Poor people need proper Medicare

By Stevie Emilia and Rita A. Widiadana

JAKARTA (JP): You have just lost your job and have a health problem which deprives you of the opportunity to look another job that will ensure financial security. In the meantime your expenses continue to add up.

This is probably the worst case scenario that many Indonesians hope they will never have to face.

With the ever-increasing number of people losing their jobs and the toning down of lifestyles due to the economic crisis, it is not all that improbable that this could happen to you.

Even worse, many Indonesians never learned how to save money properly and do not know the benefits of health insurance schemes that cover a variety of medical costs associated with a wide range of ailments.

Orie Andari Sutadji, head of the Indonesian Insurance Council's social and health division, has suggested that people start thinking about taking out health insurance.

"Most people still do not consider health insurance a top priority. As often is the case, medical costs can turn out to be astronomical and having health insurance could end up being one of the best solutions," explained Orie.

However, joining a health insurance scheme is probably the lowest on people's lists of things to do.

Businesswoman Enny Sukamto Hehuwat shared her views, saying that she had no confidence in the services and quality of local health insurance firms.

"I've already taken out life insurance. I've also insured my private property including cars, houses and my art collection," Enny said.

She was wary that local health insurance schemes were not as accessible as those offered by overseas companies.

"Actually, I need a reliable health insurance policy, but I don't have any idea which one is the best," added ex-model Enny.

Dino, a driver for a freight forwarder company, has his own reasons for not having health insurance. Despite the risks of his job, his company does not provide him or other employees with a health allowance.

"With my meager salary, how could I possibly pay insurance premiums, which are very costly? I'm better spending my money on food. I keep praying that nothing terrible happens to me," said Dino.

A large number of Indonesians, especially those of the low- income bracket, are vulnerable to serious health problems. But the medical services available to them are very limited.

Many Indonesians are unfamiliar with comprehensive health schemes, and those that are cannot afford the particular scheme they are interested in.

Often only civil servants, Armed Forces members and employees of state-owned or multinational firms are covered by medical insurance.

Only about 13 percent of the more than 200 million population has health insurance with state-owned health insurance company PT Askes, state-owned PT Jamsostek or one of the small number of private health insurance companies.

"Most of them have health insurance only because the premiums are deducted directly from their paychecks. It is not based on willingness or awareness of the importance of insurance," said Orie, who is also a director of PT Askes.

Farmers, small-scale traders and other poor people on the other hand have to pay for medical services out of their own pockets.

In a recent seminar on health insurance, economist Sri Mulyani Indrawati suggested that the government protect these vulnerable people with a reliable health insurance scheme.

"The government should pay more attention to the provision of adequate medical services for the poor, pregnant women, children and low-income workers," explained Sri Mulyani.

These people, she said, deserve equal opportunity in medical services. In developed countries like Australia, the United States and several European countries, all citizens are entitled to government medical care schemes.

"We cannot keep up with those countries in offering Medicare, but at least the Indonesian government could start it now in this time of crisis," she added.

At present, only a small number of people can afford to take out health insurance.

Zumrotin K. Susilo, a consumer activist, pointed out that Indonesia had PT Askes, which deals in social health insurance.

But people find joining the PT Askes scheme complicated. "During these critical months, we can feel the benefit of having health insurance policies," commented Zumrotin.

She added that PT Askes should improve its services because it deals with the lives of people. "I've noticed so much discrimination by hospitals and medical staff in providing medical services to members of the Askes health scheme," she said.

Various complaints have been voiced by members of Askes health scheme, including by Sardjono Jatiman, a noted sociologist and a lecturer at the University of Indonesia.

"I am a member of Askes, but I never use that facility. It is just that I don't trust Askes or other insurance companies. Their images here are not so good," explained Sardjono.

A good business image is something lacking in many local insurance companies.

"Many promotion campaigns for health insurance schemes are exaggerated. Yet insurance companies must provide their best services and not cheat their clients," warned Orie.

There are at least 62 insurance companies offering health insurance programs. The companies include Lippo Life, PT Asuransi Cigna Indonesia, Dharmala Manulife, PT Asuransi Jiwa Sewu New York.

Today, when an increasing number of people are losing their jobs and people's purchasing power is decreasing, health insurance is probably not viewed as that practical.