Medicine prices<\/p>\n
I am gratified to see that health care issues are finally
\ngetting the attention they deserve (Medicine Prices Tell A Horror
\nStory, The Jakarta Post Sept. 15, 1996). I applaud and commend
\nthe contributors.<\/p>\n
However, I was taken aback by the statement that "health is
\nnothing more that someone has to purchase in the form of
\nmedicines."<\/p>\n
Treatment of disease involves the purchase of medicines but
\nalso the doctor's skill, the laboratory, procedures, and a host
\nof other "purchases" as well. Anyway, "health" is not a "simple"
\nanything; it is a complex interaction of genetics, environment,
\nlifestyle, and other factors. The statement is erroneous and
\nmisleading.<\/p>\n
It should also be acknowledged that while pharmaceutical costs
\nmay be high in Indonesia, the total costs (drugs + doctor + lab +
\netc.) are low as a percentage of personal income and as a
\npercentage of national GDP. In fact, physician compensation
\nlevels are so low that most doctors are forced to seek other
\nrevenue streams just to survive. This is not to condone the
\nunethical practices described in the article but to identify one
\nof the major reasons behind them.<\/p>\n
The problem of drug and health care costs is complex. Studies
\nby the Ministry of Health over the last seven years have revealed
\nthat polypharmacy (excessive\/multiple prescriptions) is a real
\nproblem, especially since many of the drugs are not useful (as
\nstated by Dr. Iwan). Conversely, there is also a tendency to give
\ninsufficient amounts of the correct drugs. As much as 40 percent
\nof drugs are wasted.<\/p>\n
A major underlying problem is that the majority of Indonesians
\nstill pay for medical care out of their own pockets. Hence, the
\nsick bear the burden of health care costs. In all developed and
\nmany developing countries, widespread risk-pooling through health
\ninsurance or social insurance schemes addresses this problem.
\nUnfortunately, these schemes have precipitated their own problems
\nand most systems are undergoing radical reforms or even
\ndismantlement with a general trend towards what is called
\n"managed care".<\/p>\n
The Ministry of Health and the Indonesian Medical Association
\nhave taken substantiative corrective steps. Aside from developing
\nstandards of care for the 100 most frequent diseases, a hospital
\naccreditation system, and a strategy called Rational Drug Use, a
\n"managed care" strategy known as JPKM was promulgated in the
\nNational Health Law #23 in 1992 which holds the solution to the
\ndrug cost problem and, indeed, the entire health care cost issue.<\/p>\n
As enrollment in the JPKM program increases, both the cost of
\ndrugs and waste will be reduced. The individual who is ill will
\nbe protected from the full financial burden of health care. The
\nstandard of medical care will rise in Indonesia and most
\nimportantly and hopefully the health of the nation.<\/p>\n
The pharmaceutical costs problem is a symptom, not the
\nunderlying cause. If the issues of health care financing and
\nquality of care are addressed directly, the drug cost problem
\nwill correct itself just as treating a case of pneumonia with the
\ncorrect antibiotics will rid the patient of fever. If you treat
\nthe symptoms but not the cause, the patient will not heal and the
\nproblem will merely arise in a different place.<\/p>\n
Finally, I urge you to continue to focus on health care. The
\npublic needs to know. You can't take advantage of education and
\nbusiness opportunities if you are sick. Health must come first.<\/p>\n
Name and address<\/p>\n
withheld<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/medicine-prices-1447899208", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }