Sistem Pengelolaan Jamkesmas Akan Dialihkan

Jakarta, (tvOne)

Pemerintah masih melakukan persiapan untuk mengalihkan pengelolaan program jaminan kesehatan masyarakat (Jamkesmas) dari sistem pembayaran kembali (reimbursement) ke sistem asuransi kesehatan.

Usai membuka seminar tentang keselamatan pasien di Jakarta, Minggu, Menteri Kesehatan Endang Rahayu Sedyaningsih mengatakan pihaknya sedang mempelajari peraturan perundangan yang terkait dengan penyelenggaraan jaminan kesehatan. “Kami melihat peraturan, kan sudah ada undang-undang sistem jaminan sosial nasional,” kata Endang.

Pemerintah, dia menjelaskan, juga akan membentuk badan pelaksana (Bapel) program jaminan kesehatan terlebih dulu. Badan tersebut akan melibatkan pihak pemerintah dan swasta. “Depkes akan mengusulkan Bapel. Tidak akan satu, mungkin PT Askes tetap dilibatkan, ada juga dari unsur pemerintah,” katanya.

Sebelumnya Endang mengatakan program Jamkesmas akan dikelola dengan sistem asuransi kesehatan. Beberapa pakar, termasuk ahli kesehatan masyarakat dari Fakultas Kesehatan Masyarakat Universitas Indonesia Prof Hasbullah Thabrani dan Guru Besar Kesehatan Komunitas Fakultas Kedokteran UI Azrul Azwar menilai sistem itu lebih baik dibanding sistem yang sekarang dipakai.

Namun, mantan Menteri Kesehatan Siti Fadilah Supari yang merintis pelaksanaan program pelayanan kesehatan gratis bagi masyarakat miskin itu, tidak sependapat. Menurut dia, program tersebut lebih baik tetap dikelola oleh pemerintah dan tidak diserahkan kepada perusahaan asuransi kesehatan mengingat perusahaan semacam itu biasanya berorientasi keuntungan dan menerapkan pembatasan.

Pemerintah mulai menjalankan program pelayanan kesehatan gratis bagi masyarakat miskin pada 2005. Ketika itu program tersebut bernama asuransi kesehatan masyarakat miskin (Askeskin) dan penyelenggaraannya dilakukan bermitra dengan PT Asuransi Kesehatan (PT Askes).

Program itu dilanjutkan hingga 2007 dengan sejumlah perbaikan dalam hal pendataan, distribusi kartu peserta dan masalah teknis lain. Jumlah pesertanya juga terus bertambah. Pada 2008, Siti Fadilah memutuskan mengubah model pengelolaan Askeskin dan mengganti nama program tersebut menjadi Jamkesmas.

Perubahan model pengelolaan dilakukan karena model yang lama dinilai menghambat kelancaran pembayaran klaim pelayanan kesehatan di rumah sakit dan memicu penyimpangan penggunaan dana pelayanan.

Sejak saat itu, PT Askes yang sebelumnya menjadi pengelola seluruh program pelayanan kesehatan bagi masyarakat miskin hanya ditugasi mengurus kepesertaan Jamkesmas.

Dana untuk membayar tagihan pelayanan kesehatan bagi masyarakat miskin selanjutnya dikucurkan langsung dari kas negara ke rekening rumah sakit setelah pengelola rumah sakit mengajukan klaim pelayanan yang sudah diverifikasi.

Namun pemerintah kemudian mengucurkan dana Jamkesmas ke rekening rumah sakit dan pengelola rumah sakit mempertanggungjawabkan penggunaannya berdasarkan tagihan biaya pelayanan kesehatan masyarakat miskin pada rumah sakit yang bersangkutan. (Ant)

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