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COVID-19 treatment strains patients’ health, finances
Naufal Dhany Rizaki, a 25-year-old resident of Surabaya, East Java, said his family had to pay Rp 97 million (US$6,918) for his mother’s two-week hospital stay in January because she did not have insurance.
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n Indonesia, where a third of the population lacks health insurance, some COVID-19 patients have had both their health and their finances strained by the virus.
While the government is reimbursing both state-run and private referral hospitals for the expenses of treating COVID-19 patients under a government plan, the lack of capacity at these facilities and patients’ fears of not getting prompt or sufficient care have left some with little choice but to pay tens of millions of rupiah for private treatment.
Naufal Dhany Rizaki, a 25-year-old resident of Surabaya, East Java, said his family had to pay Rp 97 million (US$6,918) for his mother’s two-week hospital stay in January because she did not have insurance. Naufal had searched for a bed at state COVID-19 hospitals, but to no avail.
Fearing for the safety of his mother, who was diabetic, a noted COVID-19 comorbidity, he booked a bed at a private referral hospital. His mother’s condition worsened for a period after she heard of the death of her sister from the virus, but she eventually survived the disease.
Naufal was informed by a doctor about the estimated medical expenses, but still found it “a large amount” of money.
“At the time, my family didn’t have cash on hand. What we had were land investments. We were confused at first, but thank God we found a way to get the money,” he said.
The hospital informed him that it could submit a claim to the government to cover part of the expenses.
“The reimbursement can take three months or more — or even not happen at all. But the hospital said it would still try,” Naufal said.
Some 34 percent of Indonesians lack health insurance entirely, while about 56 percent are covered by the state’s Healthcare and Social Security Agency (BPJS Kesehatan) and about 1 percent by private insurance.
The remainder are covered by a variety of other schemes, according to the 2019 Social and Economic Survey (Susenas).
BPJS Kesehatan does not cover COVID-19 treatment. It only verifies the medical expenses of referral hospitals to be reimbursed by the government. Recent data from the Indonesian Life Insurance Association (AAJI) shows that its members paid some Rp 651.8 billion in claims related to COVID-19 made by 8,849 policyholders between March and October 2020.
Most of the claims were for COVID-19 treatment at local or foreign hospitals, and 6.3 percent were for COVID-19 deaths. A 24-year-old resident of Jombang, East Java, who asked to be referred to as EI, said that her family paid Rp 111 million for her father’s 11-day stay at a private referral hospital in Surabaya – a “shock” for her family.
Her father does not have insurance. It was the second private hospital her family took her father to on Dec. 24, as the fi rst was full.
At the hospital, her family was given the choice of taking a treatment plan covered by the government or paying for private care. The family chose the latter, hoping to ensure better care for EI’s father, who had uncontrolled diabetes and breathing diffi culties at the time.
“At the time, we didn’t know how much we’d have to spend. We didn’t think that far. What was important at the time was to have him treated well soon,” she said. “It had quite an impact on our family’s finances.”
Makhyan Jibril Al-Farabi of East Java’s COVID-19 task force said private referral hospitals, however, could offer patients nonstandard treatment plans that exceeded the amount the government would reimburse.
