HEALTH CARE FOR INDONESIANS

EXECUTIVE HEALTH CHOICES: HERE OR THERE?
Duncan Graham © 2006

It’s every hard-pressed manager’s nightmare: A gripping, vice-like chest pain. Maybe just indigestion after a rich meal. Maybe not.

Heart attacks are an occupational hazard for people in business and other high stress jobs. Victims are usually middle-age workaholics who smoke, eat the wrong food and don’t exercise. Most are men

They rush to a doctor and the prognosis is bad. Surgery is required. But where to go? Who wields the steadiest scalpel?

When former president Megawati Soekarnoputri had medical check-ups in Singapore she sent a clear message to all Indonesians about the quality of the nation’s health system.

Her husband Taufik Kiemas endorsed his wife’s views by choosing the nearby Western Australian capital Perth for his heart surgery.

It seems that if you’re an Indonesian with a serious health problem and plenty of money you head straight for the nearest airport rather than the closest hospital.

Back in the 90s before the economic crisis, many sick Indonesians chose Australia for treatment. Agents helped patients find the right doctors and hospitals, sort out visas and accommodation for the family, and somewhere to convalesce.

When the rupiah exchange rate multiplied exponentially those agents found business too tough and quit the market. Now the currency seems to have stabilized, and a new Australian company has entered the field.

Validus International is a health services management business linking the sick to the services they need. The company is contracted to Perth’s Mount Hospital to provide an international patient liaison officer and is affiliated to other hospitals and services, including a fertility clinic.

Validus is seeking patients from Mauritius, Malaysia, China and Indonesia – but according to managing director Mark Riseley the Indonesian market is the company’s priority.

It has opened an office in Jakarta managed by a doctor and will be running seminars for surgeons and general practitioners in the capital and other big cities in the coming months.

“The cost of surgery and other medical treatments in Perth is about the same as Singapore,” said Riseley in his Perth office. “The airfare is a little more expensive but that’s a small amount in the overall cost.

“Australia is ranked second by the World Health Organization for healthy life expectancy which reflects the quality of healthcare available. (Japan is number one.) The facilities in Perth are world class.”

Perth is close - just over three hours flight from Denpasar. The lifestyle is relaxed, the climate benign and the claims by Validus about fees and services may well be correct. But Indonesians (and many expats) prefer instead to head for Singapore where medical care is well promoted.

The tiny city state is closer to Jakarta and has some other significant advantages. It has a no-fuss, no-fee entry system. Most foreigners can just fly or ferry into the island and get stamped in on arrival for a short-term visit.

To visit Australia requires a visa in advance and forms with more than 40 questions. Malaysians and Singaporeans can apply for Australian visas through the Internet, but not Indonesians.

Medical visas are free. Tourist visas cost AUD $70 (Rp 500,000) which is non refundable if a mistake is made on the seven page application form. Although Embassy officials claim around 97 per cent of visa applicants are successful, the perception is that entry into Australia is difficult, and therefore unwelcoming.

Riseley said an Australian health visa can be arranged within three to five days – or 24 hours in an emergency. But however efficient the bureaucracy it can’t compete with Singapore’s simplicity.

“I’ve been talking to the Immigration Department and the current system of sending medical data for visa assessment by locked bag twice a week to Australia will soon be replaced by direct digital transmission,” said Riseley. “That should speed procedures.” A new visa application center has also been opened in Jakarta.

Riseley trained as a physiotherapist in Australia and Canada, then worked in the Middle East where he saw the need for international health care and patient management services.

The chair of Validus is health administrator Glyn Palmer, president of the West Australian Health Care Association. He was previously CEO of St John of God Health Care in Perth.

“In the past there were good contacts between the Catholic hospitals in Indonesia and Australia,” he said. “Australia is the equal of any country in the world in providing the best medical care.

“We also have a large knowledge base in medical care and this has to be shared.”

Palmer said he would organize seminars in Indonesia where doctors could get free information from visiting Australian surgeons and physicians on the latest procedures and medications.

He would also be talking to Indonesian doctors’ associations and working to build relationships with hospitals. He agreed that the pivotal point in getting business was the patient’s doctor who would usually offer advice on the best place for treatment. For Validus to succeed it’s critical that medicos are aware of facilities in Australia.

Doctors who refer patients to hospitals overseas can collect commissions of between four and ten per cent of the hospital bill.

The other gateway is medical insurers who have links with hospitals and laboratories where they direct their members.

Riseley said Singapore currently takes 370,000 overseas medical patients a year – Malaysia 270,000. Validus has set itself modest numbers for starters – just 450 by the end of next year.

“We understand that building relationships in Indonesia is extremely important,” said Palmer. “We must respect cultural differences.

“We’ll be going to Indonesia regularly, communicating and listening. We’re selling a good Australian product and we’d like more Australian government help.

“The visa process is frustrating – it takes too long. Singapore does a wonderful job, and we have a lot to catch up on.

“Australia is a favored education center for about 20,000 Indonesians a year so we can build on those contacts and family ties. Word of mouth is also important. The response so far has been enthusiastic.”

(First published in The Jakarta Post 18 December 2006)

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