Life Journal

If you're interested in reading my reflections on the Life Journal Bible readings, check out Ian's Life Journal blog.

Tuesday, 4 December 2007

Counting our blessings: Pusat Kesihatan Kecil Puchong

In most ways, USA is more advanced than Malaysia, but there are two things I'm aware of that Malaysia is ahead in:In USA, their EPF ("Social Security") isn't in their individual accounts, but rather becomes like a pension which they can only draw as long as they live, no matter how much money they had put in to it. Just like in Malaysia, the government takes that money and spends it on other stuff, but unlike Malaysia, they have no individual accounts that say how much money there is.

And in medicine, The rich have the best health care in the world, but if you have no money or insurance, you die. (Except that there are some Christian and charitable organizations in a few limited places that provide free or subsidised health care to the poor, for example, in Chicago there is Pacific Garden Mission -- but most places don't have this.)

What reminded me of our blessings in this area is that on Monday morning, I took baby Joni to Pusat Kesihatan Kecil Puchong (Little Medical Centre of Puchong) which is only 5 minutes from my house, for her first month checkup, and we didn't have to pay even one sen! Most government hospitals at least charge a nominal fee, e.g. RM 10 for a visit, RM 30 for 1 month's supply of medicine) but this one didn't charge anything! (Not even for the cream the pediatrician supplied for baby Joni's rashes.)

Every so often, we hear horror stories about mistakes government hospitals make. But that happens everywhere; perhaps the implication is that the incidence is higher at government hospitals than in malpractice-conscious American commercially-run hospitals, but I don't have any statistics on this.

Anyway, I've been complaining about the government a lot lately, especially with the propaganda & disinformation about the Bersih pro-democracy protests, but health care is one place where this government actually has some good policies and I'm thankful for that.


Ralph said...

You made a mistake when you said that in the US, people without money have no health care. It is easy to make this mistake, because the people who criticize the health system rarely try to describe it accurately, but make sweeping generalizations.

The problem with the US health system is that it is a patchwork. There are federal programs, state programs, and each individual hospital has its own program. At the federal level, the two main programs are Medicare and Medicaid. Medicare is for older people. It is designed for people who have retired, and starts at 60 or 65 or something like that. My mother in law (who lives with us) is on it and it pays for most of what she needs. However, she is also covered by a supplemental program put out by the state of Illinois. Medicare doesn't cover everything, but I don't think it is based on your income. The state program is "needs-based", so she has to fill out a form every year telling her income so that she can stay on the program.

Medicaid is for poor people. According to about 13% of the people in the country are on Medicaid, and 12% are on Medicare. 54% have employer-paid health insurance and 16% have no insurance. The rest buy their own insurance or get it from someplace else. Most people with no insurance are self-employed but don't make enough money for insurance (which around here is $6000 a year for a family) or at least don't think they do. A few are rich, and really don't need insurance.

When I was a grad student, I didn't have regular health insurance but instead had major medical, which is a kind of health insurance but only pays if your total cost is over some amount, which I think for me was $10,000 but might have been higher. I was covered by a university program, but it was bad and didn't cover much. In particular, it didn't cover pregnancy. So, I paid cash for my first baby, $900 for the doctor and about $1200 for the hospital. This was in 1982, of course, so would be two or three times higher now. It was a lot for a student, but I paid it proudly and happily.

The Amish don't have health insurance. Instead, their church takes care of them. When one of them goes to the hospital, the hospital treats them like anybody else, sending them a large bill. A week or two after they get the bill, a small delegation of church elders goes to the hospital financial officer and says "how much less would you take if we paid this bill immediately?" The rumor is that the hospital takes two-thirds off.

Hospitals rarely turn people away. People who don't have insurance thus get very large bills with no way to pay for them. I have friends who have been paying off hospital bills for twenty years, because about the time they have paid off one, they get another. Sometimes people declare bankruptcy. That is why the hospital is glad to take a third on the dollar for immediate payment, because so many people never pay their hospital bills.

It is a weird system, and surely something else would be better. But it is a mistake to say that poor people do not get health care.

Ian said...

Thanks for the clarification, Ralph.

I guess ordinary Americans also don't know because I have heard so many times from American friends who worry that if they lose their job and the insurance that comes with their job, they'll not be able to get treatment.

Also, there is the problem of "pre-existing conditions" including congenital illnesses.

I have also heard a lot of stories of people who indeed think that they do not have any medical coverage and so suffer along.

Get Full Moon Party said...
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