If a family member is ill, one`s admission to hospital, on average will cost over 100 percent of household income. And quite often the family is forced to sell a house to pay the medical bills. So, it`s no surprise if people are saying "If you are poor in this country, you cannot afford to fall sick."
But, there is a hope for the poor because the government is now mulling a plan to provide all poor people with health insurance in 2014, so that every body in the country will then have access to health care.
"The central government is now drawing up a program to provide health insurance for the poor segment of the population," Coordinating Minister for People`s Welfare Agung Laksono said during a visit at the Health Polytechnical campus in Tadui village, Mamuju district, West Sulawesi, on February 18, 2012.
The state will pay the hospital bills of poor people through the State Budget so that they would have access to health care services at community health centers or hospitals free of charge.
"The government will soon register all people who so far cannot get medical treatment because they cannot afford the cost at community health centers or hospitals," he said.
The program would be implemented starting in 2014 so that eventually nobody in the country needed to be deprived of health care because of penury, Agung said.
The government has earmarked Rp29.915 trillion (about 3.2 billion dollars) in this year`s state budget, and most of the fund would be used to improve health service for the poor.
To fund health insurance program for the poor this year, the health ministry has allocated some Rp6.5 trillion (about 708.8 million U.S. dollars). The program called Jamkesnas, includes hospitals providing special medical treatment to the poor across the country.
"There are more than 1,070 hospitals providing Jamkesnas scheme for the poor in the country at the moment. We are expecting 300 more hospitals to join the program this year," Health Minister Endang Rahayu Sedyaningsih said recently.
In 2009, around 76.4 million Indonesians who were considered to be poor received free medical services in class-3 hospital beds, up from 36.4 million people in 2005.
For civil servants and military personnel, the government has provided health insurance called Askes since 1968. Now, around 16.683.000 people, consisting of civil servants, military personnel, veterans, pensioners and their close family members, are benefiting Askes.
Currently, however, around 36.88 percent of the country,s 238 million population is still not covered by government health insurance.
"Health insurance coverage in 2011 reached 63.12 percent of the
237.6 million total Indonesian population. The remaining 36.88 percent has not yet been covered," Deputy Minister of Health Ali Ghuffron Mukti said in Lampung, on February 23, 2012.
Many people who were not yet covered by the health insurance system have to pay directly to health service providers.
"This could make people become poor, while health service providers could tend to give poorer service to make big profits," he said when launching the Jamkesta universal health insurance coverage program in the province of Lampung, Sumatra.
He noted that the program had been proven useful for people, especially the poor, outside the Jamkesta public health insurance program quota.
Based upon data from the ministry of health in October 2011, 349 out of 497 districts and cities had already implemented the Jamkesta regional health insurance program covering some 31 million people.
"The implementation of Jamkesda varies from one region to another, depending on the financial capability of the regions. Therefore, it is important for the provincial administrations to continue to harmonize and synchronize Jamkesda with city and district administrations to overcome problems," he said.
Lampung is the fifth province pioneering the development of Jamkesta. "Of 33 provinces in the country, Lampung is the fifth developing Jamkesta. We hope other provinces would follow suit," he said.
To help realize the national health care for all program, the parliament passed Law Number 24/2011 on the Social Security Agency (BPJS), in October 2011. The law was a government initiative to improve the people`s welfare through a health and employment security system.
The law calls for the creation of a Social Security System that will be operated by an agency to be formed by merging two state-owned companies, namely PT Jamsostek which was providing workers social security and PT Askes which was engaged in health insurance. The process to merge the two companies is subject to a deadline on January 1, 2014.
Under the law, Indonesia will have only two social security agencies, namely a Health Social Security Agency which is the transformation of PT ASKES (Health Insurance Company) and Employment Social Security Agency, the transformation of PT JAMSOSTEK (Social Security of Employee Company) which will manage employment accident benefit, old age insurance, pension fund, and death insurance.
When the law was passed by the Parliament last October, Said Iqbal, the secretary general of the Social Security Action Committee (KAJS), that comprises 67 labor unions from Jakarta and suburban areas, welcomed it and said the BPJS Law was a big victory for Indonesia that deserved to be celebrated.
"Finally, after all these years, we will have universal health insurance coverage," he said representing millions of laborers who have so far been longing to be able to get medical services without having to fear of being kicked of from hospitals because they are unable to pay the medical bills. (*)