Death toll from new SARS-like virus climbs to 9

There has been another confirmed case of a mysterious new SARS-like virus.

The Saudi health ministry informed the World Health Organization that a 39-year-old man was hospitalized with the novel coronavirus on February 28 and died two days later.

So far, WHO has recorded 15 confirmed cases of the novel coronavirus, including nine deaths, since the fall.

The Saudi patient did not appear to have had any contact with anyone who was already infected. As a result, WHO is investigating other potential exposure sources.

Symptoms

The novel coronavirus is in the same family as SARS.

SARS, or Severe Acute Respiratory Syndrome, virus sickened 8,000 people and killed 774 between 2002 and 2003.

Symptoms of the novel coronavirus include an acute respiratory infection, fever and a cough. And it could lead potentially to pneumononia and kidney failure.

The first cases were found to have occurred in an Amman, Jordan, hospital, according to the Centers for Disease Control and Prevention.

Cases

Most of the people who’ve caught the virus have been in the Middle East.

But there have been cases reported in the United Kingdom as well.

One of the U.K. patients had traveled to Saudi Arabia. Upon return, he infected two other family members.

“Once it gets you, it’s a very serious infection,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in Nashville.

Fortunately, he added, the virus is “very difficult to acquire.”

While the SARS epidemic was going on, many of those caring for patients were infected too. The fact that this hasn’t been seen with these cases so far is a good sign, Schaffer said.

Origin

It’s suspected that, like SARS, the virus originated in animals.

A study published in November found that genetically, the new coronavirus was most closely related to viruses found in bats.

While no cases have popped up in the United States, doctors say they won’t be shocked if it did.

“It could happen,” said Dr. Susan Gerber, a medical epidemiologist in the CDC’s Division of Viral Diseases.

“That’s why the CDC is working closely with the World Health Organization and other international partners.”

Spread

WHO has asked member states to keep an eye out for severe acute respiratory infections and review them for unusual patterns.

It did not recommend travel or trade restrictions for countries where the virus has been found.

Dr. Susan Gerber, a medical epidemiologist in the CDC’s Division of Viral Diseases, agrees.

There’s no evidence of sustained human-to-human transmission, she said, “where you see a chain of many cases going person to person to person.”

“People shouldn’t freak out,” she added. “There’s no evidence that this virus is easily spread, say, across a room.”

(source: edition.cnn.com)

Menkes Optimis Regulasi Teknis BPJS Tepat Waktu

menkes13

menkes13Jakarta-PKMK. Nafsiah Mboi, Menteri Kesehatan RI, optimis bahwa penyusunan regulasi teknis terkait Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, akan selesai tepat waktu. “Semua regulasi teknis itu kini sedang dibahas dan akan selesai di Oktober 2013 ini,” ungkapnya dalam rapat kerja dengan Komisi IX DPR RI, di Jakarta (Rabu, 13/3 2013).

Nafsiah menjelaskan, satu regulasi teknis yang saat ini sedang dibahas adalah Peraturan Presiden (Perpres) tentang besar iuran peserta BPJS Kesehatan. Kemudian, ia mengatakan bahwa Kementerian Kesehatan terus menyiapkan infrastruktur dan fasilitas layanan kesehatan untuk BPJS Kesehatan itu. Untuk itu, ada kerja sama dengan Pemerintah Daerah dan juga tentunya dengan pihak swasta.

Sampai saat ini, jumlah masyarakat yang belum tercakup oleh jaminan kesehatan dari Pemerintah Indonesia ataupun swasta, sebanyak 73 juta jiwa. Pada tahun 2014, ditargetkan bahwa jumlah masyarakat yang sudah dijamin oleh program jaminan kesehatan Pemerintah Indonesia ataupun swasta, di kisaran 81 persen.

Sementara dalam rapat yang sama, Mahendra Siregar, Wakil Menteri Keuangan RI mengatakan sekarang Perpres untuk penerima bantuan iuran (PBI) di BPJS Kesehatan sedang diproses lebih lanjut. “Pembahasan nilai PBI telah berlangsung beberapa kali, dengan melibatkan semua pemangku kepentingan. Telah ada 14 skenario untuk nilai PBI itu. Kisaran nilainya Rp 10.000-an per orang per bulan, sampai Rp 22.000-an orang per bulan per orang’, tambah Mahendra.

