Fauzi seeks to maintain old health service plan

Tifa Asrianti ,  The Jakarta Post ,  Jakarta   |  Sat, 08/16/2008 11:21 AM  |  City

Though the city administration has yet to finally choose which health service scheme to adopt, as between Poor Family Cards (Gakin) and Regional Health Insurance (Jamkesda), the governor has meanwhile established a modus operandi.

Governor Fauzi Bowo said Friday that while his officials were still discussing the possibility of replacing Gakin with Jamkesda, the city administration would apply Gakin for the time being because it found it effective, despite some shortcomings.

"There is no guarantee that Jamkesda will not be slower (with reimbursements) than Gakin. We want guarantees from Jamkesda. If it is better than Gakin, we'll use it. If not, we'll stick with Gakin," Fauzi told reporters at the City Hall.

The idea to use Jamkesda was brought up in 2007 after many Gakin patients were rejected by hospitals. Rejections happened because of late payments on hospital claims by the Health Agency, caused in turn by late city budget disbursements to the agency.

The Jamkesda scheme is expected to avoid such problems because payment claims would administered by a private insurance company, which would be appointed by the city administration.

Mansur Syaerozi, a member of the City Council, said that to ensure the appointed insurance company performed well, the city administration should evaluate it every year.

"If the performance was poor, we should switch to another insurance company. This will ensure the insurance companies improve performance," Mansur said.

Jamkesda was planned to be adopted in 2008. Due to the late discussion of the 2008 revised city budget, implementation will have to wait until 2009 when the city administration can allocate the budget and implement procurement procedures to pick an insurance company.

Besides having a different management, Jamkesda will serve more insurance holders than Gakin, as Jamkesda is projected to be available for use by all Jakarta residents, both rich and poor.

In the 2008 revised budget, the designated health insurance budget for poor families was increased by Rp 30 billion (US$3.25 million), from Rp 250 billion to Rp 280 billion, Mansur said.

"With the Jamkesda scheme, based on insurance premiums, the budget can serve around 450,000 patients as the premium per person is Rp 500,000. Under the Gakin scheme, which is not based on insurance premiums, the same budget can only serve around 100,000 patients (through direct support) and the scheme rejects patients that do not meet the requirements," Mansur said.

In the 2007 city budget, the Gakin budget was Rp 250 billion. According to data from the Health Agency, the budget was used for the medication fees of 150,000 poor families, meaning that one Gakin patient cost an average of about Rp 1.66 million per year.

Fauzi emphasized that the public health service should not be undermined by the bureaucracy of the city administration or of the insurance companies.

"The health service should put the poor as first priority," he said.

Copyright © 2008 The Jakarta Post - PT Bina Media Tenggara. All Rights Reserved.