Overprescribed and overpriced. Tuesday's special report on medicines cast some light on one of the country's health care management failings, detailing how as consumers, Indonesians are at the mercy of unscrupulous doctors and drug companies. Competition to sell medicines in the loosely regulated industry means doctors regularly medicate patients up to the eyeballs with drugs they do not need, at prices they need even less.

Health, as we know, is a life-and-death matter, and most consumers here have only two options: Pay for the drugs or leave them and get sick, and maybe even die. And if they cannot pay, they have no options at all.

Then there are the increasingly reported cases of medical misadventures in the operating theater. Grisly stories abound of bungled operations – of surgeon's tools sewn up in bodies, of ghastly anesthetic fires on the operating table – so it is no wonder that Indonesians with the wherewithal generally choose to go abroad for their medical care. The others, who are less well-off, often prefer to put their trust in cheaper – but not necessarily safer – alternative or traditional therapies.

Theoretically, the government provides free or highly subsidized medications for those who cannot afford to pay their bills. However, in reality, people expect little from the health care system – and their low expectations are often met.

There is a general feeling that doctors here are too busy to listen to their patients. To earn more money, doctors often work at several hospitals at once, and most are untrained in the public relations of health care.

Health consumers, however, are getting more educated – as can be seen in the increase in medical malpractice lawsuits against hospitals and doctors. However, like in other sectors, consumers here are still in a weak position, especially compared to those in developed Western countries.

Tuesday's report only strengthens public suspicions that drug manufacturers and doctors are conspiring for profit at the expense of consumers, who are pushed into buying unnecessary drugs at rip-off prices.

Industry professionals and health workers have long privately acknowledged that doctors who prescribed certain amounts of certain drugs would receive "gifts" from the drug producers.

This is one of the reasons why many doctors are reluctant to prescribe generic drugs, which are much cheaper and just as effective as the patented ones.

Influenced by drug companies' packaging and advertising, many people also prefer to buy the more expensive medicines – for reasons of status, perhaps, or because of the wrongheaded view that the patented drugs are better.

The Health Ministry and the Food and Drug Monitoring Agency (BPOM) are the two state institutions primarily responsible for the nation's health.

If they do not begin cooperating properly, most people here will never have access to safe, affordable and effective medical care.

Unfortunately, these agencies are far from working together – they are currently engaged in very public mudslinging – each accusing the other of incompetence. It would be heartening if this conflict stemmed from a sincere desire to improve the nation's welfare but, alas, it is seems to be more about venal rent seeking.

The Health Ministry is keen to regain control of the BPOM, which has been under the presidential office's control during the past few years, after being a directorate in the ministry for decades.

Monitoring and regulating food and drugs is, of course, a big-money industry – and it is unsurprising that the ministry would like this function back.

Although a proud agency chief, Sampurno, has claimed the World Health Organization ranks the BPOM as the world's fourth-best food and drug monitoring agency, he should also be humble enough to concede that he cannot guarantee there is no graft in his office.

For, if the agency is so great, why is there not more monitoring of the marketing and sales of medicines? And, as the recent formaldehyde food scandal shows, whatever the WHO ranking, the agency had long done little to enforce food safety standards in local markets.

We can only hope that the government and the House of Representatives will continue to create regulations and laws that protect consumers. However, the root of our problems too often lie not in an absence of laws, but in a failure to enforce them.

Until this changes, perhaps all medical clinics and hospitals should carry this warning notice: Don't get sick!