Currently there is heightened awareness among the general public on complementary medicine. Apparently there are more than 12,000 practitioners in complementary medicine in Malaysia and the number is fast growing. Nevertheless, there is a very loose definition on the scope and responsibilities such practioners adhere to.
Unfortunately the very term "complementary medicine" has been used interchangeably with traditional medicine, alternative medicine and herbal medicine. The public in general often has been made to believe that they all mean the same and practitioners are categorised largely on the the lines of weather they are Indian, Chinese or Malay healers. This is a misconception in definitive terms in contact with complementary medicine. Though the government intends to regulate this industry but mere legal definitions and boundries will not hold much water when there is parallel treatment sought by a patient.
Allopathy medicine practitioners are highly regulated by many different regulations, acts and ethics which carry heavy penalties if breached. A patient has the right to sought multiple opinions and have clear legal rights in reference to the different acts if he feels there has been a medical negligence on the part of the practitioner. Will they have the same avenues with complementary practitioners? Medical and pharmaceutical care has evolved into a very evidence based practice.Strict guidelines pertaining to good practices in clinical care and trials in conjunction with quality medicine is advocated to ensure that best possible care is given to a patient. Without which, licensing can be denied at any level of the supply chain. Will the same standards be applied to complementary medicine practitioners?
Medical claims made in modern medicine practice must be substantiated with adequate clinical evidence as practitioners may face medico-legal cases. Nevertheless, on the other end of the spectrum, complementary medicine practitioners substantiate their claims by mere personal experiences and word-of-mouth promotions. What will be the implications to the patient's legal rights if there is a dispute or negligence on the part of the practitioner? What will be the reference point for legal arguments? Are there sufficient experts in the country to handle such disputes?
My personal experience over the years in the health industry has seen many patients who are gullible to try complementary medicine especially for chronic ailments like diabetes, strokes, hypertension and asthma; to mention a few indeed. There is no objection to that but unfortunately I see that a large number of them disregard their modern medicines in the believe that they cause more harm than good in the long term use. Often than not, they are coaxed by the complementary medicine practitioners to abandon their medications and solely rely on herbal based. Many return over time with far more complications, deterioration in health and poorer financially after forking out money. Their dissatisfaction is met with a standard answer by the healers that it did not work on them because they failed to adhere to the many restrictions imposed whilst taking complementary medicines. To my understanding it should complement and not displace modern medications!
Another point of discontent is on the topic of side effects. Ironically, patients always have the notion that modern medicines have delibitating side effects no matter how good they can be. On the other hand alternatives are always safe. This is a very myopic view. There are also issues pertaining to drug interactions which many complementary practitioners may not be aware. Certain long term consequences may only surface after many years down the road and it can be irreversible in some instances. One must acknowledge the fact that even many herbal medicines go through vital organs like kidney, liver, lungs, heart and brain. Damage can happen.
The concerned authorities must weigh all aspects of complementary medicine practices critically from different facets before allowing a blanket consent and blessings. The well being and safety of patients must be paramount at all times. Public must be adequately educated on complementary medicine not only on the aspect of health but also legal rights. Ambiguity and grey areas of practices must be cleared especially if there is a possibility of dispute when modern and complementary medicine is received by patients at the same time. There must be a defined index of reference for drug interactions between modern and complementary medicines. Physical manipulation and examinations on patients must be highly regulated to avoid incidents of harassment claims and must be done under supervision by a third party.
And above all, the government must clearly define what constitutes complementary medicine and how the component of alternative, traditional and herbal medicine jives within its context. It will be essential to have a central governing body to evaluate, assess and certify all complementary medicine practitioners annually with a formal registry. There should also be a defined academic syllabus for aspiring students who wish to venture into this field. Currently there is also no clear guidelines on how a patient is charged a fee for complementary treatments. This must be addressed seriously to avoid exhorbitant charges. Claims made by complimentary medicine practitioners for having "cured" certain illnesess must be nipped in the bud before it escalates and do more harm than good.
It is evident the we have many more questions to be answered before streamlining complementary medicine practices in Malaysia.
Friday, May 20, 2011
Tuesday, May 3, 2011
Guarded and Gated...costly affair
THE debates concerning guarded and gated communties have resurfaced among interested parties. There are many issues and questions that have been raised with little or no answers from any relevant authority.
Developers often use guarded communities as a marketing point to enhance the image and value of their properties. House buyers are asked to sign an agreement on the terms of upkeep of the gated area. Unfortunately this “facility” comes with a fee called monthly security and maintenance. Sadly, more often than not, such services deteriorate over time and many residents opt not to continue payments as they do not see the consistency in quality of the service. The initial phase is normally run by the developers but after awhile it is handed over to the residents’ associations (RA) and that’s when things go wrong.
