Saturday, October 06, 2007

Not treating Burmese murderous Junta is against Hippocratic Oath, but making sick S'poreans accept earlier death due to cost issues is not!

Wow! Our PM Lee had came up with a ingenious argument to defend the govt on why they should let the Burmese Junta to come to Singapore for medical treatment.

According to PM Lee, it is against the Hippocratic Oath to bar the murderous generals from seeking medical treatment in Singapore!

Here is what is reported by CNA:
Mr Lee also responded to a question on whether Singapore should prevent members of the Myanmar government from coming to Singapore for medical treatment.

He said: "I think we have to decide whether we're trying to influence the policy of a government or whether you want to do petty indignities to individuals, which is really against human nature.

"Somebody who is sick, he wants to come to Singapore, he needs treatment and you're telling me that I shouldn't treat him because he is not a good man? It goes against the Hippocratic oath of doctors."
How noble PM Lee is!

If that is the case Osama Bin Laden should come to Singapore for medical treatment if he is sick, after all our govt already said that it is against the Hippocratic Oath if we don't treat him!

But wait... What should I make of this statement by PM Lee?
The practice of medicine has its limits. It takes wisdom to know these limits and the true needs of the dying. Heedless pursuit of “pure” medicine to prolong life, without regard to cost or the wishes of the patients, cannot be sustained in the long term, not even in the wealthiest countries. This is a serious problem plaguing the US healthcare system today. Alas fixing it is politically difficult. We must not get into such a situation.
PM Lee is telling the doctors that S'pore doctors that they should NOT heedlessly prolong life of Singaporeans "without regard to cost"!

Is PM Lee saying that Singaporean patients should NOT be treated when it is too costly to keep them alive?

Well, at least one of his minister had made his position clear.
I regret making the decision because, in the end, the baby continued to be in intensive care, and KKH now runs up a total bill of more than $300,000
- Lim Hng Kiang, regretting the decision to save a baby's life because KKH ran up a $300,000 bill

How is that for Hippocratic Oath!

Perhaps to PM Lee this Oath only applies to the rich people, evil or not, who can afford the medical treatment.

Singaporean patients who have problem paying for their medical bill will just have to accept their fate.

No wonder so many Singaporeans say that one "can die but cannot be sick in Singapore."

Uniquely Singapore indeed.

Sanctions against Myanmar will be counter-productive: PM Lee
By Wong Siew Ying, Channel NewsAsia | Posted: 05 October 2007 2045 hrs
SINGAPORE: Prime Minister Lee Hsien Loong has said that sanctions against Myanmar will be counter-productive.

He also stressed that ASEAN alone cannot solve the problem in Myanmar, and called on the international community to weigh in as well.

Mr Lee said this in an interview with the CNN, which was aired on Friday evening.

He was responding to the presenter who asked if ASEAN could do more besides issuing strong statements against the unrest in Myanmar.

ASEAN has to take a clear stand on Myanmar because what happens there affects the group's reputation, said PM Lee.

What ASEAN wishes to see is developments that will lead progressively to a Myanmar government that has more legitimacy at home and greater acceptance internationally, added Mr Lee.

But ASEAN, he stressed, does not have the leverage to solve the problems in Myanmar.

Mr Lee also explained why economic sanctions against the military-ruled country may not be productive.

He said: "First of all, this is a country which wants to isolate itself from the world, so they are not afraid of you cutting them off.

"Secondly, if you want to have sanctions, it cannot just be Singapore or even ASEAN, but all of the countries in the world have to do that, and that includes the Western countries, investors in Myanmar and its neighbours like China with big stake in Myanmar.

"And thirdly, if you do have sanction and it worked, I think the people who will be hurt by the sanctions will not be the regime or the SPDC (State Peace and Development Council), the government, but the people of Myanmar, so it will be counter productive."

Mr Lee added that the United Nations will play an important role, and the recent visit to Myanmar by UN special envoy Ibrahim Gambari is the first step to improving the situation there.

Mr Lee also responded to a question on whether Singapore should prevent members of the Myanmar government from coming to Singapore for medical treatment.

He said: "I think we have to decide whether we're trying to influence the policy of a government or whether you want to do petty indignities to individuals, which is really against human nature.

