The Way How Care Is Showed

My today's post is about:

"THE USE OF HEALTH INSURANCE IN FINANCING MEDICAL HEALTH SERVICE"

  

What is Health Insurance?

• It is basically a promise by an insurance company or health plan to provide or pay for health care services in exchange for payment of premiums.
• form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses.

In Indonesia, PT Askes Indonesia is one of the social insurance company that carries out health insurance to its members who are mainly civil servants and non-civilian. Their children are also guaranteed up to the age of 21 years. The retiree and his wife or the husband is also guaranteed for life.

Beyond the categories above, there are other health insurances provided:

Jamkesmas Jaminan Kesihatan Masyarakat	Programme of the Government Under Department of Health for low-income people financed by the state budget (APBN)
Jamkesda Jaminan Kesehatan Daerah Jamkesos   Jaminan Kesehatan Sosial	Under the provincial and district governments. Eg: In South Sumatra province, it’s called Jamsoskes.

Trust me, if you ever had to pay for health services yourself, you might be shocked with how high the cost are. In fact, most people will not be able to afford to pay for major health services themselves. Lets just take myself as an example on the use of health insurance in financing medical and health service:)

I was admitted in JIH in the previous May for Dengue Hemorrhagic Fever. The total of my 5 days of hospitalization, doctor's fee (Jasa visit Dokter Spesialis i.e room visit specialist), the medications, supplements, all those diagnostic and laboratories procedures, and many other things in the list costs me Rp 14 million (and plus plus plus). I am the member of Takaful Indonesia Insurance and under specific terms and conditions, I only had to pay around Rp 400 000 which goes to the supplements and extra bedding for extra people to stay with me during my stay. It's a jackpot having to pay only that much for a good, first class service:)

Simply say, we won't get stuck paying for the entire bill. Why? Because we are insured against the high cost of medical care in the event that we need it.

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References:

• "MANAGED CARE", Guest Lecture by Gatot Subroto (PT.Askes KCU Yogyakarta)
• "Physisician Income and Its Impact on Quality: GROUP 8 TUTORIAL SESSIONS (Week 2)
• Advantages & Disadvantages of HMO, PPO & POS Plans