 

Masa Kerja Dokter PTT di Daerah Tertinggal akan Diperpanjang

Jakarta: Pelayanan kesehatan yang baik seolah masih menjadi barang langka bagi warga yang hidup di daerah tertinggal di Indonesia. Kesenjangan pelayanan daerah di Indonesia mendorong dua kementerian meningkatkan pelayanan kesehatan di daerah tertinggal.

Upaya ini ditempuh kementerian pembangunan daerah tertinggal bekerja sama dengan Kementerian Kesehatan, dengan cara meminta partisipasi aktif pada tujuh universitas di Indonesia. Mereka diminta menyediakan tenaga medis yang siap ditempatkan di daerah tertinggal, terutama di pulau-pulau terluar yang berpenghuni.

Wujud lain kerjasama ini adalah dengan memperpanjang masa kerja dokter PTT di daerah tertinggal menjadi dua tahun, dan mulai akan diberlakukan tahun ini. Saat ini ada 183 kabupaten yang tergolong tertinggal.

Untuk mendukung program tersebut KPDT dan Kemenkes akan lebih memaksimalkan penggunaan internet khususnya panggilan video. Hal ini untuk memudahkan komunikasi tim medis di kota dan di daerah tertinggal dalam menangani pasien.

(sumber: www.metrotvnews.com)

South Asian countries to unite in dengue fight

The World Health Organization (WHO) will launch a special programme to unite all South Asian Region countries to fight against dengue fever.

“At the moment, countries are fighting individually to control dengue without significant progress,” a Health Ministry spokesman said.

According to the spokesman, a three day workshop is now being conducted in Colombo with the participation of over 100 specialist

doctors from Sri Lanka, India,Thailand, Bangladesh, Singapore, Indonesia, Maldives, Nepal and Bhutan in connection with the eradication of dengue from the South East Asian Region.

Commencing the workshop, Health Ministry Secretary Dr. Nihal Jayatilleke said the most severe dengue outbreak reported from

Sri Lanka was last year, with over 44,000 cases. Sri Lanka has formulated a five year strategic plan to control dengue. The main strategies are disease surveillance, case management, vector surveillance, integrated vector control, social mobilization, outbreak response, communication, inter sectoral coordination and research. The plan operates at national and provincial level. There is a Presidential Task Force to control dengue.

Pointing out the problems faced by Sri Lankan health authorities, Dr. Jayatilleke said the public should make it a priority to control

dengue, considering it a health and not an environmental problem. SEARO and Sri Lankan Health Ministry officials were also present at the workshop.

(source: www.dailynews.lk)

Program KB Tak Memuaskan, Menkes Genjot Program Kesehatan Remaja

Jakarta, Di antara berbagai program kesehatan di Indonesia, yang masih menjadi masalah hingga saat ini adalah tingginya angka kematian bayi dan ibu melahirkan. Program yang menyasar layanan kesehatan sudah dilakukan. Yang tak kalah penting adalah yang menargetkan remaja.

Pemerintah sudah sejak lama memfokuskan pada upaya preventif dan promotif. Prakteknya dengan penanaman pola hidup sehat kepada ibu hamil, untuk kanak-kanak, masa sekolah dan remaja. Khusus remaja dijadikan prioritas karena dapat mempengaruhi perkembangannya hingga dewasa dan usia lanjut.

“Remaja memiliki tempat yang ekstra penting karena remaja inilah yang akan menjadi orang tua. Jadi kalau kita mau bayi yang sehat, sejak dalam perut syaratnya utamanya adalah remaja yang sehat,” terang Menteri Kesehatan, Nafsiah Mboi dalam acara The 5th Annual Women’s Health Expo (WHE) 2013 Hotel Grand Sahid, Jl Sudirman, Jakarta dan ditulis pada Minggu (10/3/2013).

Lebih lanjut lagi, Menkes menjelaskan bahwa remaja Indonesia saat ini memang pada sadarnya sehat, namun masih ada berbagai masalah kesehatan yang perlu menjadi perhatian penting, misalnya kesehatan reproduksi, kehamilan yang tak dikehendaki, berbagai penyakit kelamin termasuk HIV AIDS, juga rokok.

Program yang dilakukan bersifat dimulai dari hulu ke hilir. Dari hulu misalnya memberi informasi tentang kesehatan reproduksi, HIV AIDS, narkotika dan sebagainya. Sedangkan di hilir, yang digarap adalah pelayanan kesehatan seperti kesehatan reproduksi, kecanduan narkotika, rokok dan sebagianya.

