DUBLIN — A miscarrying Indian woman who died from blood poisoning in an Irish hospital after being denied an abortion perished because staff bungled her diagnosis and didn’t give her prompt treatment, a jury unanimously ruled Friday in a case that has divided Ireland.

The findings from a two-week coroner’s inquest into the causes of Savita Halappanavar’s Oct. 28 death at University Hospital Galway confirmed what her widower, Praveen, has maintained all along: Hospital staff refused to give his wife an abortion citing the country’s Catholic social policies, waited three days until the 17-week-old fetus had died, then discovered she was in an advanced state of septicemia. She died three-and-a-half days later from organ failure.

At the conclusion of his fact-finding probe the Galway coroner, Dr. Ciaran MacLoughlin, praised Praveen Halappanavar for his courage in protesting publicly against his wife’s medical treatment at the western Ireland hospital, where doctors had refused to perform a termination while the fetus retained a heartbeat. Halappanavar then shook the hands of the six-man, five-woman jury that ruled she died from “medical misadventure,” meaning incompetence in her care.

Outside, he said legal action would continue to try to make particular staff responsible for her death. He said the hospital’s inaction for several days of his wife’s deteriorating health during a drawn-out, painful miscarriage meant she might as well have stayed at home.

“Medicine is all about improving patients’ health and life. And look what they did. She was left there to die. It’s horrendous, barbaric and inhuman the way Savita was treated in that hospital,” said Praveen Halappanavar, speaking on the day that would have been the couple’s fifth wedding anniversary.

“They could have intervened right from day one because they knew the fetus was inviable, so why wait?” he said, adding that the testimony had pinned down system-wide failures but no personal responsibility. “The midwife blames the consultant (doctor), the consultant blames the law. … Somebody has to take ownership when a patient walks into the hospital.”

The case highlighted a two-decade dilemma in Ireland’s abortion law. A 1992 Supreme Court ruling declared that abortions deemed necessary to save a woman’s life must be legal, but successive governments have refused to pass any law to support the ruling, fearful of voter backlash where Catholicism remains the dominant faith. That has left doctors fearful of facing prosecution for murder if they perform terminations in a country whose constitution contains a blanket ban on the practice.

The government of Prime Minister Enda Kenny has pledged it will pass a law, with related medical guidelines, by July that defines when life-saving abortions can be given. But Kenny’s own party is split down the middle, with Catholic conservatives pledging to vote against the measure amid lobbying by church leaders.

MacLoughlin published eight recommendations for the hospital to improve how it records and shares patient information among staff, and monitors the risk of infections and blood poisoning in its patients.

His other recommendation was for Ireland’s Medical Council to publish guidelines defining the exact circumstances when an abortion can be performed to save the life of the woman. These guidelines, long sought by doctors at Ireland’s maternity hospitals, “would remove doubt and fear from the doctor and also reassure the public,” he said.

MacLoughlin didn’t rule on the question of whether an abortion one or two days before the fetus died would have saved Halappanavar’s life. He found instead that staff failed to test her blood sufficiently for signs of poisoning; results which showed signs of that poisoning weren’t consulted for hours or even days; and the hospital’s notes on her file were incomplete, unclear and even had been unprofessionally amended in eight places days or weeks after her death. He said that should never happen again.

During the inquest, the key expert witness, Peter Boylan, former master of a major Dublin maternity hospital, said he was confident that an abortion one or two days before the fetus died would have saved Halappanavar’s life.

He described her case as a deadly Catch-22, because Irish law meant doctors cannot perform a termination “unless the woman looks like she is going to die.” By the time doctors finally reached that conclusion on the day her fetus died, he said, “it was already too late.”

Source: washingtonpost.com

Jakarta, PKMK. Pimpinan Pusat Persyarikatan Muhammadiyah mengajukan judicial review (uji materi) ke Mahkamah Konstitusi terhadap sejumlah pasal/ayat dalam Undang-undang Nomor 44 Tahun 2009 tentang Rumah Sakit. Pasal yang dimaksud diantaranya Pasal 7 Ayat 4, Pasal 17, Pasal 21, Pasal 25 Ayat 5, Pasal 62, Pasal 63 Ayat 2 dan 3, dan Pasal 64 Ayat 1. Mereka menilai bahwa sejumlah pasal/ayat tersebut bertentangan dengan Pasal 28 ataupun Alenia Keempat Pembukaan Undang-Undang Dasar 1945. “Pemohon meminta agar Mahkamah Konstitusi menerima dan mengabulkan permohonan sepenuhnya,” ungkap Syaiful Bakhri, kuasa hukum Muhammadiyah, dalam Sidang Pemeriksaan Pendahuluan (18/4/2013) di Jakarta.

