Without an underlying philosophy, money becomes the easiest motive because it is quantifiable – and we become furious when public money is lost, observes Nicholas Chan.
Recently, I attended a discussion panel consisting of health care professionals, academics and administrators, and among the topics discussed was health care financing.
But something felt amiss when the debates grew heated — perplexingly– when it came to the case of the homeland, Malaysia.
Everyone seemed to be besieged by a sense of crisis as if we were discussing our education system, which (i)
consumes a higher expenditure (as a percentage of total GDP) in comparison to peers and developed nations and (ii) has failed to produce outcomes that justify the spending, as can be seen in ailing Pisa and Timss results.
But neither problem plagues Malaysia’s public health care system.
To put things into perspective, Malaysia’s current total health care expenditure was about 4.5 per cent of GDP) in 2013. That is much, much lower than the OECD countries, such as the UK (9.3 per cent), Germany (11.3 per cent) or the United States (16.9 per cent) (2012 data). On top of that, only about half of our health care expenditure comes from public finances i.e. our tax money.
What’s more, our public health care system, notwithstanding certain shortcomings, is widely lauded for its affordability and accessibility; the remarkable progress made in mortality rates; pre-, ante- and post-natal care, widespread immunisation, and average life expectancy,
So if there is any basis for exploring new funding sources for health care, I have yet to see one. Are we trying to fix something that is not broken? What is the rationale or guiding philosophy for revamping health care financing? Words like privatisation, rationalisation and subsidisation are thrown around, uncritically.
This is actually the topic I want to talk about today. Our non-critical attitude towards the philosophy of government, made worse by the lack of empiricism in the critique of governance.
Policy matters are being taken for granted, and as such, they become vulnerable to ideological fault lines vehemently guarded by alarmists from the left, right and centre. Normative positions are taken without any underlying argument. Judgments instead have taken the place of arguments.
In Malaysia, it can and has always turned into an even sadder polemic, one that is erroneous and at times malicious, the pro- and anti-Bumiputera rhetoric.
Some might say it is too much of an ivory tower thing to be so theoretical, but let me quote an example on why we have to get the principles right first. Take the case of the 1MDB fiasco, which refuses to recede from public view.
Huge as it may be, it is hardly the first time financial scandals like this have exploded in our face. And if we don’t get our philosophy and priorities right, it won’t be the last.
Instead of just asking who screwed up and why, we should ask why the government got involved in this kind of business in the first place? Does it have anything to do with the provision of public goods? Where does the accruing of profits (if there is indeed any) go to? What is the role of the private sector then if the government dips its fingers so deep and so pervasively into the business cookie jar? Is that what the government needs to do to sustain its current expenditure?
But the last time I checked, the only GLC that contributes significantly to our coffers is Petronas. And if the government obtains its revenue by doing business, then why tax us in return via the GST again? Are we stuck in a position where we both need to contribute to the government and compete with it?
By not touching on these basic questions, we risk not knowing what form of government we want and how we are going to achieve it responsibly, whether from the social or economic side.
Hence, every expose turns out like theatre. You have the heroes and the villains, the shock value and the intrigue, the climax and the anti-climax, and the ending, which usually involves someone falling from grace.
We look at scandals both as tragedy and entertainment. We rally behind our heroes to support them; we despise the villains who represent everything we resent. These ‘idols’ and figures define our remembrance of the events. It is reality TV in a sense.
But these immersions, along with the public figures who revel in it, distract us from adopting a more critical attitude towards the system. The provide a stage that allows these shenanigans to go on. The political economy that is sustained by an endless loop of patronage building, clientelism, corruption and rentier capitalism escapes unscathed.
We want heads to roll, yes, but it shouldn’t end there. The discourse about bad governance should not stop at the level of heroes and villains.
Until we stop taking things for granted, we will forever be hoodwinked by glossy policy papers with elaborate wordings that sound like anything but substance.
For example, ponder at this line taken from 1MDB’s website, “1MDB’s role in the energy sector is a strategic one, aimed at supporting a secure and robust energy future for the country”.
What does it mean actually? Is our energy future under threat? What is the role of TNB when 1MDB intercepts? Is TNB doing a bad job in the first place? What is the logic of 1MDB acquiring our power assets anyway, even if the company makes profits? Who should rightly own our energy assets? Have we ever questioned that?
Without an underlying philosophy, money becomes the easiest motive because it is quantifiable. The mentality is so pervasive that our anger with government scandals is driven by it. We are furious because money is lost, but we are never critical about why the money is needed there and who benefits from it.
We just assume the money is needed and the government needs to look for it – and in many instances, they actually lose more money doing so. There are too many things being taken for granted here.
It is time we take our politics up a level by not just aiming at scoring brownie points. We should step away from the passive stance – our expectation that the will “take care of us”. We are more than denizens of a patriarchy. We are more than profit-minded non-executive directors of a company.
If we want good governance, shouldn’t we attempt first to define what a government ought to do first? Defining government involves more than just making a choice between Barisan Nasional and Pakatan Rakyat.
It is time we stop thinking of politics in terms of symbols and icons and start thinking of the philosophy in politics.