Dessy Sagita – The recent "detention" of two women and their babies by a South Jakarta hospital is further proof that many people, particularly low-income earners, don't receive the health services promised by the government, a leading antigraft body said on Tuesday.
The hospital refused to allow the women and their babies to leave for months because they were unable to settle their bills, which totaled Rp 12.1 million ($1,200). The four were discharged last week after the City Health Agency put up the money.
"Many Indonesians don't know what they are entitled to when it comes to health care. Some don't know that they are eligible for health care at all," Ratna Kusumaningsih, an Indonesia Corruption Watch researcher, told the Jakarta Globe.
Ratna said a 2009 ICW survey found that 80 percent of Indonesians did not fully understand the health security scheme for the poor, known as Jamkesmas, or the procedures for registering and obtaining a membership card and the benefits that come with it.
"I think the lack of awareness about Jamkesmas is a direct result of ineffective promotion by the government," she said.
Ratna said that although the Ministry of Health had been trying to promote the scheme, information had failed to reach the very people who need it most.
"Most promotion was done via electronic media and newspapers, but the people who really need Jamkesmas are poor and do not have ready access to the media," she said.
Introduced in early 2008, Jamkesmas is a health insurance scheme for the poor under which the government reimburses hospitals for medical costs after the expenses are verified by independent auditors. The scheme is intended to replace the Askeskin program, where medical claims are paid to hospitals through state-owned health insurance company PT Askes.
People wanting to take advantage of the Jamkesmas program are required to secure a letter from local authorities certifying that they are poor. But many complain the process to obtain proper documentation is complicated, costly and time consuming.
"There are at least seven reference letters they need to get to finally qualify for a card. Often they have to pay some 'thank you' money for the letters," Ratna said.
She said the ICW survey also found that some 40 percent of Jamkesmas cardholders still had to pay fees at hospitals, including registration and room fees.
A 30-year-old woman who did not want to be identified said that although she and her brother, who suffers from leukemia, are approved for Jamkesmas, she still had to pay a great deal of money for her brother's chemotherapy.
"I have sold my family home to pay for his treatment, but it's still far from enough and now I'm running out of options," she said, adding that she had to go through numerous institutions to obtain the card.
On Monday, the House of Representatives endorsed the health bill despite protests by some organizations that the legislation was flawed.