1Care is still in the works – the end of Primary care as we know it?


After the Health Minister let the cat out of the bag that there will be a “radical financing healthcare plan” in the works and a mysterious “single non-profit public third party payer” will be an important player in this plan, it begs to question what this means for private healthcare?
One recurring theme in pronouncements emanating from the powers-that-be is the planned “├»ntegration” of public and private healthcare.

What this means for primary care i.e. the family doctor or GPs is that it will be the end of current system as we know it. It may mean a move towards a system similar to the NHS UK GP system. Payment could quite possibly be a radically new (for Malaysia anyway) Capitation system whereby the GP is paid a fixed amount for the management of a fixed number of patients enrolled under his practice. There will be no longer any “fee for service” system as is currently practiced

Right now patients have the freedom to see whatever GP they want to but in the future, it may not be the case. It would mean however that financial concerns for chronic illnesses like diabetes and hypertension would be less as the drug costs would be (hopefully) taken care of by the new system.
Integration of private and public primary healthcare would mean all the public OPDs, 1Care clinics and the private GPs are essentially the same – run by primary care doctors under the same financing system.

The idea of the Capitation system is that the onus is on the primary care doctor to save costs as the budget is finite. How well the care can be delivered will obviously be dependent on how much the budget is.
How will the public pay for this new financing system? Another healthcare tax or through the existing taxation system?
Who is this mysterious “single non-profit public third party payer”?

A lot of questions remain unanswered and it would be imperative for Putrajaya to be transparent and forthcoming with all the stakeholders.

In the meantime we shall continue to try to get as much information as possible so watch this space. Doctors can get in-depth discussion in the on-going Dobbs (the Malaysian Doctors forum) thread 1Care version 2.


Malaysian physician, haematologist, blogger, web and tech enthusiast