Private hositals try to improve image<\/p>\n
Many people welcomed the growing number of private hospitals
\nacross the city with a hope that their presence would improve
\nmedical facilities to enable them to meet increasing public
\ndemand for better medical services.<\/p>\n
But people have started questioning whether they favor the
\nrich and ignore the poor.<\/p>\n
The Jakarta Post's reporters Stevie Emilia, Ridwan M. Sijabat,
\nLukman Natanagara, Aloysius Unditu, Johannes Simbolon, Sri
\nPurwati, Yudha Kartohadiprodjo, I. Christianto and photographer
\nOka Budhi Yogaswara discuss the issue in the following article
\nand other related stories on Page 5 and 10.<\/p>\n
JAKARTA (JP): For some, fiercer competition among private
\nhospitals has brought significant changes to medical health care
\nhere as it offers more choices for the patients than it used to.<\/p>\n
Hospital managements can no longer ignore patients. Instead,
\nthey should acquire the latest and the most sophisticated medical
\nfacilities and provide good quality services so as not to lose
\nout to the competition.<\/p>\n
Some private hospitals even have luxurious buildings and
\nfacilities, which remind one of five-star hotels.<\/p>\n
But it has turned out that such luxurious buildings and
\nfacilities have scared some people, especially the poor, from
\neven just stepping into those hospitals.<\/p>\n
They argue that such hospitals will charge them more than
\nnecessary to rake in profits, while others have accused the
\nhospitals of favoring the rich and neglecting their social and
\nhumanitarian roles to serve all, including the poor.<\/p>\n
Supratno, 25, is among those who has bitter experiences with
\nupscale hospitals.<\/p>\n
When his wife gave birth to their first child, a premature six
\nmonths old baby girl, two years ago, the baby was alive but in a
\nsickly condition.<\/p>\n
He was told to take the baby to a more sophisticated hospital
\nbecause the one where his wife gave birth could not deal with the
\nproblem.<\/p>\n
When he took the baby to a well-known private hospital in
\nKebun Jeruk, West Jakarta, which is close to his house in the
\nKedoya area, he had to walk out because he could not afford the
\nexpenses.<\/p>\n
\"We rushed the baby to the Cipto Mangunkusumo General
\nHospital. But, the baby died on the way. It's too far away from
\nour place,\" sighed Supratno, a taxi driver.<\/p>\n
He has another bad experience with private hospitals.<\/p>\n
When his mother was sick, he took her to a private hospital,
\nbut it refused to treat her just because they would not be able
\nto pay the expenses.<\/p>\n
\"People do not have time to choose which hospitals to go at a
\ntime of emergency.... I just don't know whether upscale private
\nhospitals also serve poor people like me. My two experiences with
\nthem taught me well that they are only for the rich,\" Supratno
\nsaid.<\/p>\n
\"We can never afford to pay for treatment in such hospitals.
\nWe can only afford medical treatment with written proof
\nclarifying that we're poor to get dispensation in state
\nhospitals,\" he added.<\/p>\n
Regulation<\/p>\n
Under the government's regulation hospitals owned by the
\ngovernment should set aside 75 percent of beds for the poor,
\nwhile those owned by non-profit organizations or foundations
\nshould put aside 25 percent. Private hospitals, including
\nforeign-invested ones, should allocate at least 10 percent of
\ntheir beds for the needy.<\/p>\n
Critics, however, have voiced their doubt that private
\nhospitals have met the requirements to serve the poor.<\/p>\n
The Ministry of Health's Director General of Medical Services,
\nSri Astuti, insisted that the regulation was still relevant to
\nhelp the needy, saying that her office closely monitored the
\nimplementation of the regulation every three months.<\/p>\n
But she noticed that some people were afraid to take
\ntreatment in private hospitals for fear of incurring high
\nexpenses and this after just taking a look at the luxurious
\nbuildings and facilities.<\/p>\n
\"Such an image is not always true. All hospitals should serve
\nand are obligated to serve patients without discriminating on
\ngrounds of their status, origin and religion, especially in an
\nemergency,\" Sri told the Post.<\/p>\n
Private hospitals mostly require prospective patients,
\nexcluding emergency cases, to pay in advance a deposit worth