Syaiful menyampaikan beberapa poin, yaitu keharusan bagi rumah sakit swasta untuk mempunyai badan hukum bidang perumahsakitan, telah mereduksi hak konstitusional pemohon sebagai persyarikatan. Sementara, pemohon berhak ikut menyehatkan masyarakat sebagai wujud amal usaha di bidang kesehatan. “Maka, Pasal 7 Ayat 4 Undang-undang Rumah Sakit berlawanan dengan Pasal 28 UUD 1945,” kata dia. Ia pun menyatakan, Pasal 7 Ayat 4 itu tidak mengakui hak bersyarikat dan berkumpul Muhammadiyah. Sementara, hak tersebut bahkan sudah diakui pra-kemerdekaan Indonesia. Pasal 7 Ayat 4 itu juga diskriminatif karena seluruh rumah sakit yang dimiliki pemohon harus meminta izin dari awal lagi. Pemohon berpotensi memperoleh kerugian bila sejumlah pasal dalam Undang-undang Rumah Sakit tidak dicabut. “Saat ini, sekitar 70 Rumah Sakit Muhammadiyah di Indonesia tidak mendapatkan perpanjangan izin dari Kementerian Kesehatan. Hal ini terjadi karena harus punya badan hukum perumahsakitan itu,” kata Syaiful.

Majelis Hakim Konstitusi meminta agar pemohon memperbaiki sejumlah materi gugatan. Antara lain, karena ada 22 orang pemohon, semuanya harus menandatangani gugatan, bukan hanya ditandatangani tiga orang. Majelis Hakim Konstitusi memberi waktu 14 hari untuk perbaikan tersebut. Lalu, akan diputuskan bisa atau tidaknya gugatan diteruskan ke sidang pleno. Sementara usai sidang, Syafig Mughni, Ketua Persyarikatan Muhammadiyah Bidang Kesehatan dan Kesejahteraan Masyarakat, memberikan pernyataan kepada wartawan. Masyarakat selama ini berinfak untuk pengelolaan rumah sakit dan lembaga pendidikan di Muhammadiyah. Kalau pasal dan ayat itu tidak dicabut, aset Muhammadiyah bisa hilang. “Sebab, Persyarikatan Muhammadiyah kan tidak berbentuk badan hukum perumahsakitan,” tambahnya. Lanjut Mughni, pelayanan kesehatan Muhammadiyah bersifat sosial. Semua keuntungan dikembalikan ke masyarakat. Itu berlainan dengan perseroan terbatas yang 100 persen berorientasi keuntungan. Saat ini di seluruh Rumah Sakit Muhammadiyah ada rasa gamang dan ragu. Itu karena ada ancaman pencabutan izin bila tidak ada izin sebagai badan hukum perumahsakitan.

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Jakarta, PKMK – Gubernur Sulawesi Selatan Syahrul Yasin Limpo berharap bahwa investasi rumah sakit oleh PT Lippo Karawaci menjadikan Makassar sebagai tujuan medical tourism di Indonesia Timur. Kerja sama Lippo Karawaci dengan masyarakat Sulawesi Utara diharapkan pula membangun komunitas yang lebih sehat. “Kami akan mendukung upaya medical tourism itu sepenuhnya,” ungkapnya saat pembukaan Rumah Sakit Siloam  Makassar. Syahrul dalam keterangan pers yang menyatakan sejumlah hal yang menjadi kunci pengembangan layanan kesehatan di Indonesia Timur. Salah satunya adalah kerja sama yang telah dilakukan Fakultas Kedokteran Universitas Hasanudin, Makassar, dengan Grup RS Siloam.

dr. Grace Frelita, Direktur Global Quality Development Grup RS Siloam mengungkapkan: “Kami dengan gembira melaporkan, Fakultas Kedokteran Universitas Hasanudin telah meluluskan  kurang lebih 10 dokter Siloam Group yang telah menyandang Ph. D.” Masih ada sekitar 20 orang dokter lagi yang menyusul. Itu semua adalah langkah awal dari kerja sama untuk mencakup pelayanan kesehatan kami di Indonesia Timur. Adapun dr. Gershu Paul, Chief Executive Officer RS Siloam menambahkan Makassar merupakan gerbang menuju ke Indonesia Timur dan telah berkembang menjadi wilayah menarik bagi wisatawan. “Visi kami adalah membangun satu pusat layanan kesehatan standar internasional,” ungkap Gershu.

