Health insurance to be made available to all citizens

Health insurance to be made available to all citizens

Evi Mariani, The Jakarta Post, Jakarta

The Atmin family, who were hit by a train while passing an
illegal crossing in Jakarta a couple of weeks ago, had to spend
millions of rupiah to pay for medical services and the burial of
their five-year-old son Anjar.

The family, who were about to start a small business selling
chicken noodles, did not have enough money to pay for the
expenses and expected the state railway company PT KAI to cover
them. Their hopes faded, however, as PT KAI denied any
responsibility, as they determined that the crossing was illegal.

As a result, the family had to rely on people's generosity.

To address such a problem the Ministry of Health is
formulating a national health insurance scheme that will insure
the health care of all citizens, including poor families.

The scheme, which will be called the National Health Insurance
(JKN), will oblige each Indonesian citizen from all walks of life
to obtain a health insurance card that will guarantee the person
to have proper basic medical services across the country, said
Director General for Community Health Services Azrul Azwar on
Thursday.

The scheme was developed in accordance with the amendment of
Article 34 (2) of the 1945 Constitution that requires the
government provide social security to all.

The National Social Security System (SJSN) will cover
insurances of health, life and workers' welfare, as well as
severance payments and pensions.

"Consequently, the current insurance systems, such as Askes
(health insurance for civil servants) and Jamsostek (health
insurance for private workers) have to be integrated into the
planned system so workers will only have to pay one premium for
all services," Azrul said.

He said PT Askes and PT Jamsostek, the profit-oriented state
companies managing civil servants and private workers insurance,
will have to "adjust" themselves to the planned system, which is
non-profit in nature.

When this system takes effect, all workers -- both from the
formal and informal sector -- will have to pay monthly premiums
to the JKN amounting to about 6 percent of their income.

"I expect private companies will cover the 3 percent and each
worker will pay the remaining 3 percent. I have asked the
government to give incentives to companies which pay half of the
premium, such as tax deductions," Azrul says.

He could not explain how the government would gather premiums
from informal sector workers.

The government hopes the JKN will increase the national health
spending by 1.7 percent from the Gross Domestic Product (GDP) in
2000. The World Health Organization (WHO) standard for national
health spending is 5 to 8 percent of GDP.

Currently 30 percent of the spending is covered by the state
budget while the remaining 70 percent by household budgets.

Azrul said about the half of the state health budget was used
to finance private goods, such as expensive health devices for
hospitals.

"The devices are used mostly by rich citizens, so the budget
practically subsidizes them. I expect the JKN can finance private
goods so the state budget can be focused on subsidizing the cost
of medical treatment for poor citizens," he said.

The state health budget this year reached Rp 5.7 trillion
(about US$640 million).

Meanwhile, Indonesia's disability adjusted life expectancy
(DALE) figure remains low. The figures of life expectancy and
health spending show that a lot of sick people do not get proper
health care.

The Ministry of Health has recorded that from the total health
spending, only about 20 percent of it was covered by insurance
companies. The remaining is imposed on household budgets.

Azrul said that citizens who needed more than basic health
care could join commercial insurance programs.

The ministry has not determined what items will be paid under
JKN, but it has been proposed that the scheme will cover
emergency room service, confinement, doctor bills and medicine.

The government expects to complete a bill on social security
system, including the JKN, by the end of June.