En­sur­ing In­done­sians get emer­gency health­care

The Star Malaysia - - Focus -

A FOUR-month-old baby in need of emer­gency care died re­cently while the man­age­ment of a west Jakarta hos­pi­tal re­port­edly tried to lo­cate hos­pi­tals part­ner­ing with the uni­ver­sal health cov­er­age or JKN pro­gramme.

By law, hos­pi­tals must treat emer­gency cases re­gard­less of whether pa­tients are cov­ered by the JKN or can pay the nec­es­sary med­i­cal fee de­posit.

The par­ents claim they were un­able to pay the re­quested ini­tial pay­ment of 11 mil­lion ru­piah (RM3,491) for the pae­di­atric in­ten­sive care unit (ICU); the baby was suf­fer­ing from se­vere cough­ing and breath­ing dif­fi­cul­ties. The Mi­tra Kelu­arga Hos­pi­tal in west Jakarta said the par­ents agreed to have her trans­ferred to a hos­pi­tal part­ner­ing with the JKN.

How­ever, by the time a hos­pi­tal was lo­cated, the in­fant had died. The man­age­ment stated the in­fant was born pre­ma­turely and suf­fered from con­gen­i­tal heart dis­ease and mal­nu­tri­tion.

The pa­tient, who had re­port­edly been treated else­where be­fore­hand, had ar­rived in an un­con­scious state, its state­ment said.

The pri­vate hos­pi­tal chain says it is in the process of join­ing the JKN pro­gramme, which lists only 89 part­ners among 189 hos­pi­tals in Jakarta. The Health Min­istry’s reg­u­la­tion states that pa­tients must be treated in emer­gency cases in any pri­vate or pub­lic hos­pi­tal, and pa­tients can be trans­ferred to hos­pi­tals that are JKN part­ners when they have sta­bilised.

Al­though many peo­ple have ben­e­fit­ted from the JKN, where the monthly pre­mi­ums range from a mere 25,500 ru­piah (RM8) to 80,000 ru­piah (RM25.40), com­plaints in­clud­ing long waits lead­ing to higher health risks par­tic­u­larly for the poor and se­verely ill pa­tients have per­sisted.

In June, a res­i­dent of Bekasi in west Java, gave birth to a still­born baby in a cae­sar­ian op­er­a­tion that was fi­nally con­ducted in north Jakarta af­ter she was re­jected by seven hos­pi­tals in Bekasi, in­clud­ing the pub­lic hos­pi­tal, which had said its ICU was full.

The hos­pi­tal, RSUD Bekasi, was about to add 20 beds at its ICU fa­cil­ity to meet high de­mand, the man­age­ment said. The pa­tient was en­ti­tled to uni­ver­sal cov­er­age but her in­sur­ance had ex­pired, re­ports quot­ing the hos­pi­tal said.

Many pa­tients and their fam­i­lies are at their wits end in emer­gency sit­u­a­tions. Re­jected pa­tients are con­fused by hos­pi­tal man­age­ment claims that they are out of beds, or that they have ex­ceeded their “BPJS quota”, their daily share of pa­tients cov­ered by uni­ver­sal health­care in­sur­ance man­aged by the Health Care and So­cial Se­cu­rity Agency (BPJS Ke­se­hatan).

Other rea­sons for re­ject­ing pa­tients in­clude lim­ited fa­cil­i­ties to treat the pa­tient’s emer­gency condi- tion. How­ever, pa­tients of­ten won­der aloud how hos­pi­tal man­age­ments im­me­di­ately seem to find space when they say they will pay for them­selves.

Many prob­lems still plague the JKN; while it re­mains in the red cov­er­ing 170 mil­lion cit­i­zens, it must rush to reach the tar­get of cov­er­ing all 250 mil­lion In­done­sians by 2019.

— Reuters

Cov­er­age needed: Many, like the res­i­dents of this slum area in Jakarta ,are in dan­ger of not get­ting treat­ment in health emer­gen­cies.

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