WHEN HEALTH MEETS MONEY
Now it is very popular with the government's efforts in dealing with public health which is known by the name BPJS (Healthcare and Social Security Agency) to organize the National Health Insurance (JKN). Indonesia’s BPJS participants not only became mandatory (wajib) for workers in the formal sector, but also for informal workers. Informal workers are also required to be a member BPJS. They must register and pay monthly fee in accordance with the levels of services. This program has been commenced (dimulai) gradually in 2014, and in 2019 it is expected all Indonesian citizens will already have health insurance.
The Minister of Health, Nila Moeloek, stated that BPJS is a social
insurance where the sick is helped by the healthy. She persuaded (mengajak) all people of Indonesia to sign up in BPJS, especially for the healthy ones because by signing this, people then provide themselves an ‘umbrella’ for healthcare they pay routinely.
Unfortunately this program also brings health service and trust problems. One of them is a case of a mother fighting for her baby, M. Rizki Akbar (2 y.o.) who died after six hospitals from Tangerang to Jakarta refused to accept him under cliché (klise) reasons. Agung Nugroho, Chairman of Relawan Kesehatan (Rekan) Indonesia said that some regulations must be intentionally reformulated since it will bring severe impact to the infant (bayi/anak) mortality (kematian) rate.
The most reason case is the indication of fraudulent (penipuan) committed by hospitals claiming larger reimbursement (pembayaran) from BPJS. A public health expert, Budi Hidayat, observed that 4.4% of inpatient (pasien rawat inap) cases were suspicious, and cost BPJS Kesehatan Rp 1.86 trillion. For outpatients (pasien rawat jalan), 43% cases, costing 6.9 trillion, needed further investigation. In 2015 there were 175,000 claims believed to be fraudulent, but now there are 1 million potential fraudulent claims detected. That is why they need to build a fraud-prevention system. Yet, where is the money from?
The Minister of Health, Nila Moeloek, stated that BPJS is a social
insurance where the sick is helped by the healthy. She persuaded (mengajak) all people of Indonesia to sign up in BPJS, especially for the healthy ones because by signing this, people then provide themselves an ‘umbrella’ for healthcare they pay routinely.
Unfortunately this program also brings health service and trust problems. One of them is a case of a mother fighting for her baby, M. Rizki Akbar (2 y.o.) who died after six hospitals from Tangerang to Jakarta refused to accept him under cliché (klise) reasons. Agung Nugroho, Chairman of Relawan Kesehatan (Rekan) Indonesia said that some regulations must be intentionally reformulated since it will bring severe impact to the infant (bayi/anak) mortality (kematian) rate.
The most reason case is the indication of fraudulent (penipuan) committed by hospitals claiming larger reimbursement (pembayaran) from BPJS. A public health expert, Budi Hidayat, observed that 4.4% of inpatient (pasien rawat inap) cases were suspicious, and cost BPJS Kesehatan Rp 1.86 trillion. For outpatients (pasien rawat jalan), 43% cases, costing 6.9 trillion, needed further investigation. In 2015 there were 175,000 claims believed to be fraudulent, but now there are 1 million potential fraudulent claims detected. That is why they need to build a fraud-prevention system. Yet, where is the money from?
Source: Wikipedia, thejakartapost, detik.com, wajibbaca.com
Let’s discuss!
1. Do please share any of your experience regarding to health service!
2. How important do you think the health insurance is?
3. Why do you think health can be so costly?
4. What do you think is wrong with the service of BPJS in hospitals?
5. How necessary do you think if the government remove BPJS?
1. Do please share any of your experience regarding to health service!
2. How important do you think the health insurance is?
3. Why do you think health can be so costly?
4. What do you think is wrong with the service of BPJS in hospitals?
5. How necessary do you think if the government remove BPJS?
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