Friday, December 04, 2009

Another achivement by Malaysia's IJN - but how many can afford RM122,000 - Heathcare must be FREE

I am so happy that the expertise and capabilities of the National Heart Institute (Institute Jantung Negara - IJN) is increasing.

But I am very worried that all these services that can be provided by the Malaysian governments Heart Institute is beyond the means of the ordinary person in Malaysia. The not just the poor but the majority of Malaysians cannot afford to get treatment for heart related ailments and conditions because it is not free - in fact it is very expensive. Of course, IJN do not put up the rates in their website...and only when you need to go to IJN will you find out.

The government takes care of government servants and their dependents when it comes to heart healthcare at IJN but not the private citizen. MPs and ADUNs are also public servants, and I belive they too fall withing this special group - and maybe that is why they are not so bothered about the rest of us in Malaysia.
  • Government patients include officers and their dependents (spouse and children) and pensioners of Federal Government departments
  • State Government departments
  • Local Authority / Statutory Body departments whose treatment charges and hospitalisation bills are borne by the departments.
Cost of a simple heart screening is RM1,399-00, and for a complete heart screening it will cost you RM4,279-00.

Selling Price : RM 1399

64 slice MSCT calcium scoring - RM 350.00

64 slice MSCT coronary angiogram - RM 2.500.00

Cardiac rehab programme phase II - RM 30.00

What about if you need a coronary angioplasties, heart surgery or some other procedure. What is the cost...or should we say "selling price" ...and I wonder why this is not there in this UMNO-led BN government's National Heart Institute.

Well, their recent proclamation is that they can now '...replace heart valves without open heart surgery..', and do you know how much the ordinary Malaysian will have to pay if you want it. “After that, patients need to know that the CoreValve device will be RM112,000 while another RM10,000 will be needed for other operation costs,” (Star, 4/12/2009, IJN can now replace heart valves without open heart surgery). So, how many persons in Malaysia can afford to come up with this kind of money.

In 2003, over 7,000 invasive cardiology procedures were performed. Out of which almost 3,000 were coronary angiograms, over 1,800 coronary angioplasties (PTCA), and 600 diagnostic catheterisations.No data seem to be available about how many of these were Malaysians, and how many were foreigners (oh yes, Malaysia promotes medical tourism..wooing foreigners to come here for heart treatment, etc...). How many of these were government servants and their dependents? How many of it were 'private' Malaysians? How many of these were the poor?

Previously, in Malaysia we could get very affordable heathcare at most of bigger government hospital, and then they set up IJN - and started closing all heart units in government hospitals. The last of the hospitals that provided heart healthcare was in Penang and JB - wonder whether they still do that today.

Many persons referred to the IJN by government hospitals, end up waiting...and waiting...and then they die.

IJN is becoming like any other private hospital - and most people really cannot afford to seek medical treatment there. 

Healthcare for all persons in Malaysia should be free. If there is to be registration fees, then it must be a token RM1...or RM5...or maybe RM10. For any procedure or surgery, including pre-post care,  it should not exceed RM1,000-00...or maybe the most should be RM1,500-00. 

The Malaysian government must be responsible for providing  universal healthcare to all  in Malaysia for free preferably, or for a token fee. Government must subsidize healthcare.

Thankfully, Najib's plan to sell off IJN to Sime Darby has been shelved. It was the Malaysian peoples money, administered by the UMNO-led BN government that was spent in creating and developing IJN - but alas, it is only for the rich Malaysians, 'public servants' (that it the correct term, not 'government servants') and their dependents, rich foreigners who come to Malaysia for treatment, and maybe a token number of the poor. [Oh yes, there will be a token number of poor who was treated for free by the IJN...]

But, the question that some parliamentarian should be asking is:-

* How many persons have received the benefit of the various different procedures/surgery in the IJN?

* How many were 'medical tourist'? How many were Malaysians? How many came under the category of 'public servants and their dependents'? How many came under the category of 'private patient'? How many poor?

* How many persons were referred to IJN in a particular year by government clinics and hospitals? How many were attended to by IJN? How many received treatment? How many did not receive treatment after it was suggested to them? How many referred died before they met with the IJN doctor, and underwent the required treatment/procedure/surgery? How many did not come back for treatment? [This would most likely give us the figures of those who just could not afford the exorbitant costs...]

