City has the money, people get no service
Bambang Nurbianto, The Jakarta Post, Jakarta
The city has the money and its share of poor people, but the poor do not get to enjoy the money.
The capital's health budget is Rp 74.45 billion (US$ 8.83 million) for 83,364 poor families.
The reason the money does not reach the poor, according to City Health Agency spokeswoman Evy Zelfino, is because most poor families do not register with subdistrict offices.
"The funds allocated for this year have not been distributed smoothly to the poor because of administrative problems," she said on Friday.
The Central Statistics Agency (BPS) records 83,364 poor families, or around 300,000 people, but by July the 262 subdistrict offices citywide had only 31,128 families, or 37.34 percent of the total figure, recorded.
The huge difference made the agency order all subdistricts heads to enlist the needy who deserve the health service fund.
"We have renewed our data and the subdistrict offices have managed to register 54,877 more poor families in only three months. The total figure is now 86,005 families," she said.
But when 24-year-old Sumaryono -- who doctors started to operate on five months ago but failed to close the incision and left his intestine exposed due to his inability to pay the hospital bill -- submitted a letter from the subdistrict office confirming that he and his family were poor, he still could not get proper treatment.
The agency separates poor people eligible for free health services into three categorizes: first, poor people based on BPS data; second, people who live in city-run rehabilitation centers; and domestic migrants from outside Jakarta who have been recommended by the City Psychological and Spiritual Development and Social Welfare Agency.
Each family listed for free health services receive a Health Insurance for Poor People (JPK Gakin) card. To obtain a card, each family must present members' ID cards and their family card upon registering at their subdistrict office.
Evy said the health budget comprises Rp 54.50 billion from the 2003 city budget and Rp 19.95 billion from the central government fuel subsidy.
Of the total amount, Rp 39.75 billion -- from the fuel subsidy and Rp 19.8 billion from the city budget -- is allocated for poor families based on BPS data.
"So far, we have only spent Rp 2.5 billion," Evi said.
The amount of Rp 7 billion is directly distributed to four city-owned hospitals: Tarakan Hospital in Central Jakarta gets Rp 2 billion, Koja Hospital in North Jakarta gets Rp 2 billion, Budi Asih Hospital in East Jakarta Rp 2 billion and Duren Sawit Hospital in East Jakarta Rp 1 billion.
The remaining Rp 27.70 billion is earmarked as a "rescue fund", which targets poor people not listed with either the BPS or subdistrict offices.
"We have effectively spent Rp 16 billion as subdistrict officers managed to reach the needy," she said.
Marius Widjajarto, head of the Indonesian Health Consumers Empowerment Foundation (YPKKI), criticized the health agency for its poor distribution mechanism.
He said that subdistrict officers should have actively registered residents eligible for free health care instead of waiting for poor families to register.
"Registration could be carried out by chiefs of neighborhood units as they are elected by the residents and are better aware of the residents' circumstances," he said.