Health care enters business world

Health care enters business world

MELBOURNE (JP): Health and hospital care a business commodity?
Is nothing sacred? The joint conference of the Indonesian
Cultural and Education Institute and Australia Indonesia Business
Council, held from June 16 to June 18 in Melbourne, confirmed
that indeed nothing is. Institutions seeking survival nowadays
need to go commercial. Healthcare and hospital care is no
exception; a far cry from the days when hospice care was the
domain of charitable or religious organizations.

Two aspects in health issue became apparent during the
conference. Firstly, Australia, having very high standard health
services, is in the position to provide assistance to developing
countries in establishing their healthcare systems. Indeed this
has been done since pre-commercialization days. An example of
community health projects supported by AIDAB (Australian
International Development Assistance Bureau), now AUSAid,
is the Hepatitis B immunization in Lombok from 1987 to 1991, and
the Healthy Start for Child Survival Project in Lombok, Bali and
Sumbawa being fieldtested at the moment. The second aspect is
more business oriented and commercially driven. It is not an idea
originally Australian, nonetheless.

It became obvious to Australian healthcare providers that
compared to other countries like the USA and Singapore, their
health services, experts and technical know-how, were just as
good, if not better in several aspects. And if these other
countries were able to successfully export their services, well,
so should Australia.

In the last three years there have been entrepreneurial groups
in Australia offering comprehensive healthcare services in the
region, including Indonesia. These usually involve bringing
patients to Australia for surgery or treatment and follow-up
post-surgery care. Now, a more innovative approach encompasses
not only patient care, but also the training of nurses. Such an
enterprise is Austhos, which allows international doctors,
nurses, patients and post-graduate students to gain access to the
services of Australia's hospitals. The company also intends to
institute nurse education programs in Indonesia.

Like education, healthcare as a business stretches the
definition a little. There are no visible products for the
customer to choose from at point of sale, apart from color
brochures that describe the services available but do not
guarantee results. Undoubtedly this does not mean that the
providers can relax their standards, because fierce competition
is in itself the best guarantee a customer can get. In practice,
it is not the glossy brochures that bring in customers, but word
of mouth -- satisfied former patients who live to tell the tale.
Nonetheless, a conference workshop considered it necessary to
develop universal health standards and education for providers to
adhere to.

Australian healthcare costs are considerably lower than those
of other countries, and these services are obviously attractive
to the expanding middle class in Indonesia. In the meantime those
who do not have the resources -- private or company-funded, will
slip through the net.

Community projects such as those supported by AUSAid, are
therefore still crucially needed in Indonesia. Dr. Tilman Ruff of
the International Health Unit at MacFarlane Burnett Center for
Medical Research describes the outreach methods used in the
project in East Nusa Tenggara. To reach the mothers and infants
who need preventative healthcare, the care providers make use of
a community-based registration system for vital health events,
such as pregnancies, births and deaths.

Another side of healthcare highlighted is the need for social
research. Dr. Gale Dixon of Department of Geography and
Environmental Science at Monash University has completed a
research establishing a correlation between ethnicity and infant
mortality in Malaysia. In the early 1980s in peninsular Malaysia,
Chinese babies died at a rate of 14.1 per thousand live births;
Malay babies at 23.4, and Indian babies at 23.1. These
differences, Dr. Dixon discovered, are the result of different
traditional practices. A better understanding of the relationship
between ethnicity and infant mortality may assist in locating
infants at risk and allow for improved distribution of the
amenities of development.

It appears that at present, at least, the benefits of
commercialized healthcare have not extended beyond a certain
class in Indonesia, albeit a significant and increasing part of
the community. The safety net for those outside this class will
therefore need to be retained.

--Dewi Anggraeni