Free health care almost beyond reach

The Jakarta Post, Jakarta

It was another exhausting day for Sukarti as she waited in line at the Cipto Mangunkusno General Hospital in Central Jakarta.

Her two-year-old son Bagus had been suffering from a liver disease and malnutrition for several months, meaning trips to the hospital were a regular occurrence.

After waiting for more than five hours, Bagus was eventually seen by a specialist in the children's clinic at the hospital.

"I don't understand why we had to wait for so long. Look at the empty chairs. There aren't many patients waiting," Sukarti, 37, told the Jakarta Post recently.

She said the journey from her home in Condet, East Jakarta, to the hospital was not an easy one, but was necessary for her son's health.

"It's really tiring, especially for my son," she said.

"If I had more money I would go somewhere else to get better treatment for Bagus."

Sukarti, whose husband works in a factory, said she borrowed Rp 20 million from the bank with her house as collateral in order to pay for her son's medical treatment at first.

When the loan ran out, she applied for free health insurance from the Jakarta administration.

Poverty is a chronic problem in Indonesia, which is home to more than 37 million people living below the poverty line according to Central Statistics Agency data.

Such wide-spread poverty means a large number of Indonesians do not have access to proper health care.

In 2005, the government launched a health services scheme for low-income families, with the Cipto Mangunkusumo Hospital appointed to facilitate the program.

About 80 percent of the hospital's patients are poor and receive treatment as part of the scheme.

In 2006, the Jakarta administration paid out more than Rp 10 billion in subsidies for low-income patients treated at the hospital.

However, many poor families have complained about the difficulties associated with receiving free medical treatment and medicine under the program.

Sukarti said when she took her son to the hospital as a paying customer, they were not forced to wait for hours and her son was treated more thoroughly.

She said once she joined the government's program, it was a struggle to even receive free medicine. She was often told the medicine her son required was not available and to buy it at another pharmacy.

"So on a few occasions I didn't buy medicine for my son because it was just too expensive," she said.

She said on one occasion after being told the medicine she required was not available, a nurse offered it to her for Rp 600,000.

"I took it because the price of the medicine at pharmacies was Rp 1.4 million," she said.

Service manager for insured patients at the hospital, Achmad Soebagio, said it was illegal to sell medicine directly to patients.

However, he said while the hospital was against the practice, certain individuals continued to profit from it.

"If patients or their families report cases to me, I take serious action against offenders," he said.

Some patients have also complained about being forced to pay illegal levies to employees at the hospital's health insurance center.

Yuni, 23, said the official who stamped her insurance documents put his hand to his mouth as if he was smoking.

"At first I didn't understand what he meant, but the woman behind me told me it meant he wanted me to give him money to buy cigarettes," she said.

Yuni said despite the fact there was a sign on the wall saying there was no processing fee for health insurance claims, she paid the official Rp 5,000, as instructed by other patients. (dia)