The Parable of the Banquet

If little children aged from 9 months to 13 years old can't access surgical treatments for their hearts in their own homeland, then something must be very very wrong in the Malaysian health system.

It is a paradox where a country that boasts a RM9 billion health budget, the world's top five medical tourism destination with a RM200million industry, 361 public and private hospitals with 47376 beds, and the ever-famous National Heart Institute that houses 85 cardiac specialists under one roof, can barely afford to meet the needs of a mere 17 children.

It is a national shame that we should seek the cheapest option available to fly these children and their families to another country, when there is so much capacity within the private sector to treat our own kin. We prefer to treat the rich, the famous and the foreign but marginalise our own poor and needy. Anak di riba dibiarkan, kera di hutan disusui.

We aspire to be a developed nation with huge investment poured into the many medical schools and medical scholarships annually, yet we barely provide for the needs of the poor. In 2006, there are 13,335 public medical practitioners compared to 8602 private ones, accounting to a ratio of 3:2. This seems reasonable and alright.

But when the medical needs are actually compared, the inequality to access and providence of healthcare is rather shocking. While the MOH health stats do not reveal much information, a rough estimation of doctor:bed ratio, of public and private health sector (30,396 and 11637 beds respectively), is about 1 : 2.3 (1 doctor to 2.3 beds) for public hospitals and 1:1.4 (1 doctor to 1.4 beds). This does not include the amount of doctor : outpatient ratio.

This means that public doctors are actually serving almost double the amount of beds than private doctors. This also implies that the public of all strata of society do not receive comparable proportions of health resources, with the rich enjoying almost double the amount of health resources available, while the poor are grabbing whatever resources left.

Imagine a big banquet with a huge table with luxury food and abundance for the few rich and a small table with rationed soup for the to be shared among the throngs of beggars. After a while, the soup for the poor run out, the poor old beggar and the blind orphan who came late and was hungry was disappointed that the soup has ran out. They begged for the banquet host for more soup, perhaps some of the leftovers or droppings from the table of the rich. Instead, they were turned away, and were sent to go to the pig farm next door, which served leftover food for pigs.

When there isn't enough beds for the poor, when the poor is sent to somewhere else, instead of sharing some of the rich people's beds, when even just a bite from the rich people's table is not possible, then there is something very wrong with the banquet host.