Kerja sama RS Siloam dengan Fakultas Kedokteran Universitas Hasanudin akan meningkatkan pasokan dokter spesialis. Saat ini, jumlah dokter spesialis di Indonesia Timur masih kurang. Seluruh elemen itu akan menguatkan status Makassar sebagai pintu gerbang ke Indonesia Timur. Paulus Pandiangan, Manajer Public Relation PT Lippo Karawaci menjelaskan, RS Siloam Makassar menelan investasi senilai USD 48 juta. “RS Siloam Makassar adalah satu dari 13 rumah sakit yang dioperasikan Grup Siloam Hospitals. Dan akan jadi penentu pertumbuhan jaringan di Indonesia Timur seperti Sulawesi, Maluku, Nusa Tenggara, dan Papua,” kata mantan editor di Majalah Swa tersebut.

A new study has found that hospitals benefit immensely from surgical complications. How employers like Wal-Mart and health care providers are tackling this problem.

FORTUNE — American health care is screwed up. It is a bizarre market where the prices that patients pay do not match the quality of care.

Unfortunately, that’s old news. What is new is the nitty-gritty — details about why hospitals might not have any financial incentive to follow best practices. A new paper from researchers affiliated with Harvard, Boston Consulting Group, and nonprofit health care delivery system Texas Health Resources suggests that, in some cases, providing worse care pays off for hospitals. On a hopeful note, some companies are stepping in to challenge the system.

The research group published a paper in the Journal of the American Medical Association on April 16 that looked at more than 34,000 surgical patients who were discharged from 12 hospitals in 2010. Out of those patients, 1,820 suffered at least one complication from surgery. Of course, patients with complications cost more to treat — they spend more time in the hospital and require resources like nurses and beds.

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But the study found that these patients didn’t simply cost more to treat, but the majority of them generated a much larger profit for hospitals.

Privately insured patients with surgical complications delivered almost $40,000 more in profits (per patient) than privately insured patients who had no complications. The margin was smaller for patients with Medicare — those patients who had complications earned the hospital around $1,700 more than those who didn’t have any.

Hospitals didn’t make the same profit margins off of Medicaid patients or those who paid out of pocket, but combined, those two latter groups only accounted for 10% of the total population of patients studied.

That means 90% of surgical discharges at these hospitals during 2010 participated in a payment system that rewarded the hospital if patients faced at least one surgical complication.

“We are entering this phase of tremendous experimentation in changing the model of payment,” says Atul Gawande, the corresponding author on the paper who is also a surgeon at Brigham and Women’s Hospital in Boston, a professor of surgery at Harvard’s medical school, and a medical journalist.

“We have a bonus system here that we’ve known has rewarded perverse behavior, but now we’re able to put some real numbers on it, and it’s a bigger bonus than we’ve ever understood.”

Gawande has described parts of this flawed rewards system in his landmark story “The Cost Conundrum,” which explains some of the financial incentives that drive the discrepancy in the quality of care. Namely, at many hospitals, physicians earn money for every procedure or test performed, regardless of the outcome.

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This mismatch happens all the time in the corporate world — the stated goals of a company may say one thing, but the company could have conflicting systemic financial rewards in place. Take the rogue trader who lost UBS $2.3 billion in 2011. He messed up, but in general, traders are encouraged to take big risky bets, and are rewarded when those bets pay off for companies. Effective organizations not only proclaim their ideals in grand vision statements but reward the kinds of behavior that back up those ideals.

In the case of hospitals, some may argue that the number of complications is out of the administration’s hands. That isn’t necessarily true, Gawande says. There are checklists and procedures that, if enforced, can make surgery safer and reduce the number of complications. “This business case has been difficult to make,” he says. “It will always pay to open another operating room or increase number of patients.” But CEOs of medical centers have a tougher time seeing the payoff from investments to improve the quality of care.

CEOs in other industries are starting to place a premium on quality of health care, however. It makes sense — if employers are paying for health care, they want to pay for care at better, more efficient facilities that don’t have any incentive to charge for procedures that could be superfluous.

