Lack of funds blocks road to universal care

Elly Burhaini Faizal, The Jakarta Post, Jakarta | Sat, 04/16/2011 11:18 PM

Indonesia will need to make significant strides in resolving financial problems impeding its efforts to establish universal healthcare coverage by 2014, an official says.

Supriyantoro, the director general of health development efforts, said Friday that Indonesians may receive health services at public hospitals’ third-class facilities for free once a universal coverage scheme is implemented.

“Under universal coverage, we will not probe into a patient’s social and financial background. As long as they seek healthcare at third-class facilities, we will provide full coverage for them for free,” he said at the official opening of a new patient care facility at Fatmawati Hospital.

The government is targeting to establish full free healthcare coverage, or universal coverage, for patients seeking treatment at third-class facilities at public hospitals.

“We hope universal coverage is rolled out by 2014,” Supriyantoro said.

However, much depends on the government’s finances.

Supriyantoro said universal coverage in Indonesia would cost between Rp 30 trillion (US$3.45 billion) and Rp 50 trillion per year. “It’s quite high,” he said.

He said the government had funded the national health insurance scheme Jamkesmas to the tune of Rp 6.3 trillion since 2008. This subsidy covers 74.6 million people categorized as poor.

Universal coverage would require more funds since it would cover all patients seeking treatment in third-class facilities of public hospitals, not just 74.6 million people.

“We should develop universal coverage in stages due to the financial constraints,” Supriyantoro said.

Many Indonesians, especially from low-income backgrounds, do not have adequate access to even the most basic healthcare services, while both infectious and non-communicable diseases continue to blight the poor.

The government has implemented universal coverage at public hospitals in remote areas and cross-border regions in four provinces: Aceh, Bali, South Sumatra and South Sulawesi. Such full coverage is also available at public health centers in almost 400 regencies.

“We should prioritize people living in remote areas and border regions due to their economic difficulties,” Supriyantoro said.

The Health Ministry says only 53 to 54 percent of the country’s poor people were covered by Jamkesmas.

The country’s childbirth insurance scheme Jampersal is currently the only universal coverage available to pregnant women seeking treatment at third-class facilities at public hospitals during childbirth and if the women agree to join a family planning program.

Apart from health insurance programs, the government is also attempting to provide better healthcare for the poor, Health Minister Endang Sedyaningsih said.

“Public hospitals should allocate 25 percent of their beds to third-class wards, while private hospitals should allocate 10 percent,” she said.

She added that it was a minimum requirement stipulated in a 1986 ministerial regulation on private health service.

The Health Minister says Indonesia had 1,523 hospitals, both public and private, with 151,000 beds,
while 45,000 of the 64,441 third-class facility beds were in public hospitals.

“We should increase the number of third-class facility beds both in public and private hospitals,” Ribka Tjiptaning, a member of the House of Representatives’ Commission IX overseeing health, women and social affairs, said.

She praised a recent decision by Fatmawati Hospital, a public hospital founded by late first lady Fatmawati Soekarno, to increase the number of third-class beds to 750, 63 percent of the total beds, from the current 624.