Jakarta – Sutinah and her husband, residents of Rawa Badak, North Jakarta, have to feed six children, not to mention her parents, who all live in the same house. Rundown and crammed with cheap plastic furniture, their 30-square-meter dwelling represents the family's difficult economic condition well.
Despite the fact that government health subsidies for the poor have been available since 1999, Sutinah, a 37-year-old mother, and her family have only enjoyed the free health care service for two years.
"I did not have the time to do the paperwork to obtain the kartu sehat (health card) since I had to work," she said. Her business, a door-to-door laundry service, was extremely time-consuming, she explained.
"But, when I delivered our third baby, things became so expensive that my husband decided to ask for the health card," she said, showing a stained green card labeled Kartu Gakin 2003, bearing the names of her family members.
Although the family's living quarters should have been proof enough, they had to spend considerable time applying for the service before receiving the assistance already earmarked for them.
"Previous Social Safety Net health programs, aimed at giving support to poor families, were ineffective," the head of the Indonesian Health Consumer Empowerment Foundation, Marius Widjajarta, said on Friday.
Earlier programs were not well monitored, with the funds disbursed directly to health care providers, such as doctors, hospitals and community health centers, without having a solid database to identify poor people in the country, he said.
He said YPKKI found out that some families were getting more than one card and selling the extra card for Rp 150,000 (US$16.30) to Rp 300,000 in Cilincing and Purwakarta, West Java.
"We hope that the disbursement of the current health subsidies in the form of insurance will be based on valid data," Marius said.
The new data compiled by state-owned health insurance company PT Askes and local administrations indicates there are 60 million people eligible for the government's program to assist those hardest hit by the recent fuel price hikes – not the 36 million recorded by the Central Bureau of Statistics (BPS) last year.
The new figure accounts for more than a quarter of the country's population.
However, an expert said he doubted the validity of the larger number.
Gadjah Mada University professor Mubyarto told The Jakarta Post the criteria to define poverty should be based on the financial ability to cover primary needs, including health and education, and not the $2 daily income stated by the World Bank.
Minister of Health Siti Fadilah Supari said that such a large increase in the estimated poor population was realistic and was not caused by the fuel price hike.
"The number would have probably been that large even before the fuel price hike, if the previous data compiling process had been accurate," she said.
After having completed validating the data on poor people, the government now had to monitor and evaluate the performance of the program, Marius said.
"If we still find problems in identifying and distributing the health cards in the future, maybe the government will need to make the mechanism for issuing the cards part of a binding law or regulation," he said.