That’s why Wal-Mart (WMT) announced in 2012 that it would foot the entire bill for certain bundled treatments — heart, spine, and transplant surgeries — if employees go to one of six designated health care organizations for treatment. Bundling the treatments involves streamlining the billing process. Organizations that offer bundled treatments enable whoever is paying to avoid a major financial headache. Another draw of going with the selected organizations, says Wal-Mart spokesman Randy Hargrove, is that they prioritize patient outcome over patient volume and have low readmission rates.

Take, for example, the Cleveland Clinic in Ohio, which is one of the facilities included in Wal-Mart’s program. Doctors there are on salary. “Because physicians are employed and salaried, they don’t have a direct financial incentive to do a particular thing, but really to do what’s in the best interests of the patient,” says Michael McMillan, executive director of marketing and network services for the clinic.

MORE: Is there really such thing as a ‘global CEO’?

Pursuing the best interest of the patient — what an idea. Granted, Wal-Mart’s program is a new experiment. To last, it will probably have to both provide patients better care and save Wal-Mart money.

But it is a push against the grain in an otherwise broken system. Hospitals need not profit from sicker patients. It is a simple concept but a massive management challenge: reward physicians and institutions that are the best at keeping people well.

Sumber: management.fortune.cnn.com

It was supposed to be a short stay. In 2006, Roger Anderson was to undergo surgery to relieve a painfully compressed spinal disk. His wife, Karen, figured the staff at the hospital, in Portland, Ore., would understand how to care for someone with Parkinson’s disease.

It can be difficult. Parkinson’s patients like Mr. Anderson, for example, must take medications at precise intervals to replace the brain chemical dopamine, which is diminished by the disease. “You don’t have much of a window,” Mrs. Anderson said. “If you have to wait an hour, you have tremendous problems.” Without these medications, people may “freeze” and be unable to move, or develop uncontrolled movements called dyskinesia, and are prone to falls.

But the nurses at the Portland hospital didn’t seem to grasp those imperatives. “You’d have to wait half an hour or an hour, and that’s not how it works for Parkinson’s patients,” Mrs. Anderson said. Nor did hospital rules, at the time, permit her to simply give her husband the Sinemet pills on her own.

Surgery and anesthesia, the disrupted medications, an incision that subsequently became infected — all contributed to a tailspin that lasted nearly three months. Mr. Anderson developed delirium, rotated between rehab centers and hospitals, took a fall, lost 60 pounds. “People were telling me, ‘He’s never going to come home,’” Mrs. Anderson said.

He did recover, and at 69 is doing well, his wife said, though his disease has progressed. But his wasn’t an unusual story, neurologists say.

Any older person faces dangers in a hospital, but for people with Parkinson’s — largely a disease of older adults — they’ve proved particularly hazardous. “Patients were telling us these horrendous stories,” said Dr. Michael Okun, a University of Florida neurologist and national medical director of the National Parkinson Foundation. “Even in good hospitals. Even in my own hospital.”

People with Parkinson’s are hospitalized much more frequently than others their age, and their stays last longer. A common reason: “These patients aren’t getting their meds on time, and they’re not getting the right meds,” Dr. Okun said. Some need to take their dopamine-replacing drugs as often as every two hours, a schedule at odds with standard hospital regimens.

Worse, some commonly prescribed drugs — including Compazine and Phenergan for nausea, and Reglan to stimulate bowel function after surgery — actually block dopamine and worsen symptoms in patients with Parkinson’s. Then they are at risk for falls and fractures and for aspiration pneumonia.

Moreover, any infection can lead to delirium, because Parkinson’s patients have lowered cognitive reserve. But the drug Haldol, which hospitals frequently use to reduce confusion, is also a dopamine blocker. “Haldol is the worst drug you can give a Parkinson’s patient,” Dr. Okun said. Over all, “it can be a real mess.”

With proper treatment, most Parkinson’s patients can live long and good lives, “but stressing them with a fall or an infection or anesthesia can make them fall apart,” he said, turning supposed in-and-out hospitalizations into weeks of illness and decline. Not everyone is as lucky as Roger Anderson.

What will help, in the long run, is educating hospital staffs about Parkinson’sand changing the way they function. And yet — isn’t this a sad commentary? — “it’s slow going to effect change in the health care system, and in the meantime a lot of people are getting hurt,” Dr. Okun said.

