http://www.thejakartaglobe.com/editorials/editorial-indonesias-health-care-system-on-life-support/392067
Editorial: Indonesia's Health Care System on Life Support
August 20, 2010
Indonesia's health care system is in dire need of a major overhaul but it is
clear that the government does not have the financial muscle, the human
resources or the political will needed to do so.
Even though the national health budget for 2011 has been raised, Health
Minister Endang Rahayu Sedyaningsih has acknowledged that it was not enough to
address the country's various health issues. The government has proposed in its
draft budget for 2011 to boost the allocation to the Health Ministry by 26
percent to Rp 26.2 trillion from Rp 20.8 trillion ($2.9 billion from $2.3
billion) this year.
The truth of the matter is that the health care industry needs basic
foundational as well as structural changes. More importantly, there needs to be
a mind-set shift within the government on how the health care industry should
be managed.
Indonesia requires a per-capita spending of $600 per year on health care in
order to provide adequate and quality care. Currently, however, the government
is only able to allocate $70 per person annually, a huge deficit for social and
health care services. It is crystal clear that the government does not possess
the funds to meet its obligations.
The solution must be to empower the private sector to plug the gap. The
government must allow the market mechanism to operate in the health care sector
if we are to see a dramatic improvement in the quality of medical care. There
is a great need to increase efficiency and productivity within the sector while
reducing waste and corruption.
The goal must be to maximize the spending on health care. The government must
get a bang for its buck if it is to make a difference and the only way it can
achieve this is by introducing competition and privatizing the health care
sector. Just throwing more money at an existing inefficient public sector is
not going to solve the problem. In fact, it will is doing just the opposite -
increasing waste and inefficiency.
There are too many giveaways and political promises by the government, not just
in health care but in many other sectors. Such policies create demand without
increasing supply. The public health care sector is chronically below capacity
in all areas - beds, doctors and nurses and specialists.
By improving the health care system through privatizing state hospitals, the
overall quality of care will improve. By liberalizing the sector and allowing
foreign doctors to practice side by side with Indonesian physicians, the
government will also be able to address the huge foreign exchange loss from
Indonesians seeking medical care abroad.
It is time for a dramatic change in the direction of health care. State
hospitals can provide world-class care if they are properly run and managed.
Patients will be willing to pay for top quality care if it is available. The
question is, does the government have the courage to make these changes?