Mon, 18 Sep 2000

PT Askes should be liquidated: Hospitals

JAKARTA (JP): A one-day discussion suggested here on Saturday that the state health insurance company PT Askes be liquidated or merged with other insurance firms for its failure to perform well up to now.

The discussion, organized by the Indonesian Health Consumers Empowerment Foundation (YPKKI), was attended by officials from PT Askes and several hospitals in Indonesia.

PT Askes has long been a target of complaints for its complicated and bureaucratic procedures.

The strong call to liquidate PT Askes came from the Association of Jakarta Metropolitan Hospitals (IRSJAM).

"Most hospitals have to subsidize an average 45 percent (of the total medical treatment costs) for PT Askes," said IRSJAM chairman Dady Tirtono.

The vice president of financial and general affairs of the Fatmawati Hospital in South Jakarta, Abubakar Alatas, joined the criticism, saying that the insurance claim (provided by PT Askes) was not sufficient to cover the treatment expenses.

"The result is a deficit in hospitals' budgets," he said.

"We have to subsidize at least Rp 3 billion (US$375,000) every year."

He disclosed that some 95,581 Askes members visited Fatmawati Hospital last year and cost the hospital some Rp 10.76 billion ($1.3 million).

"PT Askes could only cover up to Rp 2.9 billion ($362,500)," Abubakar said. With Rp 4 billion in government subsidies, there will be Rp 3.86 billion ($482,500) left to be covered by the hospital."

He added that Askes members, mostly civil servants and their families, only had to pay a very small amount in extra money for the hospital's services.

"We only charge each patient between Rp 1,000 (13 cents) or Rp 5,000, but the patients are often angry at us. They said PT Askes should cover all of the expenses," Abubakar said.

Every year, he added, the hospital only collected some Rp 400 million from the extra payments.

Abubakar said that merging PT Askes with the Workers' Social Security Scheme (Jamsostek) and Workers Insurance (Astek) was a good idea.

"The premiums of Jamsostek and Astek are much higher than PT Askes. Besides, most of the workers are healthy so they can 'subsidize' other members," he said.


According to PT Askes' operational director I Gede Subawa, the company also had trouble covering expenses as the insurance premium was relatively small.

There are a total of 13.8 million civil servants and their families who use PT Askes' service.

Each civil servant is obliged to pay 2 percent of his or her basic salary or a family subsidy for family coverage in the insurance scheme.

Gede said the average premium was Rp 2,500 per family per month, totaling about Rp 400 billion.

PT Askes president Orie Andari Sutadji revealed in July that 87 percent of the money was spent on Askes members' health bills.

Orie pointed out that medication for a person with a chronic disease, for example, could cost a minimum of Rp 300,000 per month.

Quoting last year's data, she said PT Askes spent some Rp 31 billion on 2,880 kidney failure patients who needed hemodialysis.

She expected the amount would increase to Rp 44 billion, with the same number of patients, due to currency fluctuations.

Internist Rully Rusli from the Kidney Caring Foundation said that the government should pay more attention to the disease as only 9.5 percent of the kidney failure patients in Indonesia could afford hemodialysis.

"Only 7.5 percent of them (the 9.5 percent) are covered by Askes, while 90.5 percent can't afford it," he said.

Therefore, he added, it was important for PT Askes to be merged with other service to strengthen the health insurance system. (09)