Households feel the pinch of rising health costs

Hera Diani, The Jakarta Post/Jakarta

With the fuel price increases, the tsunami disaster in December and reports of bird flu and polio, affordable, quality health care is out of reach for more and more people, resulting in the reemergence of diseases that have disappeared completely in other countries.

In response, activists urged the House of Representatives on Friday to revise Law No. 23/1992 on health care to put more of an emphasis on the government's obligation to provide affordable and quality health care.

Community health expert Mahlil Ruby from the University of Indonesia said the government spent US$9.30 per capita, per year on public health, far below the $35 to $40 standard set by the World Health Organization.

In comparison, Malaysia spends $95 per capita, per year on public health.

Households in Indonesia pay the majority of the medical costs, with the rest covered by insurance companies or employers.

"With or without the fuel price hike, money for public health must be provided," Mahlil said during a discussion hosted by the Women's Health Forum.

There are no clear regulations governing the allocation of government funds for health care, and much of the money is late in arriving or does not arrive at all.

"Regional budgets are mostly allocated for civil servants instead of for nutrition and public health. No wonder we still find cases of malnutrition in the country," Mahlil said.

Oncologist Zubairi Djoerban from Cipto Mangunkusumo General Hospital said that in the wake of outbreaks of bird flu, polio and dengue fever, the government should do more to provide a healthy environment.

"The environment includes offices, houses and schools. There should be, for example, clear regulations on smoke-free areas in public areas, immunization and waste disposal," he said.

Activists have long pushed for a revision of the health law, which they say is vague, outdated, discriminatory and incompatible with other regulations.

The law, for example, does not elaborate on reproductive health services or reproductive health rights, alternative medicine or technological advances such as genetic engineering, cloning and stem cell research.

The law is also incompatible with the 1945 Constitution, which stipulates that the state is responsible for providing health care for the poor, the elderly and orphans.

Legislator Mariani Akib Baramuli, who heads the House's working committee on health care, said the House had approved amendments to the law last year.

"But everybody was busy campaigning for the election so they were abandoned. Now it is stuck in Commission IX for education, health and labor, whose legislators have a different perception of the issue," she said.