Bali implementing health insurance

Bali started implementing the national health insurance (JKN) program in January 2014, allowing the province’s residents to receive quality and equal health treatment.

In a seminar entitled “A month of BPJS implementation” in Denpasar on Saturday, Denpasar Mayor Ida Bagus Rai Dharmawijaya Mantra said that there were 1,800 doctors practicing in Denpasar, while other regencies still needed doctors and healthcare providers.

The seminar, organized by the Indonesian Doctors’ Association (IDI) of Denpasar, focused on the performance of the Social Security Management Agency (BPJS), which integrated two agencies, PT Askes and PT Jamsostek.

“It is expected that BPJS will improve healthcare services and facilities and spread doctors and healthcare providers evenly,” the mayor said.

I Wayan Sutarga, director of Sanglah Hospital in Denpasar, said the JKN implementation would be more efficient.

JKN, a universal healthcare program, states in case of sickness, a person must go to a community healthcare center (puskesmas) first. If the center is unable to treat the illness, it will issue a referral for hospital treatment. The program also caps the class of hospital service a person can have.

“There will be a significant paradigm shift in healthcare services. Pharmaceutical usage could be reduced as it accounts for at least 40 percent of healthcare service components,” Sutarga said.

Providing single dose dispensing would be possible, he said. Doctors were also required to only prescribe necessary medication. “Now, patients can go home with a bundle of plastic bags containing dozens of medicines,” Sutarga said.

I Nyoman Mangku Karmaya, former IDI staff and a speaker at the seminar, said there were thousands of new medical school graduates across Indonesia.

“The placement of new doctors is not evenly distributed in every province in Indonesia,” Karmaya said.

He further said that healthcare services were provided under a market mechanism. “This leads to unequal incomes among doctors. Even state doctors are now practicing as private health providers,” Karmaya said.

When JKN was implemented in line with national standards, it would have a positive impact on the distribution of doctors.

“One doctor can serve between 3,000 and 5,000 patients in one area. Other doctors should find another location when there is already a doctor practicing in that area,” Karmaya said.

JKN would also minimize medical errors, as junior doctors could consult with their senior counterparts.

Under JKN, healthcare services at puskesmas, cost around Rp 3,000 (24 US cents) to Rp 5,000 per

person, while in-patient costs are set at Rp 100,000 per person.

Bali Governor Made Mangku Pastika previously stated that the free Bali Mandara health insurance (JKBM) service was still operating this year, while it was being integrated with JKN.

The difference between JKBM and JKN lies in its mechanism. JKBM is free health care in which all Bali’s residents are entitled to receive the service. Meanwhile, JKN is a national health insurance, which covers the health costs of a person based on the insurance premium he or she pays for. Generally, the JKN premium is set at 5 percent of monthly salary.

Private employees have to pay 1 percent of their salary, while 4 percent is paid by the employer.

Entrepreneurs are able to pay a premium in accordance with their personal choice.

BPJS will only cover the health insurance for five members of each family.

Healthcare services are available at community health centers, regional and provincial clinics, private hospitals, clinics and registered doctors.

I Putu Gede Widnyana, head of BPJS Denpasar, admitted Bali still had limited health care. There are only 359 healthcare facilities, such as community health centers, clinics and general practitioners. There are 28 government-owned hospitals and private hospitals around the island. “These facilities have to serve Bali’s 4 million population,” Widnyana said. (www.thejakartapost.com)