H

ealth Minister Nafsiah Mboi is considering exempting smokers from receiving universal health coverage slated to begin on Jan. 1, 2014, as smoking is considered a form of self-harm.

 Previously, the Indonesian Doctors Association (IDI) said Presidential Regulation (Perpres) No. 12/2013 on healthcare coverage stipulated diseases caused by activities done in the knowledge of self-harm could not be covered by the Social Security Providers (BPJS) program, and that smoking habits should be included as part of this.

'€œUniversal health coverage is social insurance. The law states it has to cover any type of disease suffered by citizens. However, if [there are caveats] stated in the Perpres, then we may have to consider it,'€ Nafsiah told reporters during a weekly media briefing at her office in Jakarta on Friday.

'€œWe know the coverage paid for by Jamkesmas [national healthcare scheme] is mostly for diseases related to smoking habits. If we didn'€™t do any preventive measures, the government would have to pay a lot for them,'€ she said.

The healthcare program will cover all citizens, including around 63 percent of 240 million Indonesians, who, according to Health Ministry data, already receive aid from various social protection programs. While universal health coverage will go live in 2014, labor coverage will be implemented on July 1, 2015.

The healthcare coverage regulation stipulates the state would pay the monthly premium for people whose source of livelihood or salary was not enough to pay for the premium. These people are apparently the majority of the smoker population in the country.

Data from the Health Ministry shows the cost to heal diseases related to tobacco, including heart disease and lung cancer, reached Rp 39.5 trillion in 2011.

She said in the meantime, the ministry was still trying to pursue the ratification of the Framework Convention on Tobacco Control (FCTC), which according to her was hampered by rejections from three ministries, namely the Trade Ministry, Industry Ministry and the Manpower and Transmigration Ministry.

'€œWe have responded to their rejections to ratify the FCTC. Some argued that tobacco excise had a big contribution to the state budget, and there were objections saying that the FCTC would hurt tobacco farmers,'€ the minister said.

'€œApparently, research shows tobacco farmers receive very low incomes and they can actually be trained to produce other crops that can give them increased income,'€ Nafsiah said.

Based on an Organization of Islamic Cooperation (OIC) health report published last week, Indonesia has the highest number of tobacco consumers in its male population compared to the organization'€™s other member states.

According to the report, cigarette consumption among males in Indonesia (which is both the only country in Asia and - along with Somalia - one of the only two Muslim-majority countries yet to ratify the FCTC) is way higher than countries ranked second (Tunisia, 52 percent) and third (Albania, 48 percent).