Physician proposes new health insurance system

JAKARTA (JP): A top physician has called for the establishment of a national health insurance system that would guarantee affordable health care for everyone.

Azrul Azwar, the chairman of the Indonesian Medical Association and dean of University of Indonesia's School of Nursing, said the time had come to introduce a health insurance law to ensure people's access to health care.

Existing health insurance schemes were limited to government employees and some private sector workers and excluded the millions of people who were self-employed, such as farmers, fishermen and casual laborers, Azrul said in a scientific oration for his professorship at the University of Indonesia on Wednesday.

Community Health Care Insurance, a mutual fund program, only covered some 31 million people, or 16 percent of the population, he said.

They include 15 million civil servants and one million private sector workers enrolled with Askes (the state-run health insurance program), one million participants of Workers Social Insurance, and 14 million participants of another health fund program.

Some 169 million others still had to pay cash every time they sought medical care, he said.

Azwar said the national health insurance scheme was even more urgent now because medical costs kept on increasing due to inflation, a growing public demand for better health services and technological and scientific progress. Changing patterns of disease in society also affected overall medical costs, he said.

To fund the national health insurance, he proposed that the government raise land and property taxes by a few more percentage points and use the proceeds to fund an agency, whether public or private, to manage national health care.

He said if the proposal was agreed upon, the country could immediately start a national health care program developed under the principles of gotong royong (mutual help).

"Linking the premiums to property taxes guarantees proportional contributions. The rich are bound to pay more than the poor," he said.

"The scheme will work on the principle of cross-subsidies. The rich helping the poor, and the healthy helping the sick," he said. (09)