Physical ills are the taxes laid upon this wretched life; some are taxed higher, and some lower, but all pay something. ~Lord Chesterfield
In old days, people were not so open in discussing about health insurance or finance. Besides, many of them will get angry when an insurance worker ask them,
“What if you are knocked by an accident, who will help you to pay all those expensive cost?”… “What will happen to your family; wife(s) and kids?”...
They thought that the workers deliberately praying for their bad luck and buying insurance only wasted their money, as if they will never hit by an accident or illness. They do not aware of the importance of the insurance.
“Prepare the umbrella before it rains!” This proverb is precisely applied in our daily lives. We as humans do not know what is going to happen in the future. Now we may be healthy, but if God wills, perhaps next week or tomorrow, we will be hit by a disease that we did not expect before. The question is, if the ‘something’ suddenly happened, are you ready to face the possibility of illness in the future? How does your financial plan? Do you aware that the cost of hospital + medical doctor’s fee + medicine is not cheap? Can you manage to pay all of them when the time comes?
That is why we need to have the health insurance, as a preparation in time of difficulties. In Indonesia, healthcare is provided, and funded, through a number of 
channels; Public, Private, Individual payment, Social security, and external/overseas funding. There are the following four existing social security schemes in Indonesia:
• Jamsostek is the social insurance fund for private sector employers and their employees. It provides four programmes: Employment Injury, Death, Health Insurance, and a provident fund type Old Age Benefit.
• Taspen is the fund for civil servants. It provides a retirement lump-sum, and a pension programme.
• Askes provides Health Insurance cover for public sector employees and some others.
• Asabri is the counterpart fund for the armed forces and police. It provides similar lump-sum retirement benefits and pensions. The Armed forces also have some hospitals of their own.
As mentioned above, around 116,8 million people from 230 million Indonesia population in Year 2009 are covered by the health finance provided by PT Askes Indonesia, PT Jamsostek, PT Asabri or through Jamkesmas and any other insurance agency.
What is managed care?
Managed care combines financing and health care in a single entity with the aim of improving quality of care while at the same time controlling the cost. These providers make up the plan's network. Restrictive plans generally cost you less. More flexible plans cost more. There are three types of managed care plans available, such as:
- Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
- Preferred Provider Organizations (PPO) usually pay more if you get care within the network, but they still pay a portion if you go outside
- Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care
How does it work?
Managed care works through modifying the actions of doctors (or other professionals initiating care) to eliminate inappropriate treatments and ensure that cost effective practice is adopted.
by
- Developing networks and selecting preferred providers;
- Supplying incentives; and
- Providing guidelines-or by a combination of these.
One of the major problems with healthcare in Indonesia is that poor or rural citizens simply aren't able to obtain the healthcare that they need. A lack of government funding, coupled with a need for the medical facilities to realize a profit, no matter how slight, means that lower class Indonesians are unable to afford the cost of treatment. This is not to say that healthcare in Indonesia is expensive, compared to the healthcare services in other Asian and European countries; however, to the local populace quality healthcare is virtually unobtainable. Those poor people will think twice to receive health care as they do not have enough money to pay for the treatment given. It is hoped with effective health insurance and financing by the government, health care in Indonesia will be better. =)
Resources:
1)Medline Plus: Managed Care
2)Social Health Insurance In Indonesia: Current Status And The Plan For National Health Insurance
3)Pacific Prime: Indonesia Medical Insurance News
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