"Somebody who is sick, he wants to come to Singapore, he needs treatment and you're telling me that I shouldn't treat him because he is not a good man? It goes against the Hippocratic oath of doctors."


Separately, Mr Lee spoke on the phone with UN Secretary-General Ban Ki-moon on Friday.

The UN chief invited Singapore, in its capacity as the current ASEAN chair, to make a statement at a UN Security Council meeting on developments in Myanmar.

PM Lee told Mr Ban that he has written to China, India and Japan to work together with ASEAN and the UN to help the parties in Myanmar find a way towards national reconciliation. - CNA/ir

ACCEPTANCE SPEECH BY PRIME MINISTER LEE HSIEN LOONG FOR THE CONFERMENT OF HONORARY FELLOWSHIP BY THE ACADEMY OF MEDICINE, 19 JULY 2007, 6.45PM RAFFLES CITY CONVENTION CENTRE

Professor Ho Lai Yun, Master of Academy of Medicine Singapore,

Distinguished guests,

Ladies and Gentlemen

1. I am honoured to accept the honorary fellowship from the Academy of Medicine. I am also happy to join you tonight for your Golden Jubilee, and for the 41st Singapore-Malaysia Congress of Medicine. I understand that members of the Hong Kong Medical Academy are here as well for the Congress. To all our foreign guests, let me extend a very warm welcome to Singapore.

2. Healthcare in Singapore has come a long way since the Academy was founded. Half a century ago, we were struggling to keep malnutrition and infectious diseases under control. Today, Singa­poreans enjoy standards of healthcare equal to or exceeding the advanced countries. Internationally, Singapore healthcare stands for quality and ethical practice. The growing numbers of foreign patients who seek advanced medical treatments in Singapore each year is testimony to this.

3. We owe this position to past generations of doctors who served with compassion, humility and high ideals. Indeed, Singapore is fortunate to have had a pioneering batch of doctors deeply steeped in the ethics and values of medicine. Professors Ransome, Sheares, Seah Cheng Siang, S S Ratnam – they, together with many others, served selflessly with the single purpose of providing the best possible care for their patients, whether rich or poor. They inspired subsequent generations to aspire to the highest standards of professional excellence.

4. We must cherish and build on this precious legacy. This is particularly so because moving forward, our healthcare system faces some daunting challenges.

5. One challenge is the rapidly growing demand for healthcare services. Ours is one of the fastest ageing populations in the world. On current demo­graphic trends, the number of Singaporeans aged 65 years and above will double in 15 years. Older people are hospitalised more often, and each time stay in hospital longer on average. Our public hospitals already run at near capacity. The existing infrastructure clearly will be inadequate to meet the needs of this surge in elderly numbers, plus the steady growth of our overall population year by year.

6. The Government is investing to expand the capacity of our healthcare system. The Khoo Teck Puat Hospital in Yishun is already under construction, and should be completed by 2010. MOH has begun planning for another hospital in the Western part of Singapore. We will also reserve several sites scattered across the island, so that new hospitals can be built when the population and patient load builds up.

7. But building hard infrastructure is the easier part. We also need to train and recruit the people – doctors, nurses, other healthcare workers – to staff the new institutions and make them work. Without them, quality of care will be compromised, and we will fall short of the high standards that Singaporeans have rightly come to expect.

8. The numbers involved are large. MOH, for example, projects that we will need to recruit over 2,000 more doctors by 2015. Given our small local talent pool and competing needs from other sectors in the economy, there are limits to how far we can expand the local supply. It will not be a simple matter of just investing more money to train more Singaporeans to become doctors or healthcare workers. We have been raising the intake of medical students each year, but this will not be enough. Increasingly, we will have to recruit medical talent from abroad. We must be open minded in accepting such imported talent, while maintaining medical standards and helping foreign trained doctors to adapt to conditions in Singa­pore.

9. While we will invest more in healthcare, it is even more important to get the economics of healthcare right. Countries all over the world have taken different approaches. Their experience shows that more resources do not necessarily improve healthcare outcomes. The reality is that demand for healthcare is unlimited and has to be rationed. Some countries have gone for free healthcare at point of use, only to face the intractable challenges of meeting insatiable demand and curbing abuse while keeping high standards of healthcare. Problems are compounded as populations age and vast amounts of high-tech resources are marshalled to manage the last few weeks of the terminally ill, delivering poor quality of life to the patients at very high cost to society.

