Low-income people still rely on RSCM
Low-income people still rely on RSCM
By Stevie Emilia and Dwi Atmanta
JAKARTA (JP): Despite the mushrooming of hospitals in the
city, the state-owned Cipto Mangunkusumo Hospital (RSCM) in
Central Jakarta still serves as the primary medical facility for
many Jakartans.
A 49-year old mother who had brought her daughter to RSCM for
medical treatment said she chose the hospital because she could
not afford treatment at more expensive medical centers closer to
home.
"There is a private hospital in my neighborhood but I think
medical treatment there would be very expensive," said Rodiyah,
who lives in North Jakarta.
She admitted she had never actually entered the private
hospital. "I just think I can't afford it," she said.
RSCM director M. Ahmad Djojosugito acknowledged there are many
hospitals established on economic profit considerations alone. He
lamented that business motives often overrode many hospitals'
obligation to serve poorer people.
He praised the cross-subsidy scheme that enables a state-owned
hospital such as RSCM to seek profit from higher-income patients
to use the money to help the majority of the patients, namely the
poor.
The hospital reserves around Rp 2.4 billion (US$1 million) of
its annual subsidy for the needy, but in return it receives Rp 24
billion a year from the government.
Ahmad said the government subsidy is used to cover the
hospital's operational costs, including the salaries of the
almost 6,000 employees.
"The cross-subsidy method is simply aimed at increasing funds
reserved for patients with lower incomes. We barely make money
from that," Ahmad said.
He said that RSCM, the oldest hospital in the country,
continues to have trouble breaking even 77 years after its
establishment.
A Jakarta hospital breaks even if it makes an average of Rp
25,000 per bed per day.
"You can imagine how difficult it is for RSCM to make a profit
if 85 percent of the beds are reserved for people who can only
afford to pay Rp 7,500 a day," Ahmad said.
RSCM has 1,305 beds with an average daily occupancy rate of 66
percent (858 beds).
Medical expenses at the hospital range from Rp 7,500 to Rp
235,000 per day (See diagram).
Ahmad, however, has a reason to smile despite the hospital's
downward-looking mission. "We have the country's best medical
experts and technology," he said.
The hospital employs 991 doctors, 90 dentists and 760
specialists. They receive support from more than 1,800 medics and
more than 2,000 nonmedical employees.
However, like other state-owned hospitals across the country,
quality of service remains a challenge at RSCM. Ahmad said: "We
admit that we are not giving the best possible service. Neither
do we have a totally clean hospital.
"But it's difficult to meet the two demands because we deal
with a staggering 12,000 patients every day."
While not directly speaking specifically of RSCM, Samsi
Jacobalis, chairman of the Indonesian Hospitals Association,
lamented the general standard of hospital services, saying that
they are simply "inadequate".
"Medical services providers should set new standards that put
customer, or patient, satisfaction first," said Samsi who is dean
of the Tarumanegara University School of Medicine.
He said hospitals must also keep up with both changes in
medical technology and customer expectations.
"If we neglect changes in the medical world, patients will
abandon us," he said.
Questions of quality and service aside, the vital role of
hospitals like RSCM cannot be neglected.
As Ahmad Djojosugito pointed out, RSCM serves as a referral
hospital; thus it cannot refuse any patients.
"This is the patients' last resort, we cannot refuse them even
though they cannot always afford to pay," he said.
Table: Hospital Occupancy and Rates Rates (Rp)
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No. Hospitals Beds III II I VIP Super VIP Executive
Deluxe Royal VIP
-------------------------------------------------------------------------
1. RCSM 714 7,500 25,000 45,000 65,000 -- --
2. Medistra 129 30,000 75,000 150,000 275,000 700,000 --
3. Mitra Keluarga 250 45,000 75,000 125,000 250,000 350,000 --
4. Metropolitan 177 30,000 90,000 160,000 250,000 375,000 400,000
Medical Center
5. Pluit 191 35,000 50,000 125,000 250,000 400,000 800,000
75,000
6. Pondok Indah 307 40,000 75,000 125,000 200,000 350,000 --
7. Siloam 328 30,000 75,000 125,000 250,000 400,000 600,000
Gleneagles
8. St. Carolus 400 22,000 45,000 75,000 200,000 275,000 --
60,000 85,000 225,000
250,000
9. Jakarta 122 40,000 80,000 140,000 210,000 350,000 --
100,000 250,000
** Rate for Siloam Gleneagles Hospital' Suite rooms is not being determined yet.
RSCM : Cipto Mangunkusumo General Hospital