40 percent of poor Jakartans still have to pay hospital bills
40 percent of poor Jakartans still have to pay hospital bills
Leony Aurora
Jakarta
More than 40 percent of poor Jakartans, whose health care
services are supposed to be covered by the government, claim they
still have to pay part of their hospital medical bills.
A recent survey by the Indonesian Health Consumer Empowerment
Foundation (YPKKI) showed that 91 out of 211 inpatients had to
pay for medicine, administrative fees, surgery and laboratory
tests.
Among the 860 outpatients surveyed, 9.1 percent also said that
they had paid for similar services, said Marius Widjajarta, the
head of YPKKI, in a press conference early this week to announce
the results of the survey.
"Most had to pay for medicine," said Marius.
The survey, conducted between November 2003 and February 2004,
was intended to evaluate the effectiveness of the welfare cards
for poor families (Gakin). The local administration introduced
the cards last year to free poor people from having to pay
medical bills.
Those who do not yet have a card can ask for a letter to
confirm that they are economically disadvantaged from their
neighborhood unit chief to get free medical services or at least
discounted ones.
However, according to the Jakarta Health Agency head A. Chalik
Masulili, this letter was the biggest problem. "It is not easily
obtainable," he said.
Such a letter could only be used once, he elaborated. "For
subsequent visits to the doctor, patients have to get Gakin
cards," he said, adding that the cards were the safest way to
ensure that only poor people received free services.
The agency plans to issue new technical and operational
guidelines that will spell out in detail who can avail of such a
card.
According to the Central Statistics Agency, the definition of
a destitute family is a family that has a living space of less
than eight square meters per member, no floor covering -- only a
dirt floor -- and only able to afford to buy one set of new
clothes per person per year. The family is not able to afford its
own clean water facilities or toilet. The family cannot afford to
buy living room chairs and is limited in the variety of dishes it
can consume in a week.
"If a family fulfills at least five of the requirements, they
can get a letter confirming that they are economically
disadvantaged," said Salimar, the agency's head of planning and
budgeting.
As the survey shows that 34 percent of the respondents
received the information regarding this policy from neighborhood
unit chiefs, the agency plans to involve them by holding meetings
to make them familiar with the requirements.
Salimar said the agency was still discussing whether those
with a Gakin card would only get a discount of up to 50 percent
or the decision would be left to the hospitals, which can
evaluate the condition of the patients themselves.
This year, Rp 40 billion (US$4.44 million) in funds from the
city budget were set aside for health services for the
underprivileged. Last year, the city provided Rp 54.3 billion in
funds, and the state, from the oil and gas subsidy compensation
funds, provided Rp 19.9 billion.
There would also be funds made available from the oil and gas
subsidy compensation this year, said Salimar, but the amount is
yet to be determined.
I-box
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Region Families (Oct. 2003) Families (April 2004)
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North Jakarta 21,513 31,383
West Jakarta 19,375 28,060
Central Jakarta 19,327 19,527
East Jakarta 17,897 29,218
South Jakarta 6,515 9,543
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Total 84,627 117,731
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Source: Jakarta Health Agency