New office to manage health insurance for city's poor

The Jakarta Post ,  Jakarta   |  Thu, 10/25/2007 4:21 PM  |  Jakarta

Adisti Sukma Sawitri, The Jakarta Post, Jakarta

The city administration is set to establish a special office tasked to manage health insurance for the poor, an official said Wednesday.

Deputy Head of the Jakarta Health Agency, Salimar Salim, said the new office, which would still be under the agency's supervision, would have the authority to determine recipients and channel funds to hospitals designated to accept patients under the health insurance scheme.

""The special unit would help the scheme focus more on reaching poor communities in the city,"" she said.

As reported earlier in the media, the administration and the City Council are concerned about the increasing number of insurance claims from hospitals.

The administration has to find another Rp 50 billion (US$5.4 million) to add to the existing Rp 200 billion fund to cover healthcare claims and medication for patients with pandemic diseases such as dengue fever and for victims of Jakarta's February floods.

In the past years, the fund has never exceed Rp 200 billion.

The agency, which directly manages insurance claims, attributes the mounting number of claims to the fact non-poor residents and non-Jakartans were also benefiting from the scheme.

""We can't tell whether it is the hospitals that cheated us or if there were simply too many people who forged documents in order to receive free treatment,"" Salimar said.

""This is why the agency decided it needed a special unit to handle health insurance claims.""

Poor families are required to show their Jakarta ID card and a notification letter from a subdistrict office stating their economic situation before qualifying for free treatment at certain hospitals.

Salimar said it was difficult to estimate the exact number of poor people in the capital who required assistance because the city's population data was poorly recorded.

The agency hopes to manage healthcare insurance not only for the poor, but for all Jakarta residents in the future, she said.

Deputy Head of Commission E overseeing public welfare, Muhammad Mansyur Syaerozi, said the Council even suggested the city build a special hospital that provided free healthcare to all Jakarta residents.

""This would expand healthcare services for all citizens and people would not be required to obtain `poor certificates' from their neighborhood units just to get free medication,"" he said.

Although a capital city, Jakarta still sees recurring outbreaks of dengue and diarrhea, which mostly affect the poor communities living in slum areas with bad sanitary facilities.

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