Curing sick hospitals

Curing sick hospitals

Hardships now endured by the less privileged in our society
seem to have no limit. However, many people may have been
surprised by the news in one of our front page stories yesterday
that 600 patients had managed to evade paying their medical bills
over the last six months at the country's largest state hospital
here in Central Jakarta. The patients, mostly from lower-income
brackets, simply refused to pay their bills and left, leaving
Cipto Mangunkusumo General Hospital, popularly known as RSCM,
with between Rp 2 billion (US$235,000) and Rp 3 billion in annual
losses.

The dirty trick has also been played on other state and
private medical centers for many years now, according to medical
sources. The number of these instances, they say, has
significantly increased since the economic crisis began. The huge
financial losses imposed on RSCM is probably the result of an old
public belief that the hospital is a social institution.

RSCM has indeed provided special dispensations to low-income
patients and allowed them to pay according to their financial
abilities. Even the poorest patients are able to receive free
medical treatment here, but such special allowances do not mean
that patients can run away en masse.

Yet some people have learned, perhaps from long suffering, how
to escape medical payment obligations. To financially protect
themselves hospitals have actually imposed advance payment fees
on patients, but some people still find a way to evade them.
Public protests have been known to occur in response to hospital
policies barring patients from leaving the hospital before paying
their bill or in which new-born babies are held until the parents
have paid for the medical service.

These protests are in fact illogical, especially now when
sharp increases in drug prices have pushed some public hospitals
and clinics to the brink of insolvency. These institutions can no
longer afford to buy imported medical equipment.

A recent newspaper report indicates that half of the 123
medical clinics in Bekasi, West Java, are closing down because
they cannot provide treatment and medication. Should massive
shutdowns of major hospitals occur, what would happen to our
nation? As in many other aspects of our economic crisis-bound
lives, a dark cloud is now hanging over our public health
situation. Today many low-income people cannot afford formal
medical treatment, prompting them to nurse their ailments
themselves until conditions force them to seek hospital services.

Foreseeing such a situation, the minister of health called on
the medical sector early in the crisis not to increase fees. But
such appeals have long lost their meaning in this country.

It is encouraging, however, to know that several countries
have taken notice of our calamity. The United States, the
Netherlands, the Philippines and China have indicated that they
will help supply essential medical supplies and medicines to meet
the immediate humanitarian needs of our poor, but nobody can say
if the offer will actually materialize. We sincerely hope that
these friendly countries will enhance their aid because public
suffering caused by the economic storm here can be likened to the
afflictions felt by the Iraqi people since the Gulf War.

In the meantime, the government should follow through on its
promise to provide a Rp 700 billion ($85 million) subsidy for
imported drugs and vital medical equipment.