Why impoverise them then try to buy them with comcare?

• robertteh

  8 Apr 06, 09:20

  We must ask the question : do we really treasure talents and people of ability.
  
  If we have real political talents, are we going to treasure them and groom them to be our future leaders ?
  
  Do our leaders so far, show commitments in honestly, sincerely, with the best of hearts treasure their contributions or participations in the running of the affairs of state.
  
  Do our leaders really take a back seat or step aside and stop clinging on to powers to allow these second-line leaders to be groomed tested and achieve renewal and motivate the masses in all our endeavours.
  
  Do we today have the core team of people who can lead in our ongoing political process to bring about greater social, cultural and political vibrancy to motivate the whole population.
  
  If such simple acts and commitments as stated in the foregoing are not seen but only rhetorics about meritocracy and finding of more and better-qualified candidates etc, we are getting nowhere really.
  
  Some good ones probably in seeing all the powerplay have chosen to resign or stay low-profiled. Our system seems to be a closed and self-centred system not likely to be appreciated by the people as the real political renewal and succession process.
  
  So even with all the tea sessions, meritocracy principles, high-flyers groupings, clandestine elite clubs somewhere to source more people, we will get nowhere. The whole exercise is not genuine springing from objective fairness, openness and accountability to the people for leaders' performance.
  
  What are seeing today in our leadership renewal may be scraping at the surface just to put up a show with look-good justification by putting up some look-good candidates who are not fully tested to have served the people. Leaders have the opportunity given by the people to them for so many years to look at the larger issues and not to gerrymander in leadeship renewal or to perpetuate self-ness and narrow agendas of the party in power.
  
  Honestly, sincerely and objectively do our leaders show that they can see the bigger things and bigger aspirations of the people in the political renewal process they themselves have been talking about for years. Or is it so far merely a smokescreen and hypocrisy or wayang.
  
  If men at the top keep talking about paying the leaders and their following elites million-dollar salaries and 6-months bonuses will we find the right kind of principled and able leaders who are passionate and willing to sacrifice for the good of the country by personal example.
  
  I cannot yet see our second line leaders showing ability to upgrade the base economy to value-adding technology-driven model needed for our survival. Neither do I see their active measures to building up our social cohesions, vibrancy and togetherness. I only see them as people who are likely to cite examples from the third world (not the first world) so as to give more excuses for them to clamp down or close the blogs or internets and shut down freedom of political renewal process.
  
  Do they know what are the larger interest of society, do we have the future for ourselves or our future generation here in this red dot.
  
  The kind of deputies and ministers who are managing our economy and social cohesion and political renewal which the society want and need is reflected by the quality of our crop of second line and third line leaders. Let people be the judge of this so-called leadership renewal. Is it real or just a look-good exercise to entrench the tenuous hold to power for our present generation of leaders.
  
  If our present leaders are not like Deng Xiao Peng, willing to take a larger objective view and constantly put up their own party or self agenda before the nation's agenda, then we will not see good second liners leaders. Our leaders will then be surrounded by runners, spokesman, controllers, executioners, propaganda espousers who would constantly have to contend with fellow citizens who have better ideas and contributions to make who are not happy because certain commitments and acts of faith are not taking place in the political renewal process people want.
  
• oxford mushroom

  8 Apr 06, 16:40

  The 'quality of services' are as stated in my postings as - " Standard medicine and medical practises - dealing with orthopaedic, paediatrics, pregnancies, heart surgeries, and other general medical practices - will cost far cheaper in Malaysia and Thailand when compared to the same being conducted in Singapore or Hongkong." - which you seem to ignore, preferring to limit your position with lab tests that are accredited by some acronymed body.
  
  Are you not selectively narrowing your argument in a direction that is totally irrelevant to the general health care for Thais, Malaysians and Singaporeans ?
  
  Should accredited lab tests be the single superior criteria over all other medical and surgical services offered by hospitals ?
  