* What are the specific charges for the different procedures and surgery provided by IJN for the 'private patient'?

* What are the ward charges?

* What happens if the 'private patient' do not have money for the deposit and charges? What will IJN do? Send him/her off to find the money and come back later when they have the money...or will they still do the necessary procedure/surgery? 

* How many persons died in Malaysia in the last 5 years by reason of a heart condition, that could  have been prevented if there was the required heart heathcare as provided for by IJN?

I wonder whether Malaysia has sufficient number of doctors and establishment to cater to all those in Malaysia that have heart related problems? 

If not and there is a shortage of doctors/facilities, why is the UMNO-led BN government and IJN promoting medical tourism encouraging rich foreigners to come get heart treatment?

Only if there is already sufficient resources to deal with all those in Malaysia should the Malaysian government be  seeking 'customers' overseas.

It must be reminded that this is not a private hospital, interested primarily in profits.

IJN is a Malaysian government facility, and its obligations is for the heart healthcare of all Malaysians first - not making money from medical tourist. [Go check out our Ministry of Health website, and you will be shocked that they are promoting medical tourism and also pricate hospitals. Is the government getting money from these private hospitals or is the money of the people being used?]

The full Star report is below.

The National Heart Institute (IJN) achieved another milestone by performing the first heart valve implant in Asia without the need for open surgery. 

Known as transcathether aortic valve implantation (Tavi), the procedure allowed problematic valves in the aorta to be replaced with an articifial one by using a tube that is 6mm in diametre known as a cathether.

The tube is inserted either at the thigh area or below the left collar bone and then slid through arteries to the heart.

And the procedures has a 99% success rate.

“Patients, who have gone through Tavi, will be able to move around on the third day after the implant but they would be required to lie down during the first 24 hours,” said IJN medical director Datuk Seri Dr Robaayah Zambahari.

She was speaking to a press conference to announce the achievement at IJN here Friday.
The procedure, which uses a device called CoreValve, causes less trauma to body tissues and enables a faster recovery compared to the conventional open heart surgery as only incisions are made at certain areas to insert the tube.

Dr Robaayah was part of the team of IJN consultants that performed the procedure on the first patient, a 73-year-old man who suffered from severe narrowing of heart valves and a second patient, a 77-year-old man on November 25.

The third patient was National Laureate Datuk Shahnon Ahmad, 76 who was treated the next day.
The team included cardiologists Datuk Dr Rosli Mohd Ali, Dr Shaiful Azmi and cardiothoracic surgeons Datuk Dr Mohd Azhari Yakub, Dr Jeswant Dillon as well as anaesthesiologists Datuk Dr Mohamed Hassan Ariff and Dr Sharifah Suraya.

The procedure was assisted by Dr Ganesh Manoharan, a consultant interventional cardiologist from Ireland, who will also overlook the operations of the next 12 to 15 patients.

“The 12 to 15 patients are currently on the waiting list to be certified by IJN and the costs of their operation will be borne by IJN.

“After that, patients need to know that the CoreValve device will be RM112,000 while another RM10,000 will be needed for other operation costs,” she said, adding that she hoped the Health Ministry would offer support and subsidise the procedures for the public in future.

Dr Robaayah said there has yet to be any case of a patient’s body rejecting the artificial valve made out of a type of metal called Nitinol.

“The procedure takes an average time of 45 minutes to one and a half hours. We took about two and a half hours for the first patient because we were still learning about the procedure and wanted to be careful,” she said, adding that the method was only performed on high-risk patients such as the elderly, so far.

Dr Ganesh said local anaesthesia was used on the patients so that they remained awake during the procedure but did not feel any pain.

“It is not surprising to see patients smiling as we conduct the procedure on them,” he said.

“About 50 centres worldwide are applying this technology but it is more suitable for this region since Asian blood vessels are generally smaller,” Dr Ganesh added. - (Star, 4/12/2009, IJN can now replace heart valves without open heart surgery)

See also earlier posts:-

When the unavailability of free universal healthcare for ALL increases health risks of Malaysians -

BN wants to increase fees for heart healthcare - STOP it, and make it free healthcare for all not just the rich..

Let's put an end to 'people need money for surgery, etc..' ads - Free government provided healthcare.

 More will die sooner because of lack FREE government-provided heart healthcare in Malaysia


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