10. The practice of medicine has its limits. It takes wisdom to know these limits and the true needs of the dying. Heedless pursuit of “pure” medicine to prolong life, without regard to cost or the wishes of the patients, cannot be sustained in the long term, not even in the wealthiest countries. This is a serious problem plaguing the US healthcare system today. Alas fixing it is politically difficult. We must not get into such a situation.

11. Singapore has opted for pricing and co-payment to bring market forces into play, minimise waste of resources, and incentivise efficient delivery of healthcare. MOH has been pushing for greater transparency, publishing information on bill sizes of hospitals and encouraging hospitals to track and publish clinical quality indicators. This will enable patients to make more informed choices and the market to function better.

12. Our system relies on compulsory savings through Medisave and risk-pooling through MediShield, a medical insurance scheme to cover large hospital bills. Medifund provides the final safety net. This approach has helped us avoid the problems experienced elsewhere and contain national healthcare expenditure, yet with very good outcomes. But managing healthcare cost escalation requires continuous effort, particularly with the ageing population. We must keep on identifying better ways to keep Singaporeans healthy and help those with chronic diseases to manage their illness, so as to avoid future complications. We need to maintain our market-based system, while exploring new and creative approaches to improve it.

13. This includes exploiting IT to the full. The National Healthcare Group, for example, has introduced tele-radiology at its polyclinics, where x-ray images are sent to Bangalore to be read. As a result, prices have been reduced and turnaround time has been cut dramatically from 2 – 3 days previously to an hour or less. Increased competition has also led to local radiologists charging less for x-rays and reporting the results faster. Patients benefit all round, saving money and time as they no longer need to make return trips for their results.

14. We must press on with such initiatives. There are other applications of telemedicine, such as tele-pathology, where technology has advanced to a stage where it makes economic sense and improves the quality of care, while assuring patient safety. Complete computerisation of hospital information systems is an ideal goal which is still some way away. These changes may be unsettling for incumbent practitioners. But the response cannot be to dig-in and resist. Just like in other industries, incumbents must look for new niche areas on the value chain, where our more advanced capabilities and recognised quality standards justify our higher costs.

15. Finally, we must not lose sight of the core values which underpin and provide the moral compass for our healthcare community. Senior members of the community must lead by example, teaching and mentoring their younger colleagues. Financial incentives play a role, and successful specialists can do very well, particularly in the private sector. There is nothing wrong in this. But values built up over many years, such as caring and compassionate service to patients and striving for the highest standards of professional excellence, must never be diluted or lost in the midst of change. Senior doctors must pass them on to the younger generation of doctors, so that they will in time produce a new generation like Gordon Ransome, Seah Cheng Siang and the other pioneers. This is perhaps the most fundamental challenge of all for the medical profession.

16. The Academy of Medicine is committed to advancing the art and science of medicine in Singapore, and promoting and maintaining the highest professional standards of competence and ethical integrity. It plays a leadership role in keeping the profession true to its mission of providing the highest quality of patient care in Singapore. I am confident that you will draw upon the rich values that have guided your profession through the years, to guide your way forward.

17. I congratulate you on the 50th Golden Anniversary of your Academy, and wish all participants of this Congress a fruitful and productive meeting.

13 Comments:

At 12:20 PM, October 06, 2007, Blogger Aaron said...

Haha! Good one! I enjoyed the read thoroughly. ;)

 
At 3:40 PM, October 06, 2007, Blogger at82 said...

Hi Aaron,

Maybe the reporter misheard PM Lee.

Actually he is referring to the "Hypocritic Oath" lah.

 
At 4:06 AM, October 07, 2007, Anonymous Anonymous said...

so depressing :(
the next burma might be us :(:(
i see lotsa talk in the blogosphere...I hope it will all amount up to something for future generations to come.

 
At 7:05 AM, October 07, 2007, Blogger at82 said...

Hi anon,

I also find this very depressing. :(

Although I understand that S'pore is tiny country, there is something where we, as decent human beings, should draw a line.

We already are like burma liao la. Did you see how many generals we have in the govt?!

