Community Health Guarantee Not Enough

Trouble is, each area applying different patterns to provide health coverage for its citizens. There is a local government only guarantees the disease with specific diagnosis, there is also the only bear the cost of outpatient care of its citizens, and so forth. On the other hand, RSCM must continue to provide services appropriate health procedures.

"So, although local governments concerned patients bear only outpatient care, if patients need hospitalization, yes we hospitalization," said Eka. Due to this limited guarantee, the difference in cost is not paid by local governments be borne by the RSCM.

Every day, RSCM receive an average of 2,000 patients. Of that amount, most of the medical uses such as letters of guarantee Jamkesmas (27.61 percent), Health Service Assurance Poor Families (JPK Gakin) DKI Jakarta (38.79 percent), and health insurance (32.16 percent). Jamkesda Assurance Program and are paid directly by the government to the hospital. Every month, claims billing RSCM Jamkesmas Rp 6 billion and USD 9 billion to JPK Gakin.

In fact, there's more of patients who have difficulty medical expenses but does not have any warranty letter. Because the funds held is insufficient to pay the hospital, the patient was owed to the hospital. On average, each month the RSCM has receivables amounting to Rp 300 million from the patients who are unable to pay medical expenses.

Limited facilities

Inequality and health care facilities in the area becomes its own burden when the government appointed the RSCM as a national referral hospital.

The hospital was overwhelmed to receive the patient because the hospital in the area is not optimal in terms of health facilities and medical personnel. Many local hospitals are not able to treat patients despite the severity of illness was not too high.

According to the RSCM Director Akmal Taher, referral of patients who come to the RSCM most have a level of severity that is not too high. "It should not be too severe patients could be handled solely by local hospitals if adequate facilities," said Akmal.

Because patients come abundant while RSCM limited capacity, many patients who can not be served at the hospital. As an illustration, every day there are 30-40 patients in the Emergency Room waiting to be served.

To access the facility with a CT scan examination, the patient RSCM must wait an average of 1-2 weeks. "If at another hospital a CT scan only serve 10 patients per day, in the same tool RSCM forced to serve about 60 people per day," said Eka.

Guarantee in Jakarta

Unlike the national referral hospital, district general hospital in Jakarta, for example Tarakan Hospital, the implementation of the JPK Gakin found no obstacle.

According to the Head of Public Relations Theryoto Tarakan Hospital, all claims billing JPK Gakin fully borne by the city administration. Since the claim process until the withdrawal of funds took a month.

The obstacle, says Theryoto, is a matter of administration, especially for women who give birth. In order to get the facility JPK Gakin and certificate can not afford (SKTM), women who give birth must include a marriage license.

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