word of mouth, most patients would simply walk into a private clinic and trust their well-being to whoever the specialist is available there.

He could be certain that for the money that he was going to pay eventually, he would expect the best possible treatment; if he needed boarding, the best restrooms and good care by trained nurses and that he would be as comfortable as they could make it.

Some of this scenario has changed somewhat in the past few years.

Due to a higher demand and a lot more patients than before, many private hospitals are now almost always full to capacity, and the rooms are not ‘as easy to book’ as before.

In the public hospitals, they are perpetually short of beds. Even if you are admitted into the Emergency Room (ER) and deemed worthy to be bedded for a night or two, it is always the case that one needs to wait, which can be as long as 48 hours in the holding area!

Spare beds at the Sarawak General Hospital (SGH) in all the various wards that are freed up by patients being discharged or who died, are almost always filled with a backlogged patient within the hour.

In conclusion, I have no realistic or truthful answer to my question – do we go public or private for our medical treatment and care?

The closest answer that I can give you is this: if it is a matter of life and death and wherever the nearest hospital is to where you are at that moment, it is where you should go.

I have seen and heard of patients who did exactly that and had later, after that ‘life or death’ moment had been resolved, transferred himself from one to the other. By then, that had become a choice.

Choose well, for it may be the difference between you living or dying.

I pray that you stay safe, keep healthy habits, pray often to God and live in peace, love and harmony with your fellowmen.

Most of all, try and stay as stress-free as you can: that is one secret to a long life.

* The opinions expressed in this article are the columnist’s own and do not reflect the view of the newspaper.