  You either fail to understand the practice of medicine or choose not to. How do you measure quality of service? In medical practice, each process is audited and accredited by an international body if it meets certain standards. You cannot provide good medical service without good diagnostics by the labs and a good clinical team. You cannot divorce one aspect of hospital care from another.
  
  Secondly, the point I am making is that a hospital that offers a lower range of services and does not have capability to handle highly complex and cutting edge medicine has lower cost structure. If you are only making Citizen watches, you do not have to employ the highly skilled craftsmen necessary to make a Rolex.
  
  You seem to suggest that you are only interested in providing cheap healthcare to simpler medical problems, which is available at lower prices in neighboring nations. That is true and I have said that outsourcing medical services for simpler medical conditions to JB and Bangkok would probably make the Minister of Health very happy. The hospitals will be happy to concentrate on providing higher value services to those who can afford it and foreign patients. Is that what you want? Will Singaporeans accept that?
  
  Thirdly, whilst most people thankfully will not develop cancer or conditions that require expensive intensive or emergency care, what about those who do require them? The journalist Chua Mui Hoong wrote recently about her experience with brea_st cancer and rightly criticised the doctors here for not telling patients of the drug Herceptin, which significantly improves survival for patients with a form of brea_st cancer. Unfortunately the drug and the lab tests required to identify patients who are suitable for the treatment are very expensive.
  
  Cutting edge medicine does save lives and improve survival, but at a high cost. If we provide that sort of treatment to the minority who need it, our cost structure will obviously be higher than a hospital that does not have the capability to handle such cases. A hospital that does heart-lung transplant for a few is obviously going to have higher costs than one that does appendicetomy for a larger number of patients.
  
  You are suggesting that we restrict expensive, cutting-edge medicine only for those who can afford them? Why not be upfront about it and admit it if you do? If not, what is the alternative?
  
  

  Are hospital built to provide high standards of AFFORDABLE Health Care, or for the 'national vanity' in the glory of providing 'CUTTING EDGE MEDICINE' ?
  
  Did Singaporeans clamor for 'cutting edge medicine' or are Singaporeans calling for lower health costs with greater transparency ?

  Perhaps I cannot blame you, as a layperson, for being ignorant about the progress of medicine. Just 5 years ago, patients with advanced malignant gastrointestinal stromal tumour, an uncommon cancer in the gut, are simply told they will die in a few months. We now have a drug that not only improves the survival but can actually causes the tumour to regress. Our hospitals now have the technology to detect the mutation targeted by this drug and the expertise to treat this disease. It may well be 'cutting edge medicine for national vanity' to you, but certainly not for the patients themselves.
  
  Perhaps not being a doctor you fail to understand the desperation of unfortunate patients. Humans are not sales figures. It may not cost-effective to spend half the health budget on the 5% of patients who require such expensive treatment but to the patient himself, it is worth every cent.
  
  Do Singaporeans clamour for cutting edge medicine? Yes, if you are the patient and your life depends on it..
  
  Doctors want to do the best they can for all their patients. I find it difficult to accept your implication that we should only provide the best treatment available to the wealthy and foreign patients who can afford it.
  
  

  The Pharmaceutical Companies are pushing out new drugs at high prices in the early stage to recover their R & D costs, much like Car Manufacturers charging atrocious prices for exotic cars that depreciate in value after the innovative designs and technologies become available by other marques.

  Yes, and the patent protection runs for 20 years. If you are suggesting that we should only offer to patients drugs that were discovered in 1986 and earlier, that's fine.
  
  

  Calm yourself from exaggeration, and you will perhaps allow yourself to see through the fog that is purposefully created.

  I wonder who is exaggerating? Perhaps if you remove your blinkers of bias, you can better see clearly the challenge we face in healthcare and come up with better suggestions than just lampooning the government. Their policies are not perfect, but we should also understand the difficulty.
  
• oxford mushroom

  8 Apr 06, 20:22

  I fear we might have hijacked Robert's thread which is about comcare. I have opened a thread to carry on the discussion on healthcare:
  
  http://www.sgforums.com/?action=thread_display&thread_id=185503