Acknowledging miscalculations in the healthcare scheme that triggered the withdrawal of 16 private hospitals from the program, Governor Joko “Jokowi” Widodo said on Tuesday that the government would consider increasing the amount of the premium. Full article
“We will recalculate the amount of the premium. Maybe Rp 23,000 [US$2.37] was not enough, but we — the city administration and the Health Ministry — should discuss this issue together,” Jokowi told reporters at City Hall.
Jokowi was referring to the Jakarta Health Card (KJS) scheme’s individual monthly premium, which was set higher than that of the national healthcare program at Rp15,700.
The hospitals, two of which — MH Thamrin and Admira — have submitted official withdrawal requests, have claimed that they could not cope with losses incurred from covering the medical expenses of KJS patients.
The remaining hospitals comprised Bunda Suci, Mulya Sari, Satya Negara, Firdaus Respiratory Hospital, Sukapura Islamic Hospital, Husada, Sumber Waras, Suka Mulya, Port Medical Hospital, Puri Mandiri Kedoya, Tria Dipa, JMC, Mediros and Restu Mulya.
Previously, a total of 341 community health centers (Puskesmas) and 132 private and public hospitals were incorporated in the KJS program, which was launched in November.
Currently, the KJS scheme is using the Indonesia Case Based Groups (INA CBG) system, a reimbursement system applied by the Social Security Providers (BPJS) in the national healthcare program (Jamkesmas) as KJS funds totaling Rp1.2 trillion are being managed by state insurer PT Askes, one of the BPJS implementing agencies for the health sector.
Wanda Hamidah of the National Mandate Party (PAN), a member of the Jakarta Legislative Council’s Commission E overseeing people’s welfare, said that the amount of the premium was not the only problem in the implementation of the healthcare program.
“The lack of supporting infrastructure and ineffective referral system are also among issues we have to solve,” she told reporters at the Jakarta Legislative Council.
“During a meeting with my commission and the Jakarta Health Agency last week, a number of hospitals cited that 40 percent of KJS patients were not supposed to be treated at certain hospitals but went to the hospitals anyway,” she said, adding that “if the referral system in Puskesmas was effective, this kind of problem wouldn’t happen.”
Wanda emphasized that the healthcare program, however necessary, should not be detrimental to the hospital’s business.
“Even state-owned and city-owned hospitals should make a profit, albeit not like the private ones. We can’t just let them violate regulations to survive while being obliged to carry out the administration’s programs,” she said.
Having met with representatives of the Health Ministry on Tuesday, the Jakarta Health Agency’s Dien Emawati said that the agency and the ministry had agreed to evaluate the INA CBGs system.
“We have also agreed to set up posts to receive complaints regarding the KJS system,” she said.
According to Dien, the agency and the ministry would summon representatives of the 16 hospitals to further discuss the matter and expected to settle the issue by the end of the month.