Critical issues not debated in 2018 general election campaign

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Patients waiting even during the lunch hour at the BM General Hospital: the needs of local patients are often overlooked

Mary Chin discusses critical issues not adequately debated in the race to Putrajaya: healthcare and social solidarity, housing speculation, migrants and refugees.

Healthcare

In many other countries, governments and peoples worry about improving their national health service, about supporting an ageing population. Large amounts of funds, for example, are allocated for dementia. We hear nothing about this here, although we share the same problem of having more and more Malaysians living longer and developing dementia.

The difference is that the elderly in those countries are everybody’s concern, and health expenses are supported by all. Individuals find their sense of security from being part of a larger, mutually supportive whole. Everyone chips in a share and contributes to a common pool, which will see to every member’s need in times of crisis.

The effect is people worry less and feel less stressed. People are able to live fuller and balanced lives. Society as a whole is stronger and more robust than a single individual. Each family would then need to hoard less, save less, insure less, fear less, feel less stressed, borrow less – and feel more secure.

That is social security. Many Malaysians find the term a mouthful. It is easily confused with personal safety: “Oh yes, I definitely agree we should catch all those snatch thieves and reduce crime rates.” No, this is nothing about police catching thieves.

And then we get, “Oh, you mean social welfare? But that’s for those poor things!” Social security is for everyone, even the richest.

Consider a rich man on long-term prescription drugs – where should he get his constant supply of medication?

A. Get consultation and treatment from five-star hospitals, and get (cheaper) medication from a general hospital.

B. Get medication from private pharmacies instead, pay more and give himself a pat on the back for not taking advantage of government subsidies; let those poor things have all the subsidies they need.

C. Pay a bit more tax, enjoy medical care of five-star quality, without paying a five-star price – get everything from the general hospital, medication included.

A is the opportunist’s option. B is the kind option, but narrow-minded. C is the solidarity option of social security.

With social security, everyone would just get quality healthcare in times of need. Politicians would be able to tell a consistent story to everyone; no need to frame different stories to different groups. There would be no need to outsource medical care to insurance companies, Google, supplements, direct selling and myths.

Many aspects of our healthcare can do with some realignment. In the case of medical tourism, there has been a race to create demand where there is none – and to overlook needs which already exist ie local patients in need who are already here.

Even certain so-called mission hospitals send marketing teams overseas to promote health tourism. Such hospitals too, create special customer desks, designated customer services and dedicated customer teams for VIP patients. The mission is to maximise profits.

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Expensive equipment is acquired for the sake of advertising rather than any substantial medical benefit. Many end up being under-used. To break even and make profit, cases may be tactically referred for procedures on expensive equipment. Multiple hospitals within short distances may have similar expensive machines which sit idly much of the week if not much of the month. Do we take pride in this inefficient use of resources?

The 6.83 acres of prime land that went to Island Hospital without open tender is poised to house the largest private hospital in the country. Who/what are the 1,000 beds for?

Let us ponder over some concerns: Are some beds in some of our private hospitals catering to patients playing the popular admissions game – admissions with the sole intention of claiming medical insurance?

Are our private hospitals prepared to handle any large-scale emergency response, outbreak, epidemic and pandemic? Are rescue helicopters being planned as a community service in new private hospitals? These questions would address our needs rather than generating non-existing demand.

Taxes are not all that bad

Can we spare a moment of openness to acknowledge that, indeed, taxes in Malaysia are already embarrassingly low. What we should aim for is not to pay less, but to pay a fairer share.

Popular demand is driving taxes even lower. The argument is that taxes end up in corrupt leaders’ pockets. There are two things here that shouldn’t be mixed up: tax and governance.

Paying a fair share of tax doesn’t mean losing. By chipping in our bit, we gain a whole lot. We gain what we alone can never achieve.

Now, the question of whether a fair share would be higher or lower than present levels would depend on individual circumstances and on tax brackets. This is where good and competent governance comes in. Choosing a government is about this, not about toppling an enemy. After all, we are voting in a general election, not a referendum on Wan Emdeebee.

So far, by default the typical Malaysian derives security from finding, guarding and multiplying wealth for himself and his own family, for daily comfort and for rainy days.

Think about it – is the model working? No matter how much people gain, they still feel they have not got enough to be sufficiently secure, “What if this or that happens; how am I going to be able to cover the cost?” That is the problem when an individual opts to take care of herself rather than letting everybody take care of everybody (social security).

Many of our struggling young and not-so-young people need to be bailed out of this vicious circle of insecurity. Not knowing when they would have earned and saved enough, many of them have taken on a full load of insurance premiums, loans and possibly debts.

Yet, they still feel so inadequate, so insecure and so lost, wondering if their jobs are really meant for them and if they are meant for their jobs, not knowing where their passion lies.

