Jokowi wants full JKN coverage

 

As Jakarta has joined the national health insurance (JKN), Jakarta residents who had been receiving full healthcare coverage under the Jakarta Health Card (KJS) program are unable to enjoy certain medical services now, due to several changes to their benefits.

The JKN, which takes effect in January this year, only covers medical treatment; it does not cover observation or monitoring procedures, which were previously covered under the KJS program, which was first introduced in November 2011.

Jatinegara community health center (puskesmas) head Yeni Restuti delivered her concerns to Governor Joko “Jokowi” Widodo during an impromptu visit on Tuesday.

“After the merger, several medical services, like blood tests, are not covered anymore,” she said.

Many patients at the Mintohardjo Naval Hospital in Bendungan Hilir, Central Jakarta, expressed their disappointment with the JKN because they were required to pay for certain laboratory tests and ultrasonography (USG) observation for pregnant women, which had been fully covered under the KJS.

Nardy, a low-ranking member of the Marine Corps, paid an additional Rp 150,000 (US$12) for two different blood tests, while several pregnant women complained about having to pay the full fee for their ultrasounds.

Several Navy personnel also said the new JKN had resulted in their wasting time and money in getting health care as, besides having to go to a community health center first, they had to pay for certain services that were not covered by the JKN.

Jokowi said that he aimed to negotiate with the Social Security Providers (BPJS) so that Jakarta patients could obtain full health coverage.

“The JKN does not cover monitoring services like blood tests, electrocardiography and so on, which were previously covered. I want to discuss this issue with the BPJS and request full coverage for Jakarta patients,” Jokowi told reporters after a visit to the puskesmas in Jatinegara, East Jakarta, on Tuesday.

Jokowi added that the city administration would be prepared to disburse additional funds to cover the medical costs, if necessary.

“Don’t worry, we have the money,” he said.

During his visit, Jokowi also asked the puskesmas staff about the transition process.

Yeni said the transition was going well, adding that her staff regularly disseminated information.

“We serve up to 500 patients a day,” she said.

Under the JKN, the central government covers 1.2 million impoverished Jakartans, while the city administration covers 2.3 million Jakarta residents who are prone to poverty.

KJS beneficiaries are entitled to free third-class medical services in incorporated hospitals in Jakarta. With the implementation of the National Social Security System (SJSN), KJS patients will also be able to access medical services in hospitals outside the capital.

The premium is set at Rp 19,225 per person per month, lower than the Rp 23,000 per person per month set by the city administration for the KJS program.

Jakarta Health Agency head Dien Emmawati said that even though the JKN premium was lower than that for the KJS program, the city had not as yet seen any significant disadvantages.

“[The central government] covers millions of other disadvantaged Indonesians, meaning the total number of premiums paid is more than enough. The government has also raised medical costs by 35 percent,” she told The Jakarta Post recently.

She pointed out that the implementation of the KJS program, which was a pilot project for the national health insurance, offered the city a number of lessons learned.

“We are already familiar with the system. We also have solid data of patients, which will be evaluated every three months,” she said.

Dien was referring to the Indonesia Case-Based Group (INA-CBG), a diagnostic reimbursement system that replaced the previous fee-for-services reimbursement system used by regional healthcare facilities — where services were paid for separately.

Dien acknowledged, however, that the largest challenge now was to disseminate information to local residents.

“Many local people are still confused. Everybody thinks that everyone will be covered in the national health insurance, when in fact the government only covers the impoverished. Other people can join the program but they have to pay their premiums themselves,” she said. (www.thejakartapost.com)