Hospitals unsure about definition of poor person

Hospitals unsure about definition of poor person

Bambang Nurbianto, The Jakarta Post, Jakarta

Doctors said many patients were financially unable to pay
hospital bills, however they were not actually categorized as
poor people and some who were poor did not have health cards.

These people often create confusion among the medical
professionals about whether or not they deserve to receive health
cards, which were intended for poor people to get health services
free of charge.

Usmanawati, a doctor at Kampung Melayu's public health center
(Puskesmas), said that she often had to deal with such cases.

"I received notes from doctors of the state-owned Cipto
Mangunkusumo hospital (RSCM), asking to issue health cards for
patients who could not afford hospital fees," she told The
Jakarta Post on Tuesday.

"It is a problem for me as many of the people who have such
recommendations from RSCM's doctors cannot be categorized as poor
people who have the right to get the free health service," she
noted.

Normally, health cards are issued by doctors at subdistrict
health centers for people who are selected by neighborhood and
community heads together with volunteer health workers in the
subdistricts.

Because of the recommendation from doctors, Usmanawati said,
she could not strictly comply with the prevailing procedures in
issuing health cards.

"If I feel they really need help, I'll issue health cards as
demanded by patients from Kampung Melayu subdistrict based on a
recommendation from RSCM doctors. Sometimes I ignore some
criteria if I think that someone really needs help," she added.

She also found another case which needed her own consideration
in making a decision. She said there was a homeless woman without
an identity card who was about to give birth. Based on the
existing criteria she had no right to the card without her
identity card.

"But, I issued the health card for her anyway as she urgently
needed treatment," she added.

The criteria of a poor family is based on Jakarta statistics
office data and includes, area of floor space in the house (less
than 8 square meters), dirt floors, no access to clean water, no
toilet, no furniture, a lack of meat, fish or eggs in the diet,
an inability to buy new clothes each year, and an identity card
which shows the person to be a legal resident of Jakarta.

There are 1,539 families classified as poor who hold the
health cards from a total of some 5,000 families in Kampung
Melayu subdistrict.

A number of health card holders said that the cards are very
useful for them.

"Thank God that I never had to use this card for a major
hospital visit, but with this card, I feel secure as I was
informed that I could receive free health services," said
Sutinah, 50, a resident at Manggarai Selatan subdistrict, South
Jakarta.

A similar statement was made by Sumini, 45, a resident at
Kampung Melayu. Sumini said that she and her husband, who is a
construction worker, received the health card from a volunteer
health worker in the subdistrict.

Usmanawati admitted that there were some people, who did not
fit the criteria but they somehow managed to obtain the health
cards. "There is still collusion, corruption, and nepotism in
deciding upon those who receive health cards. But the number is
not so significant," she claimed.

Another case she found was when a man had a blank health card.
The man from Pandeglang, Banten asked her to fill the health card
in for him. He claimed he got the card from certain health
officials.

"Based on my experience, it is very possible that many people
do not deserve the free health services as they are not poor
people," she added.