Until now Indonesia has not had a system of integrated medical care with a referral system. As a result, health services in Indonesia to be very expensive and commercial.
Why our current health care so high? The answer is because we are too late to regulate medical care system.
- Billy Soetono
This was conveyed by dr. Billy Soetono MPH, Head of Medical Services Systems Development Reference System Integrated with the Executive Board of the Indonesian Doctors Association in the event-related BPJS Interactive Dialogue on Monday (6/25/2012), in Jakarta.
"Why is our current health care so high? The answer is because we are too late to regulate medical care system," he said.
Billy convey, Indonesia only has a system of laws the hospital, do not have a law of health care systems. In fact, said Billy, the World Health Organization (WHO) has declared the entire state to build the health care system based on primary health care to reduce the high cost of health care.
"That is, every resident should go to the health care system through primary care. Primary service could mean that the private clinic or general practitioner," he said.
However, given the current state of society the widest possible freedom to utilize the medical care system and become involved in large-scale commercialization. This ignorance is then used by businesses to make health care a basic tertiary, the impact of high health care costs.
"Now, people who have money will not go to doctors and prefer immediate treatment to a specialist. In fact, many mothers give birth in a midwife shy and prefer obstetrician. This is a form of commercialization of medicine is so strong," he explained.
Supposedly, Billy continued, the public must access the primary health care first. If required further treatment, then patients can be referred to a higher level, ie specialist or subspesialis. This is the WHO recommended the actual system, which has been embraced by almost all countries except Indonesia.
Health care system is oriented to specialists or subspesialis will ultimately impact on the medical profession itself, which would make the gap between general practitioners and specialists. In fact, Indonesia is currently the primary service which requires a reliable and sophisticated.
Mirisnya, there is often a perception in the community, such as that of primary care health center connoted as a service to the poor.
Prepare a general practitioner
Within a year, at least 5,000 doctors resulting from the existing 72 medical schools throughout Indonesia. The problem is the prospective doctors were not prepared to be a primary care physician.
According to Billy, the current medical education system is different from the old days, which was passed required to enter a community health center (clinic). Thus, what is trained in medical school when really the knowledge needed for health centers.
But, now this weakness in the medical education system of Indonesia is, the prospective doctors do not know the direction of their work after graduation. Of the 5,000 doctors who graduate each year, not all accommodated in community health centers (20 percent), while the rest find their own places, such as clinics or specialist or subspesialis take in order to survive.
"The system of medical education should be a setting so that people who graduated to become a doctor was actually a primary care physician," he said.
According to Billy, currently there are about 60 thousand general practitioners. To support BPJS, he said, there should be regulation and the government's intention to raise 60 thousand doctors, both in terms of competence and respect.
"Because, if not them, who's spearheading this BPJS," he said.
"It has to be changed, that the community needs it is the primary service that can be handled by general practitioners. Your GP should be distributed throughout the country," he added.
Related issue is the distribution of doctors who had been uneven and is still centered in big cities, IDI proposed that the government make an index Geographic Practice. That is, if the physician is placed in the tepencil, they should get points higher than their colleagues who served in the city.
"Everyone wants to be better, not just the income they need, but also support for a decent life," said Billy.
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