\nseveral times the room rate before being treated. In Pondok Indah
\nhospital, for instance, prospective patients are required to pay
\na down payment amounting to 10 times the room rates.<\/p>\n
For the poor, regulation remains regulation. In reality, they
\nare still being treated differently.<\/p>\n
The poor, who cannot afford to pay, are obligated to show
\nwritten proof from the subdistrict office detailing their
\ninability to pay.<\/p>\n
Sri said that the regulation was issued by the government to
\nhelp private hospital managements in making their financial
\nreports to the owners.<\/p>\n
\"But, the quality of services for the poor should not be
\ndifferent to that of those who can afford the expenses. The
\ndifference is in the type of the rooms, the poor are in third
\nclass,\" Sri said.<\/p>\n
There are currently 1,039 hospitals in the country of which
\n515 are run by private operators. And according to the Central
\nBureau of Statistic's 1997 data, there are 98 hospitals in
\nJakarta alone, of which 45 including one foreign-invested
\nhospital are privately run.<\/p>\n
Image<\/p>\n
The rapid increase in the number of private hospitals poses an
\nalarming situation for some people, especially since many
\nIndonesians are not yet protected by an insurance scheme.<\/p>\n
They fear private hospitals will totally shift their function
\nfrom that of an unprofitable social institution toward that of a
\nprofitable business. And more people have begun wondering about
\ntheir social duty to the public, especially at this time of
\ncrisis.<\/p>\n
Pondok Indah Hospital's director of business and support
\nservices, Hartono, did not blame people for having such
\nperceptions of upscale hospitals.<\/p>\n
\"This maybe arise because we don't give much information about
\nour services to the poor. But that's only an image and it's not
\ntrue,\" he told the Post.<\/p>\n
He said his hospital has provided many more beds for third
\nclass than required by the government. And room rate for the
\nthird class has never been raised for the last four years.<\/p>\n
The hospital also did not require patients in emergency rooms
\nto pay deposits as required for other patients.<\/p>\n
\"In the end, some of the patients cannot afford to pay,\"
\nHartono said, adding that they should show written proof from the
\nsubdistrict office.<\/p>\n
He said that the hospital recorded bad debt from those who
\ncould not afford to pay medical expenses; Rp 200 million in 1997
\nand Rp 180 million in 1996.<\/p>\n
Some hospitals face a decline in the number of patients,
\nincluding in the third class. But there was an increase in bed
\noccupancy rate at the third class in Pondok Indah hospital from
\n85.9 percent in 1997 to 90.7 percent from January to September
\nthis year.<\/p>\n
\"We don't give different services to our patients. If the VIP
\npatients eat five times a day, third class patients will also eat
\nfive times a day. And the third class room is also air
\nconditioned, provided with TV, telephone and other facilities
\njust like a VIP room. The difference is only in the number of
\nbeds,\" Hartono said.<\/p>\n
A VIP room has only one bed while a third class room has up to
\nsix beds.<\/p>\n
Private hospital managements also denied that upscale
\nhospitals charged their patients more than necessary as
\ncomplained of by many.<\/p>\n
\"The higher costs are due to the completeness and good quality
\nservices requested by the patients or the doctors...,\"
\nMetropolitan Medical Center's director and CEO, Muki
\nReksohadiprodjo, told the Post.<\/p>\n
MMC, he said, even exercised rationalization of services.<\/p>\n
For instance, he said, MMC minimized supportive examinations
\naccording to clinical significance and encouraged doctors to
\nutilize locally made medicine only.<\/p>\n
The hospital also provided 17 percent out of its 171 beds for
\nthe third class, he said.<\/p>\n
\"We continually have the amount of over Rp 100 million as bad
\ndebt per annum and a greater proportion due to these patients in
\nthird class,\" Muki said.<\/p>\n
Some private hospitals only performed their annual social
\nservices outside their premises.<\/p>\n
MMC, for example, has a special social project providing
\nhealth care services in slum areas, while Pondok Indah hospital
\nprovides annual free medical services in different areas in the
\ncity.<\/p>",
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