BPJS FACADE

[Raphael Mamora]

Turns out the implied notion of Indonesia's famed BPJS health service is shockingly far from alright.

As all those knowledgeable knows, the prolong use of (human) insulin improves the HBA1c (3 month blood sugar reading) but BPJS health practicians demand the HBA1c reading to be at least over 9 to be eligible for insulin dispersion, hence long time users (diabetics) of insulin are forced to either to outrageously soar their blood sugar levels (bsl) for at least 3 months to have their HBA1c reading compliant or told to buy insulin at their personal expenses.

I met up with another Puskesmas physician who told that he too, had similar problems where is old-aged dad with lifelong hepatitis and been very long on hepatitis medication was told that his dad's hepatitis-related reading needs to be chronic to be eligible for medication, regardless of the fact that this old dad has been on hepatitis meds long time that has improved the dad's health and lowered his hepatitis-related reading to healthier levels, forcing the same outcome pattern of either unethically soaring the hepatitis-related reading or buy meds at self-cost.

The crux is national level nationwide BPJS, whether due to to its fund limitations or something else turns out to be not as they intend their image to be.

Physician-talks and online forums imply that due to the high prices of particular essential drugs only monopolized-produced by particular companies, hence rendering this country-wide BPJS as just a facade or just some terrible akward feeble effort to give the impression of adequate health care.

Rather shameful and certainly disappointing, i hope they eliminate that horrid facade impression cause clearly very detrimental for nation-scale image, international-wise as well.

 

[snpark]

Welcome to the forum indeed

 

[Helpful Herbert]

Well it's a rather specific complaint, but I'm sure it's justified. Don't forget indonesia is a developing country (lower middle income) so the fact that BPJS exists at all is a welcome surprise.

 

[scouser59]

Indeed ,This is a developing country and there is no other comparible system in similar countries as far as im aware , even the USA is still struggling to achieve socially fair healthcare for the population .

Imperfect some of the healthcare providers maybe , but after some searching, in my experience, a decent doctor and level of care will be found .

Allianz insurance failed me when I needed assistance ,bpjs stepped in and solved my problem .

They have my thanks .

 

[fastpitch17]

A lot better than nothing. Compare the cost to the services that are offered and if you need it, it's cheap. I guess some just want everything and have high demands for getting just that. Maybe meds cost some but seems to be no complaint that BPJS is probably covering visits and test. This is 2021. Nobody gets it all. There is no Utopia. You're lucky BPJS even exist at all.

If you want to complain, complain about all the people that either they or their whiney snotty kids see doctors now for something they could have stayed at home and given a spoon full of over the counter meds and not use up valuable resources.

If BPJS fails it will be totally from mis Management and allowing everybody at each level the same medical care if they need it or not.

 

[Raphael Mamora]

Scouser59, your reply makes sense, it's exclusively an individual physician's licenced-protected prerogative call.. Crossfinger i find the right one that's bereft of farmstock..

I did get plenty insulin supplies back in 2017, twice directly from just a puskesmas too, totally without hassle.. It's just currently things seems different, i hope as Scouser59 implies, it's just some lone-freak individual.. Thanks..

 

[scouser59]

Scouser59, your reply makes sense, it's exclusively an individual physician's licenced-protected prerogative call.. Crossfinger i find the right one that's bereft of farmstock..

I did get plenty insulin supplies back in 2017, twice directly from just a puskesmas too, totally without hassle.. It's just currently things seems different, i hope as Scouser59 implies, it's just some lone-freak individual.. Thanks..

Ya, we chose to live in a developing country ,with all its foibles including healthcare ,so therefore we have to work harder to find the "flower amongst the weeds", I have worked in countries in Africa where they have little in the way of medical resources ,including no antibiotics .

 

[centurion]

I stepped on a a rusty nail couple of days ago at a construction site in North Sumatra. Went to the local private hospital in a small town, and remembered that I have my BPJS and mentioned that I want to use it.

Without much bureaucracy, they took my card and ID papers, sent me to the emergency department, the doctor cleaned the wound, gave me a tetanus vaccine and I got antibiotics and painkillers at the hospital's pharmacy. At the end of the process, I signed some papers as well. The whole process took less than 45 minutes (this includes 15 minutes waiting after getting a shot for adverse effects).

Look like the system works, to give credit when credit is due.

 

[snpark]

Yes but that was Sumatra where they probably assumed you are the King of Europe and the hospital was quiet
Plus only a rusty nail

If you know what I mean

 

[scouser59]

Yes but that was Sumatra where they probably assumed you are the King of Europe and the hospital was quiet
Plus only a rusty nail

If you know what I mean

Works fine also in south bali , more hospitals than you can "shake a stick at ", no que to speak of .

Ya we live in a developing country including healthcare standards whether you use insurance or bpjs .

