Government optimistic but insurers doubt new scheme

Side by side: Patients share a room at an overcrowded ward for low-income families at Cipto Mangunkusumo Hospital in Jakarta. JP/NurhayatiWhile the government is optimistic about the National Social Security Program, insurance companies PT Askes and PT Jamsostek are skeptical about the program being implemented on time.

Their skepticism is based on poor preparation, resulting in a lack of physical, administrative and legal infrastructure.

Despite the poor preparation, two state officials on Tuesday stated that the government would be ready to launch the national health care program and the social security scheme in 2014 and 2015, respectively.

“The health care program is set to start in January 2014. We have given PT Askes two years to prepare for this program. PT Jamsostek also has 2.5 years to make adjustments,” Coordinating People’s Welfare Minister Agung Laksono said at a seminar in Jakarta.

Deputy Finance Minister Anny Ratnawati, meanwhile, said the money to cover the insurance of 30 million jobless and impoverished people would be taken from the Jamkesmas public health-care fund, which now stands at around Rp 70 billion.

“With capital of Rp 2 trillion as set out in the 2012 state budget, PT Askes will be transformed into a large public company and start running the health care program nationwide with full support from all hospitals, public health centers and regional administrations,” Anny said.

PT Askes, now a state-owned enterprise, said it would have no major problems in carrying out the internal transformation. However, it doubted the Health Ministry would be able to prepare the infrastructure it needed to serve the public by January 2014.

PT Askes’ operational director Umbum M. Marisi said the allocation of Rp 2 trillion by the government would help the company conduct the internal transformation within two years. The success of the health care programs, however, would depend on the availability of necessary infrastructure, such as hospitals, medical workers and equipment to ensure high standards of service for all.

According to Umbum, the number of hospitals is very limited and mainly located in regencies in Java. As for other islands, such as Sumatra, Kalimantan, Sulawesi, Maluku, Papua, and Nusa Tenggara, hospitals are primarily available in the provincial capitals.

“There are more than 900 public health centers in regencies and subdistricts outside Java. But only 30 percent of them have two or three doctors. Also, the majority of health centers are not equipped with modern medical implements,” he said.

Umbum doubted that workers in the informal sector could afford Rp 25,000 per month, or Rp 300,000 annually, for their individual contribution to the health care program. “In European countries, the premiums of informal workers are covered by their governments,” he said.

PT Jamsostek’s president director Hotbonar Sinaga shared the same opinion.

He said the percentage of the mandatory premium to be paid by workers was higher than that stipulated in the social security programs.

Chairman of the National Social Security Council (DJSN) Ghazali Situmorang said the council had prepared eight draft regulations and seven draft presidential decrees on guidelines for carrying out the five programs.

But he declined to explain the substance of the draft regulations and decrees because they have not yet been discussed with related offices.

The deputy chairman of the Indonesian Employers’ Association (Apindo), Hasanuddin Rahman, shared a similar skepticism because of the absence of the government’s strong commitment to enforce the 2004 Social Security System Law and its slow move to prepare the necessary infrastructure.