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Jakarta Post

Hospitals withdraw from city healthcare program

As many as 16 hospitals have withdrawn from the Kartu Jakarta Sehat (KJS) healthcare program after failing to reduce losses incurred from covering medical expenses of KJS patients

Sita W. Dewi (The Jakarta Post)
Jakarta
Mon, May 20, 2013 Published on May. 20, 2013 Published on 2013-05-20T09:26:45+07:00

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s many as 16 hospitals have withdrawn from the Kartu Jakarta Sehat (KJS) healthcare program after failing to reduce losses incurred from covering medical expenses of KJS patients.

Previously, a total of 341 community health centers (puskesmas) and 132 private and public hospitals were incorporated in the KJS program, which was launched in November.

'There's nothing that we can do about it. The hospitals could no longer suffer losses incurred by covering the difference

between operational costs and premiums paid by the city administration,' Deputy Governor Basuki 'Ahok' Tjahaja Purnama told reporters at City Hall over the weekend.

Ahok said that the administration would evaluate the reimbursement system and the amount of the individual monthly premium set in the healthcare scheme.

'We will evaluate the INA CBG [Indonesia Case Based Groups] system that we have been using because it apparently could not cover all of the medical expenses of KJS patients,' he said.

The INA CBG system is a reimbursement system applied by the Social Security Providers (BPJS) in the national healthcare program (Jamkesmas).

Currently, the KJS healthcare scheme sets the individual monthly premium at Rp 23,000 (US$2.37), higher than that of the national healthcare program, which was set at Rp 15,700.

'We are evaluating the figures. I had previously thought the ideal figure should be between Rp 30,000 to Rp 50,000. Otherwise the hospitals will suffer losses,' Ahok said.

'I hope hospital management will be patient while we are evaluating it within the next two months.'

The KJS scheme supports 4.7 million Jakarta residents, comprising 1.2 million who are entitled to the Jamkesmas national health insurance and 3.5 million otherwise uninsured Jakarta residents. The healthcare program offers free third-class medical treatment.

Jakarta's healthcare funds, which total Rp 1.2 trillion (US$123.24 million) this year alone, is managed by state-owned insurance company PT Askes, which was appointed as the implementing agency of the BPJS Law for the health sector as of Jan. 1, 2014 as mandated by the 2004 National Social Security System (SJSN) Law.

The city health agency announced on Saturday that two hospitals had officially tendered their withdrawal, while 14 others only made a verbal request but had already referred patients seeking free healthcare services to other hospitals.

The hospitals are: Thamrin, Admira, Bunda Suci, Mulya Sari, Satya Negara, Firdaus Respiratory Hospital, Sukapura Islamic Hospital, Husada, Sumber Waras, Suka Mulya, Port Medical Hospital, Puri Mandiri Kedoya, Tria Dipa, JMC, Mediros and Restu Mulya.

According to Sri Rahmani, chairperson of the Association of Metropolitan Jakarta Hospitals, the hospitals were required to subsidize 10 percent of the expenses in the previous scheme and more in the current one.

'The current system has no benefit for us. We hope for a better scheme,' she said as quoted by kompas.com on Saturday.

Askes's director for service, Fajriadinur, said that the scheme was a trial for BPJS and therefore subject to correction before its implementation next year.

The tariff set in the scheme, he said, was determined by a joint team of hospitals and the Health Ministry.

'If there are glitches in its implementation, then it's time to correct them before being implemented nationally,' he said.

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