So, unfair as it may be to put the onus on patients and families, the foundation is offering a free Aware in Care kit that includes a bracelet identifying the wearer as a Parkinson’s patient and fact sheets and reminder slips to hand out to doctors and nurses. “We want to arm people,” Dr. Okun said.

The Andersons have used the kit for subsequent hospitalizations and found it useful. And Mrs. Anderson reports that now, years after their three-month nightmare, hospitals actually encourage her to bring along her husband’s medications and to administer the pills herself as his schedule demands.

You might argue that the hospital is magnanimously allowing her to do the job its staff is supposed to do, but she’s fine with that. It beats the alternative.

Source: newoldage.blogs.nytimes.com

GUNA mengatasi imej yang berkembang di masyarakat terkait banyaknya penolakan pasien miskin oleh rumah sakit, Pemerintah Kota Depok menggelar penandatanganan perjanjian kerjasama Jaminan Kesehatan Daerah (Jamkesda) tahun 2013 di aula lantai 1 Balaikota Depok. Penandatanganan tersebut dilakukan oleh Wali Kota Depok Nur Mahmudi Ismail dengan 32 direktur RS dan klinik di Kota Depok.

Acara tersebut dihadiri oleh Sekretaris Daerah Kota Depok, Anggota DPRD, Muspida, Kepala Dinas. Kepala Dinas Kesehatan Kota Depok Drg. Hardiono mengatakan pihaknya juga membentuk tim untuk memberikan sarana pelayanan kesehatan, baik pemerintah maupun swasta yang memberikan pelayanan kesehatan tingkat lanjut pada peserta Jamkesda. Yaitu membidangi Rawat Jalan Tingkat Lanjutan (RJTL) yang terdiri dari 9 point diantaranya penunjang diagnostik laboratorium klinik, radiologi dan elektromedik dan Rawat Inap Tingkat Lanjutan (RITL).

“Yang terdiri dari 11 point salah satunya perawatan intensif ICU, ICCU, PICU, NICU, PACU), dan pelayanan gawat darurat (emergency). Setiap orang berhak sehat, karena kesehatan adalah asset. Bangsa yang sehat akan menjadi bangsa yang produktif sehingga mampu bersaing dengan bangsa-bangsa lain,” ujarnya dalam sambutannya, Rabu (17/04/2013).

Ia juga meminta masyarakat untuk menerapkan Pola Hidup Bersih dan Sehat (PHBS). Sementara itu, Wali Kota Depok Nur Mahmudi Ismail mengatakan, salah satu penyebab masih rendahnya derajat kesehatan adalah karena mahalnya biaya kesehatan, sehingga akses ke pelayanan kesehatan, umumnya masih rendah.

“Dengan penandatanganan ini, semoga Pemerintah Kota Depok bisa memenuhi hak setiap warganya, untuk memperoleh pelayanan kesehatan yang layak, sehingga derajat kesehatan di Kota Depok meningkat,” ujarnya.

Ia meminta agar pihak RS dapat memberikan pelayanan yang terbaik.

“Mari bersama-sama kita tunjukan suasana patnership yang kuat dan kokoh, sehingga orang Depok mendapat pelayanan kesehatan yang optimal, saya menghimbau untuk meningkatkan kualitas ketetapan kartu sehingga tepat sasaran,” tegasnya.

Sementara itu, di luar Balaikota Depok terjadi kericuhan penyampaian tuntutan oleh LSM kesehatan Dewan Kesehatan Rakyat (DKR). Mereka menuntut agar Pemerintah Kota memperbaiki layanan kesehatan Jamkesda yang dinilai masih carut marut.

Sumber: health.okezone.com

MAKASSAR — Menteri Kesehatan Nafsiah Mboi mengingatkan, sebenarnya tidak ada biaya rumah sakit yang gratis. Untuk keluarga kurang mampu pun tidak ada rumah sakit yang sama sekali membebaskan biaya perawatannya. Hal itu dikatakan Menkes saat meresmikan Rumah Sakit Siloam di Makassar, Sulawesi Selatan, Rabu (17/4/2013).

Peresmian itu juga dihadiri antara lain oleh Gubernur Sulsel Syahrul Yasin Limpo, Ketua DPRD Sulsel Mohamad Rum, dan Presiden Lippo Group Theo L Sambuaga. Theo menyebutkan, Rumah Sakit (RS) Siloam di Makassar adalah rumah sakit ke-14 dalam jaringan Siloam Hospital.

