Health insurance scheme gives remote areas more doctors
Leony Aurora, The Jakarta Post, Jakarta
The proposed National Health Insurance (AKN) scheme will encourage a more even distribution of doctors and hospitals, said a public health observer on Saturday.
Speaking at his inauguration as resident professor at the University of Indonesia's school of public health, Hasbullah Thabrany, who is also the dean of the faculty, said without the scheme, medical services would mostly benefit urbanites who could afford it.
"The AKN will cover everybody's insurance needs and the money will follow the patients," said Thabrany in his speech.
As a result, doctors, hospitals, and other facilities would also follow the patients, he added.
Hospitals in Indonesia are mainly located in cities. Doctors, who used to have to do compulsory tours of duty in outer regions, now have no such obligation, so they usually prefer to stay in cities and towns where more services, and money, are available.
The AKN scheme would also push forward the family doctor concept that the Ministry of Health and the Indonesian Medical Association (IDI) had proposed, said Thabrany, who was a member of the team creating the insurance scheme.
The government completed earlier this year the draft of the National Social Security System (SJSN), covering insurance on health, life and workers' welfare, as well as severance payments and pensions.
When this system takes effect, all workers -- both from the formal and informal sector -- will have to pay monthly premiums to the AKN amounting to about 6 percent of their income.
Employers are expected to pay half of the premiums and workers the remaining 3 percent. The premiums for the poor will be covered by the government.
Thabrany questioned business people who claimed that this scheme would put additional burden to the already high production costs.
Currently, private companies are obliged to pay the social insurance Jamsostek for pensions, which amounts to 12 percent of employee's salary.
Data from 2000 showed that salaries accounted for only 8.1 percent of the total production costs, Thabrany explained. Thus, even if the companies pay premiums of 5 percent of salaries, costs would only increase by 0.4 percent.
"Do we really believe that the compulsory contribution for the AKN will reduce our product competitiveness?" he said.
Aside from that, a study of the faculty's health economy research center, which surveyed 1,084 small, medium and big enterprises in 2001, shows that on average, company spending for employees and their families' health was 5.24 percent of the monthly salaries.
The government has handed over the draft to the House of Representatives, which is expected to deliberate upon it in its next session, starting next week.
"I hope that the bill can be passed before new elected members of the House take their seats, as this bill was a mandate from the last general assembly," said Thabrany.