Govt told to fix health scheme

The Jakarta Post ,  Jakarta   |  Fri, 09/21/2007 3:03 PM  |  Jakarta

Adisti Sukma Sawitri, The Jakarta Post, Jakarta

The Indonesian Doctors Association (IDI) has warned that if the government does not settle the unpaid medical bills of low-income members of the Askeskin health insurance scheme, hospitals could begin turning away members of the health plan.

Association chairman Fachmi Idris said the government could take the money from development funds at the Health Ministry or borrow it from the reserve funds being kept in central bank bills by regional administrations.

""President Susilo Bambang Yudhoyono himself should settle this problem, otherwise hospitals could start rejecting low-income people using Askeskin,"" said Fachmi on Thursday, during a break in a discussion on health insurance.

Askeskin is a health insurance scheme operated by state-owned health insurance company Askes for 76.4 million people nationwide registered as living below the poverty line.

The insurance covers treatment and medicine at hospitals and public health posts.

The government has allocated Rp 1.7 trillion (about US$180 million) for the scheme this year. However, the scheme is expected to exceed the budget, with the company already having recorded Rp 1.56 trillion in claims as of July.

There have been reports from numerous regions of people not living below the poverty line still being included in the scheme, which has further stretched the budget.

To join the plan a letter is needed from the head of the applicant's neighborhood unit stating that the applicant qualifies for the scheme.

The Health Ministry has reported that the heads of neighborhood units have been found selling these letters for Rp 50,000 to people who would otherwise not qualify.

Health rights activist Ilyani Sudradjat of the Indonesian Consumers Foundation said the government needed to set up an office to count and register low-income people, and distribute insurance cards to them.

""Our problem is pretty basic. We have too many government institutions counting poor people, and it is so easy to get insurance cards,"" she said.

Ilyani said the government should set up monitoring posts to oversee the implementation of the insurance scheme.

It should also introduce penalties for those found abusing the scheme, to serve as a deterrence for those trying to cheat the system, she said.

The chairman of the Indonesian Medical Council, Farid Anfansa Moeloek, said the government needed to introduce a program to get individual doctors to treat more low-income patients, instead of simply shuttling them to hospitals for treatment they might not need.

""The government should make it official that each doctor has to treat a certain number of poor people in the regions. This would reduce the number of people going to hospitals and using the health claims,"" he said.

Farid said President Yudhoyono had issued a decree on this issue, but it had yet to be implemented.

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