Somemore our venerable MM Lee already tell us that if S'pore got freak election "army would have to come in and stop it."

http://perspectives.singaporeangle.com/2007/03/why_saf_officers_have_fast_tra.html

However we don't need to wait until the next generation.

Do your part educate your friends and family about all lousy policies PAP set up after last election.

Eg Job for FTs, NS for S'poreans policy, GST for the poor policy, Bai Jin (annuity) policy, Millions for minister, $290 for public assistance policy, etc.

Ask them to vote correctly in the next GE to prevent being cheated yet again!

 
At 12:48 PM, October 07, 2007, Blogger James Chia said...

Good one! One country, Two System!

 
At 12:46 AM, October 08, 2007, Blogger X.jy' said...

haha that goes to show agn how ruthless pragmatism runs behind everything they do, and yet they try to cover it up with bloody hypocritical pseudo-righteousness.

i think despite all the recent controversial policies, attempts to bring the opposition to power will still be futile, because so far none of the opposition parties are able to provide strong reliable alternative policies and system. Most of them call for democratisation, more welfare and help for the poor etc, but is there a concrete plan or alternative system that guarantees us economic survival and continual progress?

i don't see one at the moment, so even though the PAP is not doing a good job, there is no replacement for them that we can fully trust at the moment. Therefore, even by voting for the opposition, all we are doing is, at best, bargaining for more freedom and welfare from the PAP, but ultimately we still want them to be in power because we havent got much of a choice anyway.

just my two cents worth, dont mind me :)

 
At 3:24 AM, October 08, 2007, Blogger Han said...

i am a burmese,
I noticed what PM said in CNN interview and I am also suspectious about his insisting not to impose senction against Burma and saying that ASEAN has no leverage to persuade Burma to make changes.
Is it a genuine confession or just an excuse to ignore Asean's responsibility?

 
At 3:38 AM, October 08, 2007, Blogger at82 said...

Hi James,

"Good one! One country, Two System!"

Don't say liao la. So sad T_T

Hi X.jy,

"haha that goes to show agn how ruthless pragmatism runs behind everything they do, and yet they try to cover it up with bloody hypocritical pseudo-righteousness."

Agreed.

"i think despite all the recent controversial policies, attempts to bring the opposition to power will still be futile, because so far none of the opposition parties are able to provide strong reliable alternative policies and system. Most of them call for democratisation, more welfare and help for the poor etc, but is there a concrete plan or alternative system that guarantees us economic survival and continual progress?

i don't see one at the moment, so even though the PAP is not doing a good job, there is no replacement for them that we can fully trust at the moment. Therefore, even by voting for the opposition, all we are doing is, at best, bargaining for more freedom and welfare from the PAP, but ultimately we still want them to be in power because we havent got much of a choice anyway."

It is really a chicken and egg problem. The Opposition need more representation in the parliament in order to make their presence felt and attract more qualified people.

If nobody gives them a chance, how can they show us what they can do?

PAP was a opposition once too. If S'poreans did not give them a chance what PAP will be now? Maybe something like its brother party, DAP, in Malaysia!

If you read up what PAP did to gain power, you might think all of them should be arrested under ISA. Actually a few of them are! A search on google will give you a wealth of information on them.

http://disgruntledsporean.blogspot.com/2007/09/lim-chin-siong-comet-in-our-sky.html

Anyway my point is that we need to give the opposition a chance to run a GRC 1st. At least the people can have more bargaining chip with those in power.

Please note I am not pro-opposition because I am anti-PAP. I am pro-opposition because I am anti over concentration of power.

I am a firm believer of the phrase "power corrupt, absolute power corrupt absolutely". We need to give opposition a chance to run a GRC, before we can make any judgment on their abilities.

 
At 3:47 AM, October 08, 2007, Blogger at82 said...

Hi Han,

"i am a burmese,
I noticed what PM said in CNN interview and I am also suspectious about his insisting not to impose senction against Burma and saying that ASEAN has no leverage to persuade Burma to make changes.
Is it a genuine confession or just an excuse to ignore Asean's responsibility?"

I fully support your people's quest for freedom and democracy. Please fight on.

As for PM Lee, I don't doubt his statement that we have limited leverage over the Junta, I mean just look at China and India.
In my opinion, ASEAN would not wan to intervene in Burma because alot of ASEAN countries are dictatorships with lousy human rights records.