Di rumah sakit ini, ada 320 tempat tidur untuk pasien dan 25 persennya adalah kelas 3, untuk pasien kurang mampu. Nafsiah menjelaskan, rumah sakit gratis bagi warga kurang mampu bukan berarti tanpa biaya sama sekali. Pemerintah pusat atau pemerintah daerah yang membayar biaya perawatan itu atau premi melalui program jaminan kesehatan nasional (Jamkesnas) atau jaminan kesehatan daerah (Jamkesda). “Jadi, bukan rumah sakit gratis,” kata Menkes lagi.

Bahkan, dana yang dikeluarkan pemerintah untuk biaya jaminan kesehatan bagi warga kurang mampu itu bisa mencapai Rp 1 triliun per tahun. Theo menambahkan, jaringan Siloam Hospital juga tetap memedulikan kesehatan warga kurang mampu.

Selain mengalokasikan tempat rawat/tempat tidur bagi warga kurang mampu hingga 25 persen melebihi ketentuan pemerintah sebesar 20 persen, Siloam Hospital juga membangun rumah sakit umum (RSU) untuk warga kurang mampu. Saat ini, RSU Siloam di Karawaci, Tangerang, Banten, saat ini memiliki 250 tempat tidur untuk pasien. Jumlah tempat rawat itu akan terus ditambah.

Sumber: regional.kompas.com

Jakarta, PKMK. Seluruh rumah sakit (RS) di Jakarta diharapkan telah terakreditasi di tahun 2014. Saat ini, yang telah mendapatkan akreditasi adalah 76 dari 153 RS di Jakarta. “Jadi, saat ini yang sudah terakreditasi sekitar 49 persen,” ucap Dien Emawati, Ketua Dinas Kesehatan DKI Jakarta, di Jakarta (17/4/2013). Masyarakat semakin kritis dalam menilai mutu pelayanan kesehatan dewasa ini, khususnya yang disajikan oleh RS. “Maka, pelatihan akreditasi bagi manajemen RS sangat penting,” ucap Emawati. Dengan pelatihan akreditasi, seluruh SDM di RS diharapkan benar-benar mengetahui standar pelayanan pasien. Alhasil, kasus malpraktek bisa semakin berkurang. “Pelatihan akreditasi RS di Indonesia telah dimulai sejak tahun 1995. Itu dimulai dari akreditasi terhadap lima pelayanan dan berlanjut kepada 16 pelayanan,” tambah Emawati.

Sementara, Wakil Gubernur Propinsi DKI Jakarta Basuki T. Purnama (Ahok) menambahkan, pelatihan akreditasi memang sangat vital bagi RS di Indonesia. “Apalagi, di Jakarta sekalipun, RS yang sudah terakreditasi sekarang masih di bawah 50 persen,” ungkapnya. Pasien kelas atas dari Indonesia saat ini masih banyak yang meninggal di RS di Singapura. “Itu sebuah ironi karena sebenarnya peralatan medis RS kita lebih baik daripada di Singapura,” ucap Ahok. Banyaknya pasien kelas atas yang berobat di Singapura terkait tingkat kepercayaan yang relatif rendah terhadap pelayanan RS di Indonesia. “Anak saya pernah diharuskan mertua berobat ke Singapura. Ternyata di sana tidak perlu di-opname dan boleh pulang. Kalau ditangani RS kita, jangan-jangan harus rawat inap,” kata Ahok. RS tidak boleh menutupi adanya kejadian tidak terduga. Kejadian seperti itu harus dilaporkan secepat mungkin. “Untuk soal seperti itu, memang RS di Jakarta belum terlalu bagus. Padahal peralatan komunikasi kan sekarang banyak sehingga informasi seharusnya mengalir cepat,” Ahok menegaskan.