“Program KB harus ditingkatkan. Selama 10 tahun ini total fertility rate kita, yaitu jumlah kelahiran tiap wanita itu tidak turun, jadi stagnan. Yang menyedihkan adalah justru peningkatan jumlah kehamilan pada usia 15 – 19 tahun, pada usia yang berbahaya. Oleh karena makin muda dia, makin besar kemungkinan ibu dan bayinya meninggal,” terang Menkes.

Program di hilir ini sebagian besar sudah dijumpai di layanan puskesmas. Sayangnya, di daerah-daerah terpencil masih belum memenuhi syarat karena masalah SDM dan akses yang sulit. Akan tetapi, Menkes mengakui bahwa di beberapa daerah yang sempat dia kunjungi sudah cukup bagus.

“Jadi ada ruangan khusus remaja untuk memberikan informasi maupun pelayanan, baik untuk kesehatan reproduksi juga tentang HIV AIDS atau narkotika dan sebagainya,” imbuh Menkes.

(sumber: health.detik.com)

 

 

Deadly New Virus Warning Issued After Eight People Die

A deadly new virus warning was issued by the US Centers for Disease Control and Prevention this week, prompted by more than a dozen reported cases of the illness — eight of which resulted in death.

Known as a coronavirus, the deadly illness belongs to the family of viruses responsible for common colds and the dangerous Severe Acute Respiratory Syndrome (SARS). Previously unseen in humans, the first confirmed case of the virus was reported in September 2012.

As of March 2013, the World Health Organization has confirmed 14 cases of coronavirus in patients from Britain and the Arabian Peninsula. The British cases were all spread within a single family following one member’s visit to the Middle East, where he is believed to have contracted the illness.

“In the UK, an infected man likely spread the virus to two family members,” the CDC states. “He had recently traveled to Pakistan and Saudi Arabia and got sick before returning to the UK.” The man’s son, one of the family members who was infected, died last month.

On Thursday the CDC released its Morbidity and Mortality Weekly Report which states that cases of the deadly coronavirus have yet to surface in the United States.

However, the worldwide outbreak of the deadly new virus prompted a warning by the CDC to US health officials in an effort to prevent the contraction and spread of the illness.

As part of its warning, the CDC strongly urges individuals traveling to countries in or near the Arabian Peninsula to seek medical attention if they develop lower respiratory illness symptoms or fever within a 10 day period after their visit.

To date, eight fatalities associated with confirmed cases of the coronavirus have been reported worldwide. Five of the deaths were confirmed in Saudi Arabia, one in Britain, and two in Jordan, according to the World Health Organization.

While the origin of the deadly new virus is speculated to be of animal nature, the CDC warning states that the coronavirus is thought to be contracted through person-to-person contact.

Individuals infected with the new coronavirus were reportedly shown to develop severe acute respiratory illness with symptoms described as shortness of breath, cough, and fever.

For further details about the deadly new virus and the warning issued this week can be found at the official Centers for Disease Control and Prevention website.

(source: www.inquisitr.com)

RI lauded for malaria elimination efforts

The Asia-Pacific Malaria Elimination Network (APMEN) has praised Indonesia’s efforts to eliminate malaria, saying the country had made impressive progress in combatting the disease.

Last week, delegates from the 14 APMEN countries visited Sabang in Aceh to witness the elimination progress. The visit was part of the network’s annual meeting held in Bali from March 2 to 7.

“Everyone was extremely impressed. It’s dramatic progress. By 2015 or 2016, Aceh will be malaria free, and the rest of Sumatra and other parts of Indonesia will progressively eliminate malaria,” the meeting co-chair Richard Feachem, who is also director of Global Health Group and a professor of global health at the University of California, San Francisco, said on the sidelines of the meeting in Jimbaran.

“Indonesia has been able to show us and teach us about rapid progress in malaria elimination. Many parts of Indonesia are already malaria free.”

He said a country’s success in eliminating malaria was dependent on malaria program capacity. Through training, workshops, research grants and fellowship programs facilitated by APMEN, each country can strengthen their technical skills to improve their national malaria programs.

Aiming at eliminating malaria in the Asia-Pacific region, the network brings together 14 countries in the region to harness collective knowledge and the voices of affected countries to share best practices, identify critical evidence gaps, and advocate for eliminating the serious, life-threatening disease.

