Maretha Uli, Jakarta – The death of a National Health Insurance (JKN) patient after waiting hours for a hospital bed, coupled with insensitive social media remarks by healthcare workers responding to his earlier complaint, has intensified scrutiny of Indonesia's strained healthcare system and professional ethics.

A number of doctors, dentists and nurses have come under fire after posting derisive comments on a Thread post on July 22 in which the patient shared his experience waiting eight hours for an inpatient bed.

Some mocked him for "being poor" because he relied on the state-funded insurance scheme, while others said he lacked " brain cells". The patient died several days later due to delays in receiving hospital treatment, his relatives said.

The case has drawn widespread sympathy for the patient while triggering outrage over what many viewed as discriminatory remarks toward someone seeking treatment through the JKN program.

Public health expert Dicky Budiman said JKN participants and self-paying patients must receive equal treatment under legal and ethical standards, with medical care determined by the urgency of a patient's condition rather than the method of payment.

"If discrimination in healthcare services based on JKN membership is occurring in this case, it constitutes violation of the law," he said earlier this week, adding that limited bed capacity could not justify denying patients access to treatment.

Health Ministry Healthcare Director General Azhar Jaya explained on Thursday that the patient had been treated at Cipto Mangunkusumo Central General Hospital (RSCM) in Jakarta, where no high care unit (HCU) beds were available at the time.

Dicky said the incident reflected broader systemic problems. He argued that some healthcare institutions fostered a culture in which public criticism was viewed as a personal attack rather than constructive feedback.

At the same time, overcrowded hospitals and growing demand for JKN-funded services is placing frontline workers under mounting pressure.

Discrimination against JKN participants has long been a recurring concern in the country. Between 2021 and 2022, the Indonesian Ombudsman received 700 complaints related to JKN services, ranging from hospitals refusing treatment to discharging patients before they fully recovered to alleged discriminatory practices.

However, the Indonesian Health Council (KKI) rejected suggestions that JKN participants are systematically stigmatized or treated differently from other patients.

"There is no stigma [among health workers] towards JKN participants, as JKN has become one of the pillars of healthcare in Indonesia and many patients have survived thanks to it," KKI member Agus Samsuddin said during Thursday's press briefing in Jakarta.

The council nevertheless acknowledged that hospitals frequently struggle to meet demand. With JKN now covering 98 percent of Indonesia's roughly 280 million people, patients often have to wait one to two days in emergency units before an inpatient bed becomes available.

The KKI had further identified 10 healthcare workers and specialist medical residency trainees allegedly involved in the online abuse of the patient. However, it declined to disclose the institutions where they work or study, citing an ongoing ethics investigation.

Those found to have breached professional ethics could face sanctions ranging from warnings to temporary suspension. Cases involving doctors will also be referred to the Honorary Council of Medical Ethics (MKEK) for disciplinary proceedings.

Following widespread public backlash, several of the doctors and healthcare workers involved issued public apologies after internet users identified them and exposed their institutions. As pressure mounted, a number of healthcare facilities reportedly suspended or dismissed doctors implicated in the controversy.

Health Minister Budi Gunadi Sadikin had previously expressed regret over the incident, saying it had exposed weaknesses in the country's healthcare system. He pledged to improve healthcare facilities, medical equipment and human resources to ensure patients receive timely and quality care.

Meanwhile, state-owned health insurer BPJS Kesehatan overseeing the JKN program said all JKN participants remain entitled to healthcare services guaranteed under the program, even when hospitals are operating at full capacity. Spokesperson Rizzky Anugerah said the agency was committed to ensuring members continue to receive treatment.

Lawmakers have called for an objective investigation into the case. House of Representatives Commission IX member Nurhadi, who oversees health affairs, reminded healthcare professionals that compassion and respect are fundamental to their duties.

Source: https://asianews.network/patient-death-doctors-mockery-expose-healthcare-cracks-in-indonesia