Free health services for Jakarta's poor

One of Jokowi-Ahok gubernatorial campaign’s promises was the provision of free access to health services for Jakarta’s poor. Soon after the inauguration Jokowi made good on his promises, handing over cards called “Kartu Jakarta Sehat” ("Jakarta Healthy Card") directly to the poor himself. By using the card, the poor could get free access to medicine, medical operations, and hospital rooms. Many observers have applauded Jokowi-Ahok’s move as a revolutionary affirmative welfare policy for the urban poor.

The responses, as many have expected, are very high, as shown by the explosive turn out from the poor to utilize the free health services. The media reported that by the end of January 2013 (around three months after the card were distributed) the number of patients in Jakarta hospitals increased by 70-80 percent, causing shocks to the health workers, forcing them to make an extra time to serve the poor patients, who make a daily long queue in front of the hospital’s registration counter.

Jokowi’s health policy for the urban poor drastically affected the "business as usual" among the public health practitioners who for too long have excluded the poor from the state’s basic health services. The existing public hospital system allows the market to dictate the standardization of hospitals according to the level of sophistication of the services, resulting in a hierarchical class of public hospitals in Jakarta. C and D class are mostly state’s own public hospital that, under Jokowi’s new policy, are now obliged to serve the poor. A and B class are mostly privately-owned hospitals that serve the rich. The glaring gap between the rich and the poor in Jakarta is perhaps typical of cities in the countries in the southern hemisphere, and the gap will get wider and wider without a radical policy change.

The bureaucratic strain in the area of public health that is caused by Jokowi-Ahok's affirmative action policy of providing "Jakarta Healthy Card" for the poor as shown in the last three months is only the beginning of a more inclusive urban development policy. As the policy has created a high demand for health services, Jokowi-Ahok certainly has to do a lot of work to reform the bureaucratic structure within the Jakarta’s governmental office. As the press has reported, Jokowi-Ahok has clearly shown his persistence in reshuffling the personnel in various levels of the bureaucracy, from the city mayors to the district’s heads.

The health pro-poor policy has also stirred a public debate on social media among the health professionals' circles in Jakarta, as they are the ones who become the target of public criticism if something goes wrong in their service to the poor. Such a professional responsibility has been tested when a failure to save the life of seven-day premature baby occurred in the middle of the euphoria over Jokowi-Ahok's pro poor policy. The public perceived the cause of the baby’s death to be related to the poor facilities of the neonatal intensive care unit in public hospitals. The tensions currently felt among the health workers and professionals obviously need to be resolved wisely by Jokowi-Ahok's administrations, as they are the backbone of the success of such revolutionary pro urban poor health policy.

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