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Here’s a better deal: let social security see to our rainy days. Pay a fair share of tax – certainly far less than the sum currently paid out to the full suite of insurance premiums, loan repayments, debt repayments, contributions to schemes and investments which keep many awake at night.

Just pay a fair share of tax – in return, everyone gets quality and affordable services including healthcare, transport, education, personal safety and more.

If voters demand lower taxes, it makes it too easy and convenient for politicians to join the chorus when their real goal is to gain power, not to propel the nation forward. Suggesting anything different would require the sort of leadership we haven’t seen from those who are loud. It also involves risks they are unwilling to take. So we see only obliging yes-men and women.

Yet, a new model is exactly what our battered nation needs. Macron arguably did it for France. Trudeau arguably did it for Canada. Obama arguably did it for the United States. That is the making of a tsunami.

Patchwork building on an old model is not the key to a tsunami. The cheer of “ini kalilah, ini kalilah” has been like an engine that couldn’t start. Obviously, we need new hope that goes beyond Wan Emdeebee.

Don’t moan that we have just those two or three choices. In many cases, we do have more. It just takes some openness and a bit of homework the same way we shop for, say, a kitchen blender or a toaster. Do some background checks – some might not be as loud as those noisy campaigners, but they can be experienced and promising.

Housing

I once asked a housing agent, “Am I going to be the only one living here?”

“Condos nowadays are like that lo!” she replied. I love her candour.

Do we need to build more affordable housing? First, do an inventory of empty homes. We need to stop building homes nobody will live in. In the name of progress and liberalism, which Penang and Johor proudly champion, we have fallen prey to speculation.

Don’t blame it all on the Chinese from China (which is a separate problem and is a problem). We do have enough locals playing the speculation game. Some even take out loans to buy additional homes in which they have no plans to reside.

Among those who take out loans, many do not need one. Taking no loans is interpreted as stupid: you don’t know how to take advantage of low interest rates and use the money to generate more money elsewhere?

Such strategies become yet another standard way of Malaysian living. Many do it rather unknowingly, not thinking of the wider implications. Whether by ignorance or by design, speculation drives up home prices and denies others from having a home at all.

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Such homes are bought not for living in, but for price appreciation – effectively turning real estate into a stock market, if not a casino. We’ve got some environmentally costly stock markets here.

This new band of owners are not even interested to rent out their homes. So they remove homes from the local housing stock, thus driving up house prices beyond the reach of people who actually live and work there. London and Vancouver face similar problems. While a tax to deter speculation is being introduced elsewhere, we are still in slumber.

Apart from regulation (by the authorities) and self-discipline (by ordinary people like you and me), we can have a pilot project for cooperative housing, where occupants neither rent nor own. Non-profit and community-based cooperative housing is common elsewhere.

Are we open to this idea or do we prefer more money and more profit in private pockets – and then we complain about the rising cost of living, about not being able to service housing loans, not being able to find jobs, about petrol prices and taxes that are too high.

Immigration

Many Malaysians are openly xenophobic. So why do we hear no serious protest against our unwelcome guests?

We do this by pressing migrants’ heads down: give them just enough to survive and just enough to do the dirty jobs – don’t give anything more, lest the locals start protesting.

The Malaysian formula on migrants and refugees is to exclude them from the society, just harvest them for sweat and blood. No integration necessary.

The Rohingya have been around since the 1980s but we only came across the word recently. They are in their third generation already. Not sure if we regard them as full persons, half persons, quarter persons or whatever fraction, you name it. Many have no ID, no access to state education and healthcare.

They are in on constant hide-and-seek with those out to cari makan at their expense. They need to be sure to have some cash ready on them, and hope they don’t get caught.

Detention can be months, maybe years. Making a phone call while in detention could be difficult, if not ‘expensive’.

This is another conspiracy of silence between voters and politicians: you keep quiet, I keep quiet, no issues here – if it doesn’t trouble you, it doesn’t trouble me either.

We don’t need yes-men assuring us not to worry, that they will take care of migrants and refugees. Convince us of the sincerity to first understand the problem. With the current economic model, there is no overnight solution to the migrant and refugee problem. Their numbers defy the current economic model. It would take tremendous sensitivity, patience and creativity to roll up one’s sleeves to try and resolve the problem, probably by exploring alternative economic models.

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Teo Chuen Tick

“..not a referendum on Wan Emdeebee.” – you are right, Mary Chin, this GE14 is indeed not a referendum on 1MDB(I did not know that word is now off limits?). But I feel it has great bearing on the type of governance our country will get. If the umnoputras retain control of Putrajaya, it will just be business as usual.Well, maybe not really, as we can be sure more schemes will be hatched to siphon the rakyat’s money from the nation’s coffers.
Yes, it is true the issues you raised here are very thought provoking and ought to form the framework for a new social order in our country. Perhaps, Aliran can take it upon itself to ensure these issues get the attention of a new Federal Government – should that come to be.

Saham
Saham

A thoughtful critique of the situation in our country