I mean what makes you think that Vietnam and Laos will support democracy and freedom?

However that is no excuse for S'pore to sell weapons to the Junta. There is a line to be drawn somewhere.

May peace be you and your people. Actually in my opinion, more Burmese should find ways and means to get out of Burma. Only when there is a large and wealthy overseas Burmese community then can you all have the money to fund democracy struggle back home.

 
At 2:06 PM, October 08, 2007, Anonymous X.jy' said...

"PAP was a opposition once too. If S'poreans did not give them a chance what PAP will be now? Maybe something like its brother party, DAP, in Malaysia!

Anyway my point is that we need to give the opposition a chance to run a GRC 1st. At least the people can have more bargaining chip with those in power."

haha i don't think the PAP managed to come into power because we gave them a chance. it was rather the circumstances at that time and the ruthlessness of the PAP in manipulating the situation to eliminate all opposition that enabled them to come into power and retain it all these yrs.

but the situation now is such that the PAP will by all means(probably even more unthinkable than in lim chin siong's case) prevent that from happening. they wouldnt even allow the opposition to come close to coming across as a viable alternative leadership.

from how i see it, it is not whether we are willing to give them a chance, but the PAP who will crush all chances, but at the same time present the illusion that there is a chance for them(and thus for us to bargain and complain).

but of course, this will not stay for long, for i believe that once the ruthless 'old hands' disappear from the scene and more post-65ers start to take over the party, things will change. either the PAP will have to loosen their grip and shift their mindset or there will be cracks for the opposition to move in and prove themselves to the people.

time will take its course. :)

 
At 7:16 PM, October 08, 2007, Anonymous Anonymous said...

Good blog and I enjoy reading it.
To sum it up, I think LHL should have added another sentence to his statement so as to make it clear what he meant:

"Somebody who is sick, he wants to come to Singapore, he needs treatment and you're telling me that I shouldn't treat him because he is not a good man? It goes against the Hippocratic oath of doctors."
"By the way, this oath only applies to those with money."

His performance as PM has not been up to scratch sofar and hardly convincing eg mee siam with no hum,
etc. He is more effective as a lieutenant to PM Goh.

 
At 5:54 AM, October 09, 2007, Blogger at82 said...

Hi X.jy,

"but the situation now is such that the PAP will by all means(probably even more unthinkable than in lim chin siong's case) prevent that from happening. they wouldnt even allow the opposition to come close to coming across as a viable alternative leadership.

from how i see it, it is not whether we are willing to give them a chance, but the PAP who will crush all chances, but at the same time present the illusion that there is a chance for them(and thus for us to bargain and complain).

but of course, this will not stay for long, for i believe that once the ruthless 'old hands' disappear from the scene and more post-65ers start to take over the party, things will change. either the PAP will have to loosen their grip and shift their mindset or there will be cracks for the opposition to move in and prove themselves to the people.

time will take its course. :)"

Whatever the PAP does, the vote is yours.

Luckily PAP had not snooped so low as to rig the ballots, although they came dangerously close to. :-P

So no matter what it does, you are still the one who make the decision. Just don't chicken out when the moment of truth arrive.

 
At 6:00 AM, October 09, 2007, Blogger at82 said...

hi anon 7:16 PM, October 08, 2007,

"Good blog and I enjoy reading it.
To sum it up, I think LHL should have added another sentence to his statement so as to make it clear what he meant:

"Somebody who is sick, he wants to come to Singapore, he needs treatment and you're telling me that I shouldn't treat him because he is not a good man? It goes against the Hippocratic oath of doctors."
"By the way, this oath only applies to those with money.""

Thanks for your compliments.

Anyway I totally dislike this "wu lui si lao peh" (got $ is my father) mentality of the PAP govt.

"His performance as PM has not been up to scratch sofar and hardly convincing eg mee siam with no hum,
etc. He is more effective as a lieutenant to PM Goh."

He is going too far liao la. I used to had good impression of him. I thought he can do a "Chiang Jing Guo" in S'pore. After all he promised a "open society" when he took over.

But he prefer to turn S'poreans against hi, by introducing policy that go against the express wishes of Singaporeans and sending police to harass Singaporeans like Dr Chee.

Sigh

 

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