Transparency Is the Cure for Medical Tourism in Indonesia
Yohanes Sulaiman | August 08, 2012
Last week, President Susilo Bambang Yudhoyono expressed his unhappiness that so many Indonesians decided to go abroad for medical treatments. Immediately, critics had a field day, pointing out that his wife had just recently returned from the United States after undergoing treatment for a nerve problem in her neck.
Later, it was also revealed that the president himself went to Kuala Lumpur for a medical checkup, with the website of the hospital claiming that the president was a regular customer.
Thus, rather than telling people not to go abroad and then risking personal embarrassment from such expose, maybe it was better for the president to actually investigate why people decided to go abroad for their medical treatments.
It is doubtful that the quality of Indonesia's practitioners is an issue here. While there are obviously some bad apples, bad doctors who performed terribly, a lot of Indonesian doctors are competent, well versed in their skills, with many top-of-the line hospitals being built with modern facilities rivaling hospitals in Singapore and Malaysia.
At the same time, however, the notorious case of Prita Mulyasari came to mind. Dissatisfied with her treatment in Omni International Hospital, Prita vented her anger in an e-mail sent to several of her friends. Unbeknownst to her, the e-mail went viral, and soon her complaints were widely read.
The Omni International Hospital, however, instead of contacting her and trying to settle her complaints, decided to sue her for defamation, with the Tangerang prosecutor's office deciding to indict her by using the controversial Electronic Transaction and Information Law (ITE). It was later alleged that officials in the Tangerang prosecutor's office were offered free medical checkups there.
All these factors fueled much public outrage toward what they saw as cronyism and injustice, which in turn heavily undermined the public's trust in Indonesian hospitals. Did the hospitals really have the interests of the patients in mind? Or were they just money-seeking corporations, more interested in ripping off the patients than curing them?
Moreover, the botched handling of the Prita case further convinced the public that it would be impossible to win any malpractice case should it be brought to the court system, unless the plaintiff has either a very deep pocket or is politically powerful enough to force the wheels of justice to turn.
In contrast, if one wishes to know why especially Singapore became a magnet for medical tourism, one need not look farther than the case of Susan Lim.
Last year, the Singapore Medical Council, having received complaints from her former patient, a member of Brunei's royal family, began an investigation into whether Lim had improperly charged $24.8 million for seven months of treatment.
Of course, it can be argued that these two cases are different, that the treatment is always different between the rich and the poor. Laws would be bent for rich people like the Brunei royal family, while the poor like Prita Mulyasari would receive the short end of the stick.
Still, given Singapore's reputation as the top destination for medical tourism, it would seem more expedient for Singapore to settle this outside of the courts, away from the glare of the press, to the terms beneficial for the Brunei royal family, simply to keep them quiet and to maintain Singapore's rich clientele.
Yet, Singapore chose the most transparent way, through the Medical Council system, even allowing Lim the chance to challenge the Council through the court system, thus ensuring transparency and fairness.
While the investigation is still ongoing and thus it could not be determined for sure whether Lim was guilty or not, the take-home message is clear: Singapore has a strong legal system that protects patients' rights. Patients' complaints are taken seriously, with enough transparency that patients can be assured that the hospitals are not going to rip them off.
Yudhoyono could have the best interest of the nation in mind when he deplored what he saw as unnecessary medical tourism abroad.
Yet, it would be more beneficial for Indonesia's struggling medical system if he used more political capital to strengthen the rule of law and ensured that patients' rights are not violated and that hospitals are honest and transparent in dealing with patients.
Yohanes Sulaiman is a lecturer at the Indonesian Defense University (Unhan).
Later, it was also revealed that the president himself went to Kuala Lumpur for a medical checkup, with the website of the hospital claiming that the president was a regular customer.
Thus, rather than telling people not to go abroad and then risking personal embarrassment from such expose, maybe it was better for the president to actually investigate why people decided to go abroad for their medical treatments.
It is doubtful that the quality of Indonesia's practitioners is an issue here. While there are obviously some bad apples, bad doctors who performed terribly, a lot of Indonesian doctors are competent, well versed in their skills, with many top-of-the line hospitals being built with modern facilities rivaling hospitals in Singapore and Malaysia.
At the same time, however, the notorious case of Prita Mulyasari came to mind. Dissatisfied with her treatment in Omni International Hospital, Prita vented her anger in an e-mail sent to several of her friends. Unbeknownst to her, the e-mail went viral, and soon her complaints were widely read.
The Omni International Hospital, however, instead of contacting her and trying to settle her complaints, decided to sue her for defamation, with the Tangerang prosecutor's office deciding to indict her by using the controversial Electronic Transaction and Information Law (ITE). It was later alleged that officials in the Tangerang prosecutor's office were offered free medical checkups there.
All these factors fueled much public outrage toward what they saw as cronyism and injustice, which in turn heavily undermined the public's trust in Indonesian hospitals. Did the hospitals really have the interests of the patients in mind? Or were they just money-seeking corporations, more interested in ripping off the patients than curing them?
Moreover, the botched handling of the Prita case further convinced the public that it would be impossible to win any malpractice case should it be brought to the court system, unless the plaintiff has either a very deep pocket or is politically powerful enough to force the wheels of justice to turn.
In contrast, if one wishes to know why especially Singapore became a magnet for medical tourism, one need not look farther than the case of Susan Lim.
Last year, the Singapore Medical Council, having received complaints from her former patient, a member of Brunei's royal family, began an investigation into whether Lim had improperly charged $24.8 million for seven months of treatment.
Of course, it can be argued that these two cases are different, that the treatment is always different between the rich and the poor. Laws would be bent for rich people like the Brunei royal family, while the poor like Prita Mulyasari would receive the short end of the stick.
Still, given Singapore's reputation as the top destination for medical tourism, it would seem more expedient for Singapore to settle this outside of the courts, away from the glare of the press, to the terms beneficial for the Brunei royal family, simply to keep them quiet and to maintain Singapore's rich clientele.
Yet, Singapore chose the most transparent way, through the Medical Council system, even allowing Lim the chance to challenge the Council through the court system, thus ensuring transparency and fairness.
While the investigation is still ongoing and thus it could not be determined for sure whether Lim was guilty or not, the take-home message is clear: Singapore has a strong legal system that protects patients' rights. Patients' complaints are taken seriously, with enough transparency that patients can be assured that the hospitals are not going to rip them off.
Yudhoyono could have the best interest of the nation in mind when he deplored what he saw as unnecessary medical tourism abroad.
Yet, it would be more beneficial for Indonesia's struggling medical system if he used more political capital to strengthen the rule of law and ensured that patients' rights are not violated and that hospitals are honest and transparent in dealing with patients.
Yohanes Sulaiman is a lecturer at the Indonesian Defense University (Unhan).
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