Jakarta, PKMK – Pérusahaan farmasi yang mayoritas sahamnya milik Pemerintah Indonesia, PT Kimia Farma, mengincar pendapatan tambahan dari berlangsungnya Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan di tahun 2014. Pendapatan tersebut berlangsung dari sejumlah lini bisnis, antara lain dari penjualan obat generik, Kimia Farma menargetkan pendapatan Rp 1,2 triliun di tahun 2014. Demikian rangkuman percakapan via telepon hari ini (17/4/2013) dengan Djoko Rusdianto, Corporate Secretary PT Kimia Farma. Djoko mengatakan, pada tahun 2012, pendapatan Kimia Farma dari penjualan obat generik di kisaran Rp 80 miliar sampai Rp 400 miliar. Itu setara dengan 40 persen total pendapatan di tahun itu. “Dengan demikian, pendapatan Rp 1,2 triliun dari obat generik di tahun 2014 adalah kenaikan tajam,” kata Djoko.

Menyongsong beroperasinya BPJS Kesehatan, Kimia Farma pun berusaha meningkatkan jumlah apotek yang dimilikinya. Tahun ini, Kimia Farma menargetkan 66 apotek berdiri sebagai  penyaji layanan one stop solution. Djoko menambahkan, di tahun 2015 jumlah tersebut diharapkan menjadi seribu unit. Lebih lanjut Djoko berkata, untuk penambahan apotek  itu, Kimia Farma bekerja sama dengan sejumlah pihak. Pendirian apotek bisa melalui kerja sama operasi ataupun waralaba dengan pihak lain. Sementara untuk tenaga medis, telah ada kerja sama dengan Ikatan Dokter Indonesia (IDI). Dengan konsep apotek one stop solution, pasien dimudahkan dalam layanan kesehatan. Sebab, di situ ada layanan penjualan obat, pemeriksaan oleh dokter di klinik, optik, konsultasi obat, dan lain-lain. “Pasien BPJS dilayani dengan tarif yang ditentukan Pemerintah Indonesia. Sedangkan pasien di luar BPJS dilayani dengan tarif umum,” Djoko menjelaskan. Kini Kimia Farma juga meningkatkan kapasitas produksi obat, dalam hal ini Kimia Farma membuat sejumlah pabrik baru. “Itu terutama untuk produksi obat generik terkait berjalannya BPJS Kesehatan,” ucap Djoko.

Jakarta, PKMK – Basuki T. Purnama (Ahok), Wakil Gubernur DKI Jakarta menyampaikan bahwa pihaknya telah mengusulkan penghapusan Pajak Penjualan atas  Barang Mewah (PPn BM) pada alat medis. Pertimbangan usulan itu, alat medis tidak bisa dikategorikan sebagai barang mewah. “Jika peralatan operasi jantung digunakan untuk menolong pasien, masa’ digolongkan sebagai barang mewah,” ungkap Ahok saat membuka Pelatihan Akreditasi Rumah Sakit Terbaru di Jakarta (17/4/2013). Usulan itu disampaikan Ahok saat rapat membahas rencana kenaikan harga BBM (bahan bakar minyak) subsidi dengan Presiden RI Susilo Bambang Yudhoyono dan para menteri berlangsung. “Saya menyampaikan usulan itu ke Bu Wakil Menteri Keuangan Ani Ratnawaty” kata Ahok. Kemudian, usulan itu sudah dicatat oleh Menteri Koordinator Perekonomian RI M. Hatta Rajasa.

Ahok mengharapkan, proses perumusan usulan itu menjadi regulasi dan tidak terlalu lama. “Kalau di Pemerintah Propinsi DKI Jakarta, perlu waktu seminggu untuk keluarnya aturan tersebut. Ya kita harapkan saja aturan pembebasan PPn BM itu keluar dengan cepat,” kata mantan bupati Kabupaten Belitung Timur itu. Dalam kesempatan yang sama, Ahok juga mengatakan bahwa dokter dan tenaga medis yang lain selaiknya digaji tinggi. Hal itu terjadi karena profesi tersebut terkait dengan keselamatan manusia. “Kalau pengemudi TransJakarta kami bayar tiga kali lipat upah minimum propinsi (UMP), ya mengapa pula dokter tidak digaji lebih dari itu?”. Ia menegaskan, bila dalam bertugas para dokter masih memikirkan kebutuhan yang belum terpenuhi, tentu masyarakat sulit mengharapkan kepedulian yang lebih tinggi. Program Dokter Keluarga dari Pemerintah Propinsi DKI Jakarta memberikan imbalan yang laik untuk dokter umum. “Satu dokter menangani 3.000 orang dan imbalannya Rp 7.000 per orang. Juga, kalau yang berobat sedikit, dokter tetap dibayar untuk pelayanan 3.000 orang itu,” ucap Ahok.