The 14 countries are Indonesia, Bhutan, Cambodia, China, South Korea, Malaysia, Nepal, the Philippines, North Korea, Solomon Islands, Sri Lanka, Thailand, Vanuatu and Vietnam.

“Indonesia has much to teach other countries in the region. We look forward to working together to achieve elimination in all APMEN countries,” Feachem added.

Tjandra Yoga Aditama, director general for disease control and environmental health at the Health Ministry, said the success of malaria elimination was measured by the Annual Parasite Incidence (API), which is ideally below 1.

“Currently, the country’s average API still stands at 1.69, but has been significantly decreased from 4.68 in 1990 to 1.96 in 2010, and down to 1.75 in 2011 and to 1.69 in 2012,” he said, adding that most of the country’s areas — where 75 percent of its population live, had demonstrated an API below 1.

The Health Ministry recorded some 300,000 cases of malaria each year. In 2011, the disease claimed 19 lives.

Similar data from the ministry, which includes a map of malaria disease intensity across the archipelago, showed that the prevalence was still high in the eastern part of the country, particularly in Papua and Nusa Tenggara.

The ministry is targeting eliminating malaria in Java, Aceh and Riau by 2015, in Sumatra, Kalimantan, Sulawesi and West Nusa Tenggara by 2020, and in Papua, West Papua, Maluku, North Maluku and East Nusa Tenggara by 2030.

In the Asia-Pacific, the number of cases has decreased significantly by 64 percent during the last decade, from 1,272,139 cases in 2000 to 455,479 cases in 2010, according to World Malaria Report 2011 issued by WHO.

However, the region is facing a growing crisis of antimalarial drug resistance, which has been detected in Cambodia, Thailand, Myanmar and Vietnam.

The growth in drug resistance is partly driven by the distribution of counterfeit antimalarial drugs and human movement related to increasing trade in the region.

Importation of malaria is another common issue faced by the region. The risk for malaria importation and new outbreaks greatly increases with migration.

To make greater impacts in malaria elimination, APMEN’s priorities during the coming years are to reduce the spread and eliminate drug-resistant parasites, to increase the effectiveness of surveillance and response systems for malaria case detection and treatment, as well as ensuring financial and political support.

(source: www.thejakartapost.com)

IDI: SJSN Hanya Bisa Selesaikan Sebagian Masalah

Jakarta – Ketua Umum Pengurus Besar Ikatan Dokter Indonesia (PB IDI), dr Zaenal Abidin mengatakan, Sistem Jaminan Sosial Nasional (SJSN) hanya akan menyelesaikan sebagian masalah kesehatan saja.

“SJSN tidak akan serta merta menyelesaikan semua masalah kesehatan, tetapi hanya sebagian yaitu biaya langsung layanan kesehatan kepada pasien,” kata Zaenal Abidin saat membuka sarasehan “SJSN: Anugerah atau Musibah Terhadap Mutu Pelayanan Kesehatan Masyarakat” di Jakarta, Rabu (6/3).

Zaenal mengatakan, selain biaya layanan kesehatan sebagai biaya langsung, masih ada biaya tidak langsung yaitu berbagai biaya yang dikeluarkan pasien dan keluarga pasien untuk mengakses layanan kesehatan.

Selain itu, dia menilai persebaran dokter pelayanan kesehatan primer juga masih belum merata di seluruh Indonesia. Menurut dia, Indonesia tidak hanya kota-kota besar seperti Jakarta atau Surabaya saja.

“Indonesia itu juga termasuk Sumatera, Maluku dan Papua yang selama ini masih kekurangan tenaga pelayanan kesehatan primer,” ujarnya.

Karena itu, kata dia, terkait dengan persiapan pelaksanaan SJSN yang akan mulai diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan pada 1 Januari 2014, PB IDI memiliki beberapa rekomendasi.

Pertama, mendorong persebaran dokter dan tenaga medis pelayanan primer ke seluruh wilayah Negara Kesatuan Republik Indonesia dengan pendekatan “public-private partnership”.

Kedua, menata ulang sistem pelayanan kesehatan agar sejalan dengan jaminan kesehatan nasional sehingga terbangun sistem rujukan dengan pelayanan primer sebagai ujung tombak pelaksanaan SJSN.

