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Indonesia
will start the National Social Security System (SJSN) in healthcare in
2014. Starting from that year, gradually until 2019 all citizens will be
covered under a government-sponsored universal health insurance scheme.
With the
SJSN, a citizen will no longer face a cost barrier to receiving
healthcare. The SJSN will also act as poverty prevention.
Around the
globe, around 100 million persons every year are forced into poverty
because they have to pay for their healthcare. A universal health
coverage program such as the SJSN in Indonesia will ensure all people can
access health services without financial hardship. Global support for
such programs has been gathering momentum as well, with the adoption of a
resolution in the United Nations General Assembly. The resolution,
adopted on Dec. 12, 2012, requires governments to initiate universal
healthcare programs to contribute to international development,
considering the role of health in achieving millennium development goals.
The SJSN will
remove the burden of medical costs from individuals. Everyone should no
longer worry about falling sick as a healthcare system, mostly supported
by the government, will be ready to cover the cost.
But a new
debate arises. The more people get sick, the heavier the taxpayers’
burden for healthcare under the SJSN scheme will become.
In the United
Kingdom, which has had its National Health Service (NHS) since 1947,
illness costs the country at least £1 million (US$1.5 million) every
hour, or more than Rp 15 billion (US$1.5 million). Diabetes costs the UK
£9 billion per year, which may increase given the fact that 2.9 million
people were diagnosed with the disease in 2011 alone.
We can
estimate the cost burden of diabetes in Indonesia, where the prevalence
rate of the disease is 5.7 percent of the population in urban areas in
people aged 15 years old and above (Basic Health Research, 2007). The
number of people with diabetes will keep increasing in the coming years
in Indonesia, with currently the world’s fourth highest percentage of the
population with diabetes, if no significant preventive measures are taken
nationwide.
Diabetes
mellitus is relatively easy to prevent. Several modifications of
lifestyle have proved effective in preventing or delaying the onset of
the disease.
The
modifications include enhanced physical activity, a healthy diet,
maintaining ideal body weight and not smoking.
Moderate
physical activity of around 30 minutes, five days a week could decrease
the risk of diabetes. A healthy diet, consuming 3-5 portions of fruit,
vegetables and restricting consumption of sugar and saturated fats, will
help maintain an ideal body weight that will prevent diabetes. Obesity is
of great relevance since around a half of diabetes cases can be prevented
through the maintenance of weight within the ideal range. Non-smoking is
also important because smoking increases the risk of coronary heart
disease and strokes which diabetes can cause.
The health of
citizens will eventually impact on the success of development programs.
The better each individual takes care of his or her health, therefore,
the more beneficial it will be as state funds can be allocated for
education, poverty eradication and infrastructure development.
On the
contrary, an unhealthy lifestyle will not only cost an individual but
will also create an unhealthy environment. We can see the evidence from
smoking, which exposes both smokers and nonsmokers to toxins that can
cause respiratory and other diseases.
Facing the
era of the SJSN next year, and the coming global agenda of universal
health coverage, people do not have to worry about health costs, but it
should be understood that the more a population follows healthy
lifestyles, the more government funds can be used on development. The
health budget should not be wasted on diseases that can actually be prevented.
A healthy lifestyle
will contribute significantly to the completion of the development agenda
and an increase in investment in education, poverty eradication and the
development of better basic infrastructure and public facilities.
A healthy
lifestyle should therefore serve as the manifestation of our new spirit
of nationalism. ●
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