Red tape lethal than dengue fever
Eva C. Komandjaja and Damar Harsanto, The Jakarta Post, Jakarta
The City Council urged the Jakarta Administration on Monday to cut down on the bureaucratic red tape on disbursements for impoverished dengue fever victims, who are unable to get timely or professional medical treatment without the money.
"In such a state of emergency, the Jakarta Health Agency must bypass all its normal, and unnecessary, paperwork so it can speed up the procedures for medical bill reimbursement (paid to city- run hospitals from the agency over medical costs for poor patients)," councillor Syamsidar Siregar of the National Mandate Party (PAN) said in a hearing between with the council's Commission E overseeing people's welfare and health.
The commission recommended that the administration use the Rp 800 billion (US$95.2 million) emergency fund to help cover all costs needed to curb the dengue outbreak. The city must get the council's approval to use the emergency fund.
Long bureaucratic procedures have forced city-run hospitals to provide just the bare minimum of treatment for patients without money.
Unlike public health centers that each received Rp 150 million in cash for their operational costs to combat the outbreak, hospitals must cover the patients' costs first, then deal with the time-consuming mountain of red tape to get reimbursed from the city health agency. The reimbursement fund is taken from the city budget for poor families' health needs and amounts to Rp 40 billion.
Deputy Director of Service of the city-run Tarakan Hospital, Sutirto Basuki, said that his hospital had to lower their standard of treatment for dengue fever victims who could not pay as a result of the backlog of reimbursement requests that they were still waiting for.
"We don't have enough money to even do blood tests. We have to use our own (operational) budget to pay for the tests and still limit them," he said.
Basuki said that instead of conducting a standard blood test for a dengue fever patient every two hours, the hospital extended the period for each test to a minimum of six hours for the sickest patients.
Widianingsih, a resident of Kebon Jeruk, West Jakarta, confirmed that the nurse took the blood samples from her son Ali every six hours.
The Ministry of Health has instructed doctors to conduct blood tests on dengue fever patients every two hours for three consecutive days. If a patient's condition improves, the blood test can be done every 12 hours.
Another city-run hospital Budhi Asih in Cawang, East Jakarta, also had to use its other parts of its budge for poor dengue fever patients.
"We are still in the process of trying to get reimbursed from the health agency. We are using the hospital's funds to cover the costs," said Srihati Sinulingga, an official of the hospital.
Since the dengue fever outbreak hit Jakarta earlier this year, the death toll has reached at least 58, while there were 7,366 known reported cases as of Monday.
Councillor Ahmad Heryawan of the Justice Party urged the agency not to use the Rp 40 billion allocated for poor families on dengue victims, but to save it for later.
"If that fund is used for the poor dengue fever patients, we are afraid that the allotment for poor families to get subsidies for other medical treatment will be reduced," he argued.