From a legal perspective, all houseowners in gated and guarded communities are independent subjects and are not governed by the in-house rules made by the residents’ associations. The individual owner does not become a signatory to any rules by default just because the RA sanctions it. Now the question that needs a legal clarification is – Can security guards ask for the details of a visitor or even owners coming into the housing area? Under what laws are they allowed to check a person’s ID?
Even the government advises the public to ask for an enforcement officer’s identification card before revealing more details to them, even if they are in uniform. What makes security guards immune. The irony of all this is that the security company waives all liabilities of theft or burglary if it happens within the community citing that it is agreed by the RA. Then why are the owners paying a monthly security fee? And as for the maintenance and upkeep of any residential area, isn’t it the responsibility of the local council as we all pay taxes to them and there is no exception to the rule or discount granted for gated and guarded communities?
It is time the relevant agencies formulate a standard protocol for gated and guarded communities which is legally accepted and gazetted at the council level at least. The current practices are just too “cow-boy” styled and do not conform to the minimum legal requirements. The RAs must be made legally responsible and use monies collected prudently and not increase the monthly fees unilaterally without the consent of state governments.
In the last year itself, the RA in my housing area increased its monthly charges from RM30 to RM50 citing increased cost for security. This exorbitant rise of nearly 67% is unacceptable by any standards and this was immediately imposed as soon as the RA took over responsibility from the developer. Surprisingly a large amount collected from the previous year was spent on social activities. This is daylight robbery. All social activities under the RA must initiate a different collection drive as this is not even mentioned in the agreement. Then why are monies collected as “security and maintenance” used for the few who attend such functions? Only those who would like to participate pay the extra and it should not apply across the board.
These are just the few of many other grouses shared by people in the same predicament. In this difficult economic times, RM600 a house annually is unjustified. There are nearly 600 houses within the community and even if 80% pay up, that amounts to a whopping RM288,000 collected anually. That is lots of money to pay for security.
Developers often use guarded communities as a marketing point to enhance the image and value of their properties. House buyers are asked to sign an agreement on the terms of upkeep of the gated area. Unfortunately this “facility” comes with a fee called monthly security and maintenance. Sadly, more often than not, such services deteriorate over time and many residents opt not to continue payments as they do not see the consistency in quality of the service. The initial phase is normally run by the developers but after awhile it is handed over to the residents’ associations (RA) and that’s when things go wrong.
From a legal perspective, all houseowners in gated and guarded communities are independent subjects and are not governed by the in-house rules made by the residents’ associations. The individual owner does not become a signatory to any rules by default just because the RA sanctions it. Now the question that needs a legal clarification is – Can security guards ask for the details of a visitor or even owners coming into the housing area? Under what laws are they allowed to check a person’s ID?
Even the government advises the public to ask for an enforcement officer’s identification card before revealing more details to them, even if they are in uniform. What makes security guards immune. The irony of all this is that the security company waives all liabilities of theft or burglary if it happens within the community citing that it is agreed by the RA. Then why are the owners paying a monthly security fee? And as for the maintenance and upkeep of any residential area, isn’t it the responsibility of the local council as we all pay taxes to them and there is no exception to the rule or discount granted for gated and guarded communities?
It is time the relevant agencies formulate a standard protocol for gated and guarded communities which is legally accepted and gazetted at the council level at least. The current practices are just too “cow-boy” styled and do not conform to the minimum legal requirements. The RAs must be made legally responsible and use monies collected prudently and not increase the monthly fees unilaterally without the consent of state governments.
In the last year itself, the RA in my housing area increased its monthly charges from RM30 to RM50 citing increased cost for security. This exorbitant rise of nearly 67% is unacceptable by any standards and this was immediately imposed as soon as the RA took over responsibility from the developer. Surprisingly a large amount collected from the previous year was spent on social activities. This is daylight robbery. All social activities under the RA must initiate a different collection drive as this is not even mentioned in the agreement. Then why are monies collected as “security and maintenance” used for the few who attend such functions? Only those who would like to participate pay the extra and it should not apply across the board.
These are just the few of many other grouses shared by people in the same predicament. In this difficult economic times, RM600 a house annually is unjustified. There are nearly 600 houses within the community and even if 80% pay up, that amounts to a whopping RM288,000 collected anually. That is lots of money to pay for security.