But Imho Indonesia should be proud of the system compared to asian countries ,even the Usa is lacking ,especially for the poor .

 

[snpark]

Tru dat

 

[Hawk256]

But Imho Indonesia should be proud of the system compared to asian countries ,even the Usa is lacking ,especially for the poor .

The US isn't that bad for health care if you are dirt poor. The problem is if you are still poor but your income is $1 over the limit to be able to get help. (The limit to get help is much lower than what you would imagine.) It's all or nothing in most states. A tiered program would be a more helpful for the low income people that actually try to make a living but that is a pipe dream. The system here is way ahead of other SE Asian countries. IMHO

 

[fastpitch17]

Works fine also in south bali , more hospitals than you can "shake a stick at ", no que to speak of .

Ya we live in a developing country including healthcare standards whether you use insurance or bpjs .

But Imho Indonesia should be proud of the system compared to asian countries ,even the Usa is lacking ,especially for the poor .

BPJS is good everywhere that I have heard of except wherever snpark is, nothing works there.

BPJS is like the majority of Indonesian programs. Have an idea, implement it, think about it, change it, think about it. Now it's being changed again. Every man, woman, and child must be on it and the rates standardized for all at a lessor rate per person. Still they will see cash shortfalls simply because they do not manage it right or, IMO, set it up right.

They really need a level if care covered tier system. Your level of care and what all is covered by the level you pay for. Right now untik the change you have 3 levels. All offer the same care no matter what and the higher price only seems to get you a different room if hospitalized. The Rp60,000 payer gets the same as a Rp150,000 payer, just a different room if needed. 3 levels needed. Each covering a basic care and then various services added as the levels increase. Levels 1 and 2 still go through the Puskesmas step, level 3 goes to approved clinic. All levels cover emergency care but not after care. There are a lot of things that could make BPJS profitable or at least where the gov isn't constantly supporting it. They could also make it so all KITAS and KITAP holders be on it but that is faught by hospitals and insurance companies because that would cut into their easy cash. There is a lot they could do better.

 

[centurion]

I have heard some indirect stories about BPJS but having direct experience now I just wanted to share my personal experience. I am on spouse KITAP and insured as a dependant.

 

[Nimbus]

BPJS is not perfect, but my dad received surgery that would be downright impossible to afford in USA without solid insurance, even the copay would still be in the thousands of dollars range. It says a lot when a developing country still plagued by corruption like Indonesia has a better health system than USA.

 

[pantaiema]

With the launch of BPJS, make it Indonesia to be one of the best affordable healthcare system for the poor.

Compared it with a few decades ago, when a poor from the village, villager need major surgery; they will need to prove that they have enough funding and asked to make down payment before they will be admitted. Many people know this so will not go to the hospital just to get rejected.

Now by just paying Rp.60,000 a month people could get expensive treatment in a hospital, major surgery including medication. For a low income family, who can not effort private treatment, it is a no brainer.

It seems a lot of criticisms for BPJS in Indonesia mainly come from parties, people who make profit by providing private healthcare, insurance. Unless they are part of intentionally renown insurance, I would not touch any private insurance, including healthcare insurance in Indonesia with a barge pole. You just need to look at Jiwasraya, ASABRI and this supposed to be under the control of the government but privatised. But even though with such a big loss due to one of the largest corruption corruption case in Indonesia, they could still continue the scheme as the government bail them out.
Also I have heard in the past a few horrible stories from people regarding when come to making a claim.

You will only know, it is a good insurance if your bill of 10,000X+ (or the like) of the premium you have paid get reimbursed. State run insurance could easily effort that thorough cross subsidy. But for private insurance especially who is yet to grow member to allow cross subsidy, it could become entirely a different story when come to making choice either approved your claim or go bankrupt. For non international reputable company going bankrupt is a very ample option. They have not got a well established brand that is valued more than the entire claim.

In the wrong hand, low enforcement, corrupt countries, the Insurance system will sit next to what is so call "advance fee scam/fraud". Once they get your money that you have paid for a few decades they could make up any excuse to reject your large claim in the future.
"Advance Fee Fraud / Scam"

Advance-fee scam - Wikipedia

en.wikipedia.org

 

[scouser59]

Hi guys may I suggest a seperate thread for Usa elections ?

To stay on topic .

 

[R Cameron]

Hi guys may I suggest a seperate thread for Usa elections ?

To stay on topic .

Moderators can do that if they like, but seems the BPJS discussion was already dead anyway.

 

[El_Goretto]

Hi guys may I suggest a seperate thread for Usa elections ?

To stay on topic .

Moderators can do that if they like, but seems the BPJS discussion was already dead anyway.

Thanks, I have moved the US election posts to their own thread: https://www.expatindo.org/community/threads/the-us-electoral-system-a-discussion.6606/