Treatment for health problems in developing countries, especially in Indonesia, is still considered a tertiary luxury. Poor environmental sanitation, lack of public awareness in maintaining health in health installations are some of the factors that need government’s attention, especially when the government wants to improve the health of the residents.
According to Adhitya Ronnie Effendie, S.Si., M.Sc., M. Sc, several things are considered as the cause of such high cost of medical treatment and proper health facilities for the wider community. "There are two main components in the medical expenses that have to be paid by a patient, i.e. goods and services. Components of goods are in the form of medicine and pharmacy, while components of services are health facilities and honorarium (fee) of the doctor," said Adhitya Ronnie at the Faculty of Pharmacy on Thursday (30/6) during his open examination of Mathematical Sciences doctoral program.
Drug distribution issue, said Ronnie, is the main issue that dominates the main cause of the expensive components of the goods resulting in the high cost of the treatment. As for the component of services, the absence of clear rules regarding tariff and services in Indonesia might makes some doctors abuse authority in determining the rates.
Ronnie emphasized one way to assist the government in building affordable health systems for all levels of society is to build a strong system of insurance. The government can distribute its budget as a capital for this health insurance system. "Unfortunately, this option would require a large budget allocation and also strong political support. Therefore, it takes another simpler and easier alternative to be taken by the private doctors, medium-scale health installations such as community health centers and health clinics," the UGM lecturer explained his dissertation Model of Health Insurance Valuation Based on Multistate Interest Rate and Dynamic Approach.
Ronnie hopes the micro-insurance can be an alternative for financing health care. In contrast to life insurance, health insurance system is much simpler and can be applied to private doctors, medium-scale installations such as community health centers and health clinics. "This is a community-based insurance called the community base financing arrangement system, a health financing that is derived from low-income communities to meet their own needs, and such insurance is already widespread in India," he said.
He asserted that this insurance system is based on data, a system that allows policy decisions to determine the amount of premiums based on the patient's medical record. With this system, the policy-making can control income and expenditure, which is expected to meet the payments of health insurance claims. "This system is much more secure, because it’s based on data of people that often come to health facilities," he said.
In order for micro-insurance system to be more equitable, Adhitya proposes to decide different premiums for each participant, but rather adjusted to the level of visits and frequency of participants’ illness. The latter is called morbidity in terms of actuarial science. In this case morbidity rate together with the interest rate model become a major component in the construction of the Health Insurance valuation model. "Valuations here literally mean to calculate or set prices, so the Health Insurance valuation can be interpreted as a process to provide a price of a health insurance product," said Ronnie who graduated as UGM’s 1403th doctor.