National Health Plan
THE Health Ministry recently announced that the government is mulling over a national healthcare system. It runs on the principle of the rich subsidising the poor by contributing a sum to a financial pool.
There are many issues that need to be addressed before a revamp is even thought through. Our healthcare system is fragmented and driven by a free market policy. We have government funded and privately-run establishments. The sentiment among the public and insurance companies is that the private healthcare providers are inadequately governed. Health insurers have been increasing premiums for the past 10 years. Their excuse is that private hospital fees are increasing. And they only want "healthy" clients. If you have a history of chronic medical illness, forget about insurance or pay a huge loading fee. Will there be a substandard care provided by private hospitals when admitting a patient under the scheme? Will there be adequate controls to ensure consistency?
There are no price controls on medications. On the entire supply chain of providing healthcare services, the government must ensure that each contributing factor will be regulated. The public must be assured that if a doctor is paid by the health scheme, the patient is not shortchanged by receiving under par treatment. Will there be a cap on visits to a clinic? And after a number of visits for the same problem, will the doctor be compelled to refer the patient to a specialist or hospital and not wait to max out the allocation for the patient?
The health minister also said that each family must register a clinic as their family physician as to keep records. What happens when you are out of town and require medical attention? Will the doctor or patient be reimbursed? Will all the clinics be hooked up to the system to monitor patient mobility?
Employers pay Socso and EPF. If they are further asked to contribute to this new fund, it will increase their operating costs. Will the government reduce the quantum to this two funds if contribution is made to the health scheme by employers? Many companies take up group insurance schemes. If they were to further contribute to a new scheme, I am sure many if not all will scale down the benefits to reduce costs. The employees will be the losers.
Our medical system runs on a "one-stop centre" basis. Patients are examined by the doctor, treated and provided medication. Often a bill is issued that does not itemise the cost of medicines and consultation or treatment. Will itemised billing be mandatory? The government must ensure that doctors follow an approved essential drug list and are and not driven by pharmaceutical promotions. Any deviation from the list must be justified. We should not have a situation where the establishments benefit the maximum payout from the scheme and yet enjoy extra payment by the patient by coaxing them to take the "better drug"! There must be a list of reimbursed drugs’ list and the percentage of quantum reimbursed for each drug.
Whatever system we adopt, the government must ensure there is no cronyism, monopoly and or kickbacks to the key players.
There are many issues that need to be addressed before a revamp is even thought through. Our healthcare system is fragmented and driven by a free market policy. We have government funded and privately-run establishments. The sentiment among the public and insurance companies is that the private healthcare providers are inadequately governed. Health insurers have been increasing premiums for the past 10 years. Their excuse is that private hospital fees are increasing. And they only want "healthy" clients. If you have a history of chronic medical illness, forget about insurance or pay a huge loading fee. Will there be a substandard care provided by private hospitals when admitting a patient under the scheme? Will there be adequate controls to ensure consistency?
There are no price controls on medications. On the entire supply chain of providing healthcare services, the government must ensure that each contributing factor will be regulated. The public must be assured that if a doctor is paid by the health scheme, the patient is not shortchanged by receiving under par treatment. Will there be a cap on visits to a clinic? And after a number of visits for the same problem, will the doctor be compelled to refer the patient to a specialist or hospital and not wait to max out the allocation for the patient?
The health minister also said that each family must register a clinic as their family physician as to keep records. What happens when you are out of town and require medical attention? Will the doctor or patient be reimbursed? Will all the clinics be hooked up to the system to monitor patient mobility?
Employers pay Socso and EPF. If they are further asked to contribute to this new fund, it will increase their operating costs. Will the government reduce the quantum to this two funds if contribution is made to the health scheme by employers? Many companies take up group insurance schemes. If they were to further contribute to a new scheme, I am sure many if not all will scale down the benefits to reduce costs. The employees will be the losers.
Our medical system runs on a "one-stop centre" basis. Patients are examined by the doctor, treated and provided medication. Often a bill is issued that does not itemise the cost of medicines and consultation or treatment. Will itemised billing be mandatory? The government must ensure that doctors follow an approved essential drug list and are and not driven by pharmaceutical promotions. Any deviation from the list must be justified. We should not have a situation where the establishments benefit the maximum payout from the scheme and yet enjoy extra payment by the patient by coaxing them to take the "better drug"! There must be a list of reimbursed drugs’ list and the percentage of quantum reimbursed for each drug.
Whatever system we adopt, the government must ensure there is no cronyism, monopoly and or kickbacks to the key players.
Subscribe to:
Posts (Atom)