Sunday, February 13, 2011

THERE'S ALWAYS A HELPING HAND

At IJN, there are three options a patient in financial difficulty can consider: The Medical Assistance Fund, the IJN Foundation and the Unit Taksiran Khas Kementerian Kesihatan Malaysian (UTKKKM)

Walking into a hospital is a scary time not just for the patient and loved ones but also for those who are wondering how they will afford the rising costs of healthcare. Government hospitals form a safety net for those who cannot afford the big bills at private hospitals, but what happens when treatment is not available anywhere else? What happens when a Government hospital refers you to IJN?

Some of our patients from the lower income group cannot afford the fees at the hospital. When they are asked for the deposit at admission, they are usually taken by surprise. The scenario is a familiar one: We’ve heard it from relatives, friends or read about it in the newspapers – but that’s where our knowledge usually ends. Most of us don’t know what comes next or how the story ends.

We assume that patients are turned away, refused treatment or end up at newspaper offices looking for help. While it’s true that some do look for public funds collected through the media or other organisations, patients can actually approach the hospital itself for financial help.

When they say they have no money to pay the deposit, they are brought to Patient Services Department. Here, each patient’s case is analysed before a decision is made about which course of action is best to take. At IJN, there are three options a patient in financial difficulty can consider:

First, there’s the Medical Assistance Fund (MAF, also known as the Tabung Bantuan Perubatan or TBP). The MAF is administered by the Ministry of Health and has an annual allocation of RM25 million. The fund covers treatment and purchase of medicine not otherwise available in government hospitals. For example, in the cardiothoracic field the MAF will fund, either in part or in full, the Implantable Cardioverter-Defibrillator (ICD). Neither the procedure nor the device is available in government hospitals, so the MAF covers those who need the implant. (The ICD is a device that sends an electric current to the heart if it stops beating. It is surgically implanted into a patient’s body and includes a pulse generator that constantly monitors the heartbeat like a small computer.) The device costs between RM30,000 to RM80,000.

In the last 3 years (2008-2010) we have 67 patients who implanted their ICDs funded by MAF. To be eligible for MAF assistance, a patient needs a government hospital reference with a signature and stamp, a medical report from the doctor, and must be a Malaysian citizen. Patients applying for the fund will also need to visit the Welfare Department to have their financial situation assessed. The department will weigh income levels, number of dependents, and other relevant details that affect one’s economic situation. With this, the department will then recommend an amount to be sponsored by MAF.

Besides the MAF, the IJN Foundation also helps those with financial difficulties, such as children without birth certificates who needed help. Finally, the Health Ministry’s Unit Taksiran Khas based at IJN can also be approached to subsidise cases that are referred to IJN from government hospitals.

IJN serves 500 to 600 outpatients daily, about three quarters are sent to the Unit Taksiran for financial assistance, and out of the 50 to 60 daily admissions, about 40 are sent for financial assistance. However, patients must keep in mind that charges are usually not subsidised fully. Patients are usually asked to contribute partly to the payments, no matter how little, as this gives them a sense of responsibility.

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