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Sistem Kesehatan Nasional Belum Pihak Rakyat Miskin - KOMPAS.com

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Jumat, 12 Februari 2016
Selamat Datang   |      |  
KOMPAS
Sistem Kesehatan Nasional Belum Pihak Rakyat Miskin
Selasa, 14 April 2009 | 18:11 WIB

JAKARTA, KOMPAS.com - Sistem kesehatan nasional yang diterapkan saat ini belum sepenuhnya berpihak kepada masyarakat miskin, kata Guru Besar Kedokteran Komunitas Fakultas Kedokteran Universitas Indonesia Prof Dr Azrul Azwar dalam diskusi publik di Jakarta, Selasa.
    
Menurut Prof Azrul, sistem kesehatan nasional yang berpihak kepada rakyat miskin setidaknya harus memenuhi enam syarat, di antaranya memberikan bantuan biaya pengobatan bagi masyarakat miskin.

Hal lain untuk mendukung kesehatan kaum miskin, kata dia, yaitu membangun fasilitas kesehatan yang banyak dimanfaatkan masyarakat miskin dan memrioritaskan penanggulangan penyakit yang banyak diderita masyarakat miskin.

Selain itu, pemerintah harus mengalokasikan lebih banyak dana kesehatan bagi masyarakat miskin, mengutamakan keterlibatan masyarakat tingkat akar rumput dalam pembangunan kesehatan dan menerapkan program kesehatan masyarakat nonpersonal.

"Dari keenam syarat itu, hanya yang pertama yang dilakukan, itu pun belum secara benar," katanya.

Ia menjelaskan, saat ini pemerintah memang telah memberikan pelayanan kesehatan gratis bagi masyarakat miskin melalui program Jaminan Kesehatan Masyarakat (Jamkesmas).
    
Sayangnya, kata dia, pelaksanaan program itu tidak disesuaikan dengan sistem jaminan sosial nasional sebagaimana diatur dalam undang-undang nomor 40 tahun 2004.
    
"Jaminan kesehatan yang dilakukan sekarang belum menganut sistem asuransi sosial dan tanpa konsep kendali biaya, uang terhambur tidak menentu," katanya.
    
Ia mengatakan, saat ini pembangunan fasilitas kesehatan lebih diarahkan pada pembangunan rumah sakit bertaraf internasional dan bukan pada pembangunan sarana pelayanan kesehatan dasar yang dibutuhkan masyarakat miskin.
    
"Puskesmas yang sangat penting perannya dalam pembangunan kesehatan masyarakat kurang diperhatikan, demikian pula dengan upaya pemberdayaan masyarakat," katanya.
    
Ia menambahkan, saat ini upaya peningkatan keterlibatan masyarakat dalam pembangunan kesehatan justru menyempit menjadi pendirian pos kesehatan desa yang kegiatannya pada akhirnya lebih banyak bersifat kuratif.
    
Program-program kesehatan masyarakat yang bersifat nonpersonal seperti peningkatan akses terhadap air bersih, kesehatan lingkungan dan gizi masyarakat pun, kata dia, belum dijalankan secara maksimal.
    
"Kegiatan promosi dan penyuluhan mengenai hal itu juga tidak banyak," katanya. Pada kesempatan itu Prof Azrul menyarankan agar pemegang tampuk pemerintahan pada masa selanjutnya memperhatikan elemen-elemen penting dalam penerapan sistem kesehatan yang berpihak kepada rakyat miskin tersebut.
    
Ia mengatakan, selanjutnya pemerintah harus merancang sistem kesehatan nasional sedemikian rupa sehingga seluruh masyarakat bisa menjangkau pelayanan kesehatan yang berkualitas dengan biaya terjangkau.  "Tentu dengan menerapkan konsep kendali biaya," katanya.
    
Azrul menjelaskan pula bahwa pemerintah harus menunjukkan komitmen politis yang kuat untuk mewujudkan sistem kesehatan nasional yang berpihak kepada rakyat miskin.
    
"Dan itu bisa dilakukan dengan memperkuat program pelayanan kesehatan dasar yang didukung oleh pembiayaan dan tenaga kesehatan yang memadai serta meningkatkan peran masyarakat," demikian Prof Azrul Azwar.  

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