City to issue individual Gakin cards to outcast smokers

02/27/2010

The administration is planning to issue individual cards for Gakin, its free healthcare scheme for poorer people, to outcast smokers from burdening its budget.

"Every family member will have a Gakin card," Jakarta Health Agency head Dien Emawati said Thursday.

She said the move was part of the agency's effort to curb the scheme's soaring spending, which is caused by treatment for ailing smokers.

"The Gakin's fund is limited. It is useless to spend it on patients of smoking-related diseases," she said.

The policy is also aimed to raise awareness on healthy lifestyles among the poor, she said.

The administration is currently preparing a gubernatorial decree that would work as a legal basis for the policy.

Dien said the city would conduct a survey on Gakin card holders as well as owners of SKTM cards.

SKTM cards are held by residents that are recognized by the administration to be living in poverty.

The cards, which last up to six months, enable the bearer to receive up to 50 percent off their healthcare costs. SKTM is a complementary health scheme designed to cover the poor who are not registered as Gakin recipients.

Dien, however, did not elaborate on how the Health Agency would distinguish between active smokers and passive smokers.

The city spent Rp 413 billion (US$44 million) for the two schemes in 2009 and allocated Rp 550 billion for this year.

The plan to ban smokers from free healthcare was initiated by Governor Fauzi Bowo, but has received criticism from his deputy, Prijanto, who voiced concerns over the fairness of the scheme.

He said it would be unfair if a smoker who needed non-related smoking treatment was unable to access free healthcare.

"In my personal opinion, the mechanism should focus on the probe on what caused a disease not by one's habit," he said on Thursday.

He cited as an example that if a smoker that has been denied from the scheme got into an accident.

"We can use doctor's referals for disease assesments.

"If a doctor tells a poor patient their illness is caused by smoking, then the patient can be denied from the healthcare right," Prijanto said.

A 2004 national socioeconomic survey says 63.1 percent, about 138.82 million, of Indonesians are smokers.

According to research by the Demography Institute of University of Indonesia (UI), released in 2008, smokers' household spent 11.5 percent of their income on cigarettes.

Tubagus Haryo Karbyanto, the deputy chairman of the Jakarta Residents Forum (Fakta), said the policy was applicable, but he hoped the city could do a thorough study to determine the mechanism.

"Whatever mechanism they use, it should not create the misinterpretation in the public that the city does not serve the poor," he told The Jakarta Post over the phone.

He said before the policy took effect, the city could give around one-year to promote healthy lifestyles in neighborhood units and assist low income families to quit smoking.

"It's important to create an environment that is free from smoking and facilitate the smokers to stop the bad habit because cigarettes are addictive," Tubagus said.

The city's effort to curb smoking, he said, should be supported by the central government in the form of higher cigarettes excise and stricter advertisement and sponsor bans.

"As long as cigarettes can be bought cheaply, low-income people will smoke," he said.
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