Government Cancels Plan to Boost Jakarta Health Card Budget
Members of the Jakarta Health Card (KJS) program await treatment at a hospital at Pasar Rebo in East Jakarta in this file photo. (SP Photo/Joanito De Saojoao)
The Jakarta government is canceling a plan to increase the budget for a public health insurance scheme, the city's Deputy Governor Basuki Tjahaja Purnama said on Tuesday, sparking concerns that hospitals will not be reimbursed for treatment.
Basuki said that the administration had previously planned to increase the budget for the Jakarta Health Card (KJS) program to Rp 50,000 ($5.10) per person per month, or Rp 2.4 trillion in total for 2013, but the allowance will instead stay at the current rate of Rp 23,000. This compares to the national government's budget of Rp 15,000 per person per month.
Basuki said that even though the KJS budget will not increase, the government would still work to improve treatment for cardholders.
Hospitals have raised concerns that the limited budget could impact the government's ability to pay claims, but Basuki said he is confident that the budget will cover 100 percent of the treatment costs. As of March 2013, the Jakarta government owed more than Rp 300 billion in hospital claims.
Since April, the government has been piloting a new reimbursement program, known as the Indonesia Case by Group System (INA CBG), that offers a "packaged" payment based on each patient's illness. Basuki said that the new system was adopted to standardize treatment for every patient and prevent hospitals from marking up claims.
"If additional medicines are prescribed, it [the claim] will be rejected," Basuki said. "The system will not include additional medicine, so they will not automatically be paid. There are calculations for all [diseases]."
Igo Ilham, a city councillor, told the Jakarta Globe that the hospitals had complained that under the new system, they received only 40 percent to 50 percent of the service cost.
"This has made the hospitals complain and caused some 16 hospitals to once back off from the system, or at least question the system," Igo said. "The private hospitals were promised to be paid by the government, but they were not paid fully which caused them to suffer losses."
Under Jamkesda, a previous insurance program, hospitals received 90 percent of the service cost.
Basuki said that he had no plan to differentiate the tariffs for government and private hospitals participating in the KJS program.
Tria Dipa Hospital, which earlier considered withdrawing from the KJS program, said that it would continue to participate and evaluate how the new reimbursement scheme worked out.
"There has been a meeting with the Jakarta Legislative Council [DPRD] recently, and they said they will be [fully adopting the] INA CBG program. We decided to wait for the program [before we reconsider withdrawing]," Hadi, a medical staff at Tria Dipa, told the Jakarta Globe.
"So, whatever Ahok said, that's alright, as it's only his version. We'll wait for the DPRD decision," he said, referring to Basuki by his nickname.
The Jakarta Medical Center (JMC) said that it was not concerned about the budget for the KJS program, as long as the government paid every claim.
"As long as they properly pay the claims, we can accept their decision," Anis, a spokesman of JMC hospital, told the Jakarta Globe on Tuesday.
Jakarta Governor Joko Widodo instituted the KJS system in November of last year in an attempt to increase the capital's health service capacity and provide free health care to the capital's 4.7 million poor people. The card entitles holders to free medical treatment at community health centers and third-class wards in local hospitals.
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