Hospitals providing free health care for the 'rich'

Bambang Nurbianto, The Jakarta Post, Jakarta

The health card system aims to provide a free health service for the poor. But while many destitute people are unable to enter the program due to their lack of an ID card, employees of several hospitals admitted on Monday that many of the recipients look affluent.

Meri Silalahi, a nurse at Tarakan hospital in Central Jakarta, said that many of the cardholders were people with a university education, who owned cellular phones and wore gold jewelry.

"The hospital offers services free of charge to anyone who holds a health card. We don't ask those people how they obtained the card, because they would become angry if we were to do so," Meri told The Jakarta Post.

Tunggul Setiabudi, an employee at Koja hospital in North Jakarta, also said that he often received complaints from nurses who treated patients holding health cards.

"Some nurses told me that some patients with health cards were hospitalized here but did not deserve the free health facility," Tunggul told the Post.

However, like Meri, Tunggul also did not ask health card holders about how they had obtained their card, saying that he had no authority to do so.

Head of the City Health Agency Abdul Chalik Masulili said last week the health cards were often counterfeited and sold to people who had no right to receive free health services.

Masulili also admitted that many poor people could not enter the program because they were unable to produce a city ID card.

According to the City Statistics Bureau, there are more than 30,000 families or at least 100,000 poor people in Jakarta who do not have a city ID card.

Both Meri and Tunggul said on Monday they had received warnings from the health agency about counterfeit health cards. But they said they had never come across any.

Health cards are issued by doctors at the nearly 300 health centers in the capital for poor people with a Jakarta ID at the recommendation of subdistrict heads.

All hospital fees for health card holders become the responsibility of the city administration. The free services include surgery.

"We will provide any health service needed by a patients with a health card as long as the facility is available here," said Nurul Huda, a staff member of the public service division at Koja hospital.

She added that the hospital would provide service to any health card holder as long as the person could produce supporting documents such as an ID card, a family card and a recommendation from a health center doctor.

Dr. Makmur Mandaria of the Tarakan hospital medical service division, shared Nurul's statement, saying that his hospital was obliged to serve all health card holders without asking how they had obtained them.

Makmur said that so far the city health agency had no mechanism to monitor whether health services were reaching the right people.

He said the abuse of health facilities for the poor also occurred at a hospital in Surabaya, East Java. But such practices were stopped as the health agency in the city checked the addresses of patients who received health services.

"If they found that a patients was not poor, the person would be obliged to repay all of the hospital fees. Under such a mechanism, they could cut the reimbursement by up to 50 percent. Here, we do not have such a mechanism," Makmur told the Post.

Masulili said that his agency would issue a new type of health card so that they could not easily be counterfeited. Unlike the current health card, the new card will bear a photograph of the holder.