The new Hospital Law says hospitals should treat sick patients properly regardless of their status, ethnic group or religion. Hospitals should also look after the poor, who may not be able to afford hospital fees. While the House of Representatives passed the law on Sept. 28, members of the Indonesian Hospitals' Association said hospitals could not provide such services unless the government provided financial assistance and infrastructure to facilitate the work of the hospitals. The Jakarta Post's Nia Imaniah talked to Minister of Health, Endang Rahayu Sedyaningsih, about possible greater access to government's health facilities for the poor in the future. The followings are the excerpts:
Question: What is your strategy to improve hospital services in the country?
Answer: I expect to implement a health insurance scheme in line with the national social security system by 2014. I am now pre-paring a road map to achieve this objective.
The government and the House of Representatives have worked on the issuance of updated government regulations as the implementing regulations for the 2004 National Social Security System Law.
As of 2008, the number of the poor reached 76.4 million. We are preparing to accommodate their health needs.
What points are going to be included in the road map?
The road map is expected to provide guidelines for our five-year program the main objectives of which are to improve coordination between regional administrations and the central government.
The key points will include the improvement of hospital service quality, people's health surveillance and monitoring.
We already have a health insurance scheme for the poor, called Jamkesmas. However, its implementation is still based on regions.
I acknowledge that there are still problems with new registrations for insurance holders, who have changed addresses and income status from previously categories into low income to middle income.
We will try to improve the system to address the problems.
I will prioritize the provision of greater access to health for the poor *especially those* registered as Jamkesmas card holders in the first 100 days of my administration.
A Jamkesmas card, which can be only used in a region, is expected to become applicable in other regions. We will improve the system step by step.
We will cooperate with regional administrations to make sure that this happens in the near future.
Hospitals in some regions, like Bali, have *already* welcomed Jamkesmas cards from other regions.
We will also distribute Jamkesmas cards to orphanages and old folks' homes to provide them with access to health facilities managed by the government.
If the system is in line with the 2004 National Social Security System Law, what will the implementation be like by 2014, especially regarding the right of the poor to obtain health services from the government?
The poor will not pay the premium. The government will provide financial support for this. The amount will be determined later during the road-map design *elaboration* process.
I expect no more hospitals to reject poor patients by 2014. Everybody should have health insurance by 2014.
People who have money and permanent employment status are going to obtain access to health provision provided by their companies.
We will push people with money to have health insurance via insurance institutions to make sustainable efforts ensuring this *via private contributions*.
This is part of our effort at implementing the Hospital Law. Everybody will get access to health regardless of their status, ethnic group or religion.
This is also part of our strategy to achieve the Millenium Development Goals (MDGs), of which the main points include eradication of poverty and hunger, reduction of infant and maternal mortality rates, the war against communi-cable disease and environmental preservation.
Do you have other plans to increase the quality of hospital services?
I will improve the ministry's research functions in disease prevention and curative capacities. The emergence of new kinds of viruses will require hospitals to anticipate and mitigate the impacts.
We now have several health experts in charge of this program. I also have talked to professors from several universities on how to effectively manage this.
I will also develop "hospitals without walls". Hospitals should not perform functions merely to treat their patients. Nobody should feel intimidated by hospitals.
Therefore, hospitals should carry out their social responsibilities by coordinating monthly and annual events for their environment, including the provision of free health services.
I also look forward to seeing some green hospitals to emerge in the next three years. The Persahabatan Hospital in East Jakarta already has a grand plan to make this happen.
