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淡马亚:医疗基本人权,反对私营化

by Yee Loon
23/07/2018
in 健康, 政治, 新闻
Reading Time: 1 min read
0

民主党主席淡马亚医生,冀望投身有鲜明意识形态的政党,而民主党(SDP)的中间偏左路线,与他对基本人权如居住权、医疗和基础教育的观点相符。

他在2010年开始活跃于民主党,于2011年曾为该党竞选活动站台。但直到2015年,才作为候选人之一在荷兰-武吉知马集选区上阵,他主打的主要议题之一,就是医疗融资。

他坚称终身护保仍有改善空间,“医疗是基本人权,而不是施舍,医疗私营化是一个错误,”大众应享有可负担的医疗服务”。

在1960年,世界卫生组织派代表考察新加坡的医疗体系,时任卫生部长阿末伊布拉欣(Ahmad Ibrahim)说狮城拥有完善医疗体制,提供民众近乎免费的医疗服务。看门诊(OPD)只需1新元,住院也大概5新元。”这种状态一直维持到80年代中期。

淡马亚说,在1983年出台的新加坡医疗蓝皮书,显示新加坡的婴孩夭折率甚至低于英美两国。我国确实曾以低廉价格提供民众一流的医保服务,证明可负担医疗福利是可行的。

“或许你想住进私立医院,但前提是,只要政府作为公共医疗唯一经营者,你不需担心因癌症或心脏绕道手术承担高昂费用。”

他补充,这不意味着政府一手包办,因为这可能导致体系过于臃肿而缺乏效率。不妨参考澳洲、法国和德国,政府不必然承办服务,而是背后出资人。

他放眼打造免赔额和保户自付额都较低廉的基础医疗服务。淡马亚认为,没有证据显示,只因为医疗服务免费或可索赔保险,病患就会刻意接受无必要的治疗,大部分人对常常看医生和吃药可不感兴趣,所以政府过度赔偿的问题不应存在。

商业化鼓励过度消费医疗资源

“一般民众对医疗的认识有限,仰赖他们的医生和保险公司建议最好的疗程,造成信息不对称现象。”

他分析,促成狮城医保成本上涨的因素很多,最重要的就是商业化,医疗机构必须赚钱,确保投资股东能获得回酬,结果造成市场扭曲,过度消费医疗服务资源反而被奖励。

例如一些病患被特地安排住院接受诊断,只为了能享用保险提供的优惠,也为这些医保机构盈利最大化,即便有关病患原本只需挂门诊,费用反而更便宜。

“结果医生成了雇员,必须向顶头股东交代,与此同时还要维持对病患的职业操守,这是很大的挑战。”加上狮城医疗诉讼兴盛,医生担忧因疏忽招惹官司,结果对病患过度小心谨慎,做更多无谓的诊断。

淡马亚也介绍,民主党提出的医疗计划,则可以避免资源过度消费的问题。该党倡议推出有效、据实索偿的全国性医疗保险,为治疗程序的优惠设限,索偿也必须有实质的科学根据。

11811306_10153740153338455_8998772484796739321_n

冀改善选举选举制度

对于我国选举制度,淡马亚医生更希望,选举能由独立的选举委员会,选区划分根据所有政党、公民社会和个体选民平衡分配。然而,现今的选委会,却直接由总理署管辖。

总理李显龙曾有缩小集选区、增设更多单选区的建议,有学者分析这能让资源有限的反对党较能集中火力,对此淡马亚则嗤之以鼻。

“即使是三名候选人的集选区,你也可以策略性地划分,把较有胜算的地区划在一起。”

他呼吁新加坡全面回归到单一选区制,不认同集选区能较平均代表多元族群权益,“反之在早年,新加坡仍实行单一选区制的时候,国会拥有更多元的代议士比例,也有更多的少数群体代表。”

他说,选民也不必然只投选同族群的候选人,例如武吉巴督补选既是一例,穆仁理成功打败民主党秘书长徐顺全,保住该行动党自1992年以来即稳守的议席。

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