Firstly,
we have to know what UHC is. UHC stands for Universal Health Coverage
(Universal Health Care). It is one of many programs of government, Health
Department specifically, that concerns for giving health care entirely for all
of the citizens of Indonesia, no matter whether they are lower, middle, or
higher class. This huge program is planned to be done in 2014. It means less
than a year. But, the big question is: How ready we are to conduct this
program. Are all the facilities and infrastructures well-prepared to be used
for society in need?
We,
as the medical students, have to know more about this program. The earlier we
know about UHC and its issues, the more responsive we will be in the future to
solve those problems. UHC does not distinguish between the rich and the poor,
all the same. Thus, society indiscriminately will get a commensurable health
care including promotive care, preventive care, rehabilitative care, and
curative care. UHC itself will be a big challenge to people who works surround
health care, including general practitioners, dentists, midwives, practical
nurses, government itself, and society generally.
There
is a rule that has to be followed by health facilities for being capable to
give health care to society in need. Firstly, those health facilities should
cooperate with BPJS (Badan Penyelenggara Jaminan Sosial). Then, they will
easily run this program as it is ordered.
But what is the implementation? We still face a poor cooperation between
health facilities and BPJS itself. The impact is society in need feels that it
has to take much time for administering health care, even though they have had
participants and health insurance cards. Besides, the quality of health care is
still disappointing and the costs, that actually should not be spent, are used
to pay certain medical procedures and drugs. For those people that only have
money barely, it is such a suffering enhancer. They will accept whatever it
takes, it is up to sooner or later. But, for people who have a lot of money,
they will move to non-referral health facilities or medical treatment abroad.
Is it sad, isn’t it? Therefore, there must be a regulation for this. Health
facilities should fix the relationship between itself and BPJS, getting rid of
the gap between the poor and the rich, enhancing the quality of healthcare, and
lowering the cost of any medical procedures or drugs, and many more.
Talking
about how ready we are, we need such a well-prepared preparation. From the
hospital to the society itself. Hospitals and healthcare facilities are the
ones who are directly affected by implementation of the universal coverage
program. With the enactment of universal coverage program, we can bet the
number of patients who come to hospitals and health facilities will increase
sharply. This is due to the previous class of people put off going to the
hospital because of cost reasons, so now they will be more enthusiastic about
going to the hospital if they were sick, because the government guaranteed
financing. Do our health facilities ready? With the increasing number of
patients who can be up to three times, the hospitals should anticipate
readiness strength. It is common, that doctors in government hospitals and
private hospitals also have a private practice outside the hospital where they
work. Working hours which is currently owned, they still have time to make
preparations in private practice in the afternoon. Practice in the afternoon
seems to be still an option the doctors at the government hospital, if the
government does not improve the welfare and benefit of the doctors at the
government general hospital. Moreover, patients receiving health insurance in
the future not only from the poor, who had been the group receiving public
health insurance. Of course there will be changes in the behavior patterns of
patients receiving health care in hospitals. In the universal coverage program,
receiving health insurance not only covers people who are poor, but it also
includes people who are not poor. The poor, as recipients of health insurance
for this, of course, have a different pattern of behavior with the behavior
patterns of patients receiving health insurance are not poor. Poor patients
might not be a lot of protest with health care received. For those receiving
free health care is indeed a significant help, though often they have to
undergo various procedures hassle. Instead public health insurance
beneficiaries who are not poor are likely to be more critical, because in
addition to being poor, they also may have a good level of intellect.
Therefore,
there are many things to consider and note to the Indonesian government before
implementing truly universal coverage program. Ministry of Health as a
responsible program, should prepare carefully all devices associated with the
implementation of the universal coverage program. Starting with a comprehensive
policy and preparing the hospitals, particularly hospitals in the area to
improve the quality of human resources, services and information systems and
financial management. And last that is no less important, is us. As the medical
students, we should concern more about these issues. Those problems will be a
challenge for us in the future to be fixed. Let’s speak up our new ideas, make
a brighter Indonesia with a brighter healthcare system without any
discriminations.
Fajar
Defian Putra
Standing
Committee on Research Exchange
CIMSA
UNAND