Ketiga, mengembangkan pelayanan primer dengan mewajibkan BPJS mengalokasikan 40 persen hingga 50 persen dana untuk pelayanan primer.

Keempat, mendorong tersedianya dan terselenggaranya standar pelayanan yang menjamin pelaksanaan jaminan kesehatan nasional.

Kelima, perlu ada dorongan politik atau “political will” pemerintah untuk mengalokasikan dana kesehatan sesuai dengan Undang-Undang Nomor 36 Tahun 2009 tentang Kesehatan yaitu lima persen dari APBN dan 10 persen dari APBD.

Sarasehan “SJSN; Anugerah atau Musibah Terhadap Mutu Pelayanan Kesehatan Masyarakat” menghadirkan beberapa pembicara yaitu Wakil Gubernur DKI Jakarta Basuki Tjahaja Purnama, Wakil Ketua Komisi IX DPR Supriyanto, pakar jaminan sosial Prof Hasbullah Thabrany, anggota DJSN Moeryono Aladin dan Direktur Utama PT Askes dr Fachmi Idris.

(sumber: www.suarapembaruan.com)

10 years after SARS outbreak, WHO boss shares lessons learned

Ten years ago, a new, unnamed disease was spreading out from China to various parts of the world, including Canada.

The emergence of SARS — severe acute respiratory syndrome — reminded countries that in a globalized world, diseases move as far and as fast as goods and people.

Dr. Margaret Chan was director of health for Hong Kong — a nexus of SARS — during the outbreak. Today, Chan is director general of the World Health Organization, a post she has held since late 2006.

She recently spoke with The Canadian Press about the impact SARS had on global health, whether she would use the tools employed by a predecessor in a similar situation and how she feels about a new virus that keeps pinging the world’s radar.

Note: The International Health Regulations, a treaty aimed at enhancing global health security through outbreak preparedness and transparency, were strengthened after SARS. China’s secrecy during the early stages of the outbreak meant the world was caught offguard when the outbreak emerged.

The following answers were edited and condensed.

CP: Is the world better prepared for a disease outbreak like SARS now than it was in 2003?

MC: “SARS was a very important event…. And many countries have learned from SARS…. The SARS event sort of gave them additional impetus and the sense of urgency for them to really revise the International Health Regulations.”

“…All in all, and because of the impetus coming from the SARS outbreak in 2003, countries of this organization reviewed and also renewed and also updated the IHR and all these requirements actually paved the way for countries to build their capacity and also understand the need for transparency.”

“And we have noticed that the time from event diagnosis to reporting to WHO has decreased tremendously. And the country capacity is much better than pre-SARS. It’s a long way to tell you: Yes. Because of SARS, I think the world is in a much better position to detect events.”

CP: But are some of those provisions better on paper than in reality? Indonesia wouldn’t report new bird flu cases to WHO for several years because of a dispute over access to vaccines made from H5N1 viruses. And countries in the Middle East are clearly chafing at being identified as the source of the novel coronavirus.

MC: “In disease outbreaks, when you are doing well as a country or even as a city, you are vigilant, you are being responsible, you acted in accordance to IHR requirements, you do your global responsibility, you report … you should deserve credit for having the capacity and the courage to tell the world.”

“… (But) countries for different reasons — political and otherwise — will always ban travel, will always stop their products coming (in). And this is why I’m saying it’s counterproductive, from the perspective of prompt and transparent reporting.”

“When WHO joins hands with our brothers and sisters in OIE and FAO” — the World Organization for Animal Health and the UN Food and Agriculture Organization — “to say that it is safe, no need to ban travel, no need to ban products, I wish countries would listen to them. If they do, that will help countries to be much more forthcoming.”

CP: Some people believe the response to the H1N1 pandemic was overblown. Has that hurt the agency’s capacity to urge countries to maintain their emergency preparedness efforts?

MC: “According to the IHR, it is countries’ responsibility to do emergency preparedness. Yes, of course, public opinion is important. But based on what I’m seeing, the IHR is still a live document.”

CP: During SARS, the WHO issued advisories to warn travellers away from locales that were battling the disease. It was a controversial tool, at least in Toronto. Would you use issue travel advisories in a similar situation?

MC: “That tool is still open and available to WHO. But whether or not we will use it, we have to judge the situation, whether it merits that. I cannot say yes or no. … When you’re dealing with new and emerging diseases, you have no idea and you can’t predict in advance what would happen.”

