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The hospitals today convince the classes that the qualifying rooms are full so people upgrade and pay the difference. We are class 1 and prefer private rooms so pay the difference. With the new system, more people will be paying for more than one level of upgrade. Hospitals get the cash. Hospitals have been complaining for years that BPJS does not pay enough and this is one way the hospitals will get more.
Class 1 has been a shared room for quite some time now. As for profit, there is none as far as the government knows since they have to subsidize it by great amounts every year. From my observation the big culpret in money shortage are all the people visiting a doctor for little problems that really don't need a doctors visit but have to because BPJS will cover medication whereas they need to pay cash for them outside the system. For those that receive BPJS at no cost to them enjoy the privilege of they or their kids being seen by a medical professional.
That's correct. They are planning to eliminate the current classification system (e.g Class I, II, III) and replace it with what is called KRIS (Standard Inpatient Class), a universal class that will be implemented by July 1, 2025.
I could write a book about my recent BPJS expereice and want to tell the story but it is just so long and complicated. The problems I see with BPJS are with the doctors and hosptials milking the system for every charge they can. If BPJS will pay for it, they will do it wheter you need it or not. They turned an outpatient procedure into 2 procedures and a 3 day hospital stay just becasue that was the max BPJS will pay. 6 doctor visits, prodecure done twice (once without proper antehesia so needed to be redone again before they could actaully do the small operation), 3 hospital visits full of tests and a 3 day hospital stay all for a standard prodecure that is handled as outpatient in 2 max visits in the rest of the world. If you question them they just say that's BPJS procedure but it really looks more like the hospital and doctors will look at what the max BPJS will pay and then make sure that it what happens. The government is actually a big loser in these cases.
Yes, this is my experience too. At that time I had a private insurance. Went to Siloam with high fever. They turned me inside out.
They abosuletly get money almost like a commission. I used think that the govenment was the probelm with BPJS but after my personal experiences it appears to be the doctors and hospitals that are actually to blame. Of couse the patient isn't anywhere in their thought process.
If what you believe is true, then why should someone pay for a higher grade if they all will treated the same? Facts are much better than what you believe.
But this isn't exclusive to Indonesia. They wanna sell you a c-section in many other (western countries included) countries too. So much that the job "midwife" is a dying breed. At least that was my last state of knowledge.
I was firmly in the beleif that the problems were all with the govenement until my long drawn out personal expereice but that is just not where the evidence points. If I shared the whole story, there would be doubt in your mind who is milking who. I will say that in the case with my heart attack that was handled by BPJS there were no obvious issues nor in my wife's case with a torn shoulder tendon. Which makes me wonder how often it does happen. I know it happens, I just can't say how often.But this isn't exclusive to Indonesia. They wanna sell you a c-section in many other (western countries included) countries too. So much that the job "midwife" is a dying breed. At least that was my last state of knowledge.
For BPJS, personally I still can't say anything negative about it. Iam sure it needs optimization but I hear different stories. Doctors that do too much, because they get money. Then doctors who don't do enough cause they don't get enough money from it and complain that BPJS is very slow in paying the bills.
So yeah, what is it now? BPJS or the doctors/hospitals?
So far I never felt under- or over treated. Everything was ok so far in the last 5 years.
About Shadrachs complaining, I would guess it doesn't have anything to do with BPJS but with the general quality of some doctors. They wouldn't be much better if you paid them more. It would even be more wasting money in the end.
Yes - for the medical team its handy - they control the timing of the surgery rather than the baby/ mother deciding. A friend here is pretty certain the reason they were pressed into C-section is that it was a Friday and their Dr didnt want to work late. The lady is a yoga instructor and the damage to her abdominal muscles has impacted her significantly (and 2nd child also needed to be C-sectioned due to the first one being done that way).
Forty years ago, producing occasional reports for a national ABC health program in Australia I recall a story that suggested many women were pressed to have caesarians as their doctors were playing golf over the weekend and did not want to be disturbed from their games. It seems that it is a commonplace around the world where doctors' convenience plays a greater role than patient welfare.