“…In the absence of complete science and information, I think the organization would make the best decision in good faith.”

CP: A new coronavirus, from the same family as SARS, emerged last year and has caused sporadic cases since. Does it give you a sense of deja vu?

MC: “I have a special interest in new and emerging infections because, perhaps, of my previous experience. I keep a very high level of vigilance.”

“…We don’t know enough now about the virus and about the disease to be able to say anything. Is it going to be having a mild phase that is not being detected early enough? It’s just like a cough and cold? Or is it only in certain individuals where you have severe disease? … This is the kind of situation that deserves a lot of humility and modesty but extremely high vigilance.”

“When you say whether I get a sense of deja vu, well I have to say yes.”

(source: www.ctvnews.ca)

Pemerintah Masih Pandang BPJS sebagai Beban

Pemerintah semestinya memandang Badan Penyelenggara Jaminan Sosial (BPJS) sebagai investasi dan bukan sebagai beban. Soalnya, bila kesehatan rakyat terjamin maka produktifitas rakyat pun semakin meningkat.

Namun kondisi yang terjadi saat ini sebaliknya. Pemerintah dinilai merasa terbebani dengan keberadaan BPJS. Buktinya, Kementerian Keuangan dianggap enggan menganggarkan iuran untuk peserta Penerima Bantuan Iuran (PBI) dalam besaran yang cukup.

Anggota Badan Pekerja Majelis Pekerja Buruh Indonesia (MPBI) dari KSPSI, Subianto mengatakan, dari kesepakatan sebelumnya antara serikat pekerja, Menkokesra, Kementerian Kesehatan dan Dewan Jaminan Sosial Nasional (DJSN) diusulkan iuran sebesar Rp22.200/orang/bulan.

Namun, lewat surat yang ditujukan kepada DJSN, Menkeu memangkas iuran itu menjadi Rp15ribu. Pemangkasan iuran itu berpotensi besar mengurangi manfaat kesehatan yang diterima peserta PBI.

Karenanya serikat pekerja menuntut agar pihak terkait segera merevisi PP PBI dan Peraturan Presiden tentang Jaminan Kesehatan Nasional (Perpres Jamkes). Selain melakukan kajian akademik atas peraturan pelaksana BPJS, serikat pekerja merencanakan empat demonstrasi besar dan mogok kerja nasional.

Pada kesempatan yang sama anggota Presidium Komite Aksi Jaminan Sosial (KAJS), Timboel Siregar, mengaku heran kenapa PP PBI mengutamakan peran Menkeu, khususnya dalam hal menetapkan iuran untuk PBI. Padahal, mengacu UU SJSN, Timboel melihat DJSN punya hak untuk mengusulkan berapa iuran yang diperlukan untuk PBI.

Konstitusi, lanjut Timboel, juga mengamanatkan agar anggaran kesehatan minimal sebesar lima persen dari APBN. Melihat potensi keuangan negara, Timboel menghitung anggaran yang ada cukup untuk membiayai jumlah peserta PBI sampai 120 juta orang. Apalagi, tiap kementerian punya anggaran bantuan sosial (Bansos) yang dinilai sering tak tepat sasaran.

Oleh karenanya, ketimbang anggaran negara digunakan untuk perihal yang tak jelas, Timboel menyarankan agar dana bansos dialihkan untuk menambah besaran iuran dan peserta PBI. “Anggaran lebih dipentingkan untuk hal politis daripada kesehatan rakyat,” tegas Timboel dalam sebuah diskusi di Universitas Atmajaya, Jakarta, Senin (4/3).

Untuk menentukan besaran iuran PBI, Timboel menegaskan agar Menkeu tak mengambil keputusan sepihak. Menurutnya, Menkeu harus melakukan konsensus dengan kementerian terkait lainnya untuk menyepakati besaran iuran PBI. Jika nantinya pemerintah menerbitkan Peraturan Pemerintah Pengganti Undang-Undang (Perpu) untuk menunda BPJS, DPR punya kewenangan untuk menolaknya. Begitu pula soal besaran iuran PBI.

Sementara, Koordinator BPJS Watch, Indra Munaswar, mempertanyakan kenapa Perpres Jamkes mengamanatkan peraturan itu berlaku pada 2014 nanti. Walau di awal tahun itu BPJS Kesehatan mulai beroperasi namun persiapannya harus dilakukan jauh hari. Sejalan dengan itu mestinya Perpres Jamkes dijalankan setelah peraturan itu diundangkan. Indra khawatir jika persiapan menuju BPJS baru dilakukan pada 2014, pelaksanaannya nanti akan carut marut. “Kami mendesak presiden revisi Perpres itu,” tuturnya.

Soal besaran iuran, Direktur Kepesertaan PT Askes, Sri Endang Tidarwati, mengatakan hal itu sangat berpengaruh atas manfaat pelayanan kesehatan yang diperoleh peserta BPJS. Bahkan, Endang mencatat biaya kesehatan cenderung meningkat tiap tahun. Untuk mewujudkan manfaat pelayanan kesehatan sebagaimana amanat UU SJSN dan UU BPJS dia mengatakan iuran minimal yang dibutuhkan sekitar Rp27 ribu. Besaran itu menurutnya sesuai manfaat yang selama ini didapat oleh peserta Askes yang tergolong PNS.

Dengan besaran iuran yang tepat, Endang berpendapat tak hanya memberi kenyamanan bagi peserta, tapi juga pihak rumah sakit. Pasalnya, dengan minimnya jumlah iuran Endang khawatir RS akan memberi pelayanan yang kurang maksimal. Endang sepakat, untuk melaksanakan BPJS dibutuhkan regulasi yang sangat baik. Sehingga, ketika BPJS beroperasi, seluruh peserta dapat dijamin pelayanannya.

Untuk mempersiapkan beroperasinya BPJS Kesehatan di tahun 2014, Endang mengatakan pada Kamis depan PT Askes dan PT Jamsostek akan menjalin kerjasama. Yaitu PT Jamsostek bakal menyerahkan secara bertahap peserta program Jaminan Pemeliharaan Kesehatan kepada PT Askes. Dengan begitu diharapkan pada 2014 nanti BPJS dapat berjalan baik. “Jangan sampai ketika sakit, karena tak terdata, peserta ditolak RS,” urainya.

Sementara Badan Kebijakan Fiskal Kemenkeu, Isa Rachmatarwata, mengatakan besaran iuran PBI sebesar Rp15 ribu yang diusulkan Kemenkeu merupakan hasil pembahasan yang panjang antar kementerian terkait.

Menurutnya, besaran itu ditentukan oleh banyak faktor, mulai dari teknis aktuaria seperti tingkat utilisasi, biaya kapitasi dan pergeseran jenis penyakit. Terkait fiskal, iuran itu baginya akan berpengaruh terhadap aspek lain salah satunya APBN. Untuk itu dari rangkaian pembahasan yang sudah dilakukan, Menkeu berkesimpulan iuran yang tepat untuk PBI sebesar Rp15 ribu. “Karena tidak mengubah drastis APBN,” ujarnya.

Selain itu Isa menekankan bahwa pada perjalanannya nanti, Kemenkeu akan mengevaluasi pelaksanaan iuran PBI itu. Sehingga, ke depan, besaran iuran itu akan terus mengalami perbaikan.

Untuk menambahkan besaran iuran PBI itu, Isa berharap ada pos subsidi lain yang dapat dialokasikan. Misalnya, memperketat subsidi di bidang energi. “Kami juga melihat BPJS sebagai investasi (di bidang kesehatan,-red),” ucapnya.

Sedangkan anggota Komisi IX dari FPDIP, Caroline, mengatakan dalam pembahasan terakhir antara Komisi IX dengan Kemenkes, Wamenkes menjelaskan belum ada kesepakatan lintas kementerian terkait untuk menetapkan besaran iuran BPJS. Menurutnya, jika belum ada kesepakatan, Menkeu tak tepat menetapkan besaran iuran itu.

Caroline mempertanyakan kelayakan manfaat pelayanan BPJS Kesehatan bila anggarannya seperti yang disampaikan Kementerian Keuangan. Untuk mengawal dan mengevaluasi persiapan BPJS, Caroline berjanji akan mengusulkan pembentukan Pansus di DPR. Selain itu Caroline mengatakan upaya pengawasan yang dilakukan DPR itu harus mendapat dukungan dari rakyat. Namun, Caroline menegaskan, apapun yang terjadi, pelaksanaan BPJS tak boleh terhambat. “Jangan sampai ribut-ribut ini menunda pelaksanaan BPJS,” tegasnya.

(sumber: www.hukumonline.com)