Indonesia will enter
the gate of the ASEAN free trade or referred to as the ASEAN Economic Community
(AEC) within a few months forwards. AEC itself is considered as an exact way
for ASEAN countries to realise the ASEAN’s Vision 2020. ASEAN’s economic idea
has been started since 1977 with the approval of Preferential Tariff
Arrangement. Then, several economic agreements were also made and agreed
since the late few years. For instance, an agreement which became the
forerunner of the establishment of the AEC's vision in 2015 was the agreement
on Common Effective Preferential Tariff - ASEAN Free Trade Area (CEPT-AFTA) in
1992 with a target initial implementation in 2008. In 2006, the ASEAN Economic
Ministers meeting held in Kuala Lumpur, Malaysia, agreed to develop the ASEAN
Economic Community Blueprint which is a guideline for the realization of the
AEC in 2015.
In the future, AEC will
become a single market and production base of international where goods,
services, investment, skilled labor and even capital will flow more freely from
one country to the other ASEAN countries. Of course, this will lead to high
economic competitiveness. Currently, the ASEAN countries are already preparing
for the free market. All sectors should be ready by 2015: Economic, Social, and
even the health sector also participated in the free market will be targeted.
Indonesia, the country with the fourth largest population in the world, still
has a lot of homework that should be addressed first in the health sector.
Seeing that, a variety of problems in the health sector has not been completed.
Question after question emerges because of the condition of the nation's health
sector; what the problems are happening in the health sector in Indonesia? So
what needs to be prepared, especially in the field of Health? Is Indonesia
ready to face the AEC Indonesia?
No doubt, the current
health sector in Indonesia is trying hard to improve itself to face the free
market competition in 2015 where the health goods or services easily come in
Indonesia later. The most fundamental problem of the quality of health services
in Indonesia is still not up and completed the implementation. For example,
there are many government or private hospitals are not providing optimal care
to patients. As another example, the distribution facility or health workers in
Indonesia are not evenly distributed. Indonesia needs a master plan that
accurately, effectively and efficiently to improve itself dealing with health
issues, considering being endowed the demographic Indonesia comprising the
islands.
The most fundamental
thing in optimizing the quality of health care is revamping the health care
organization itself. Health care organization is the key to providing health
care in the community in which it is included in administration and management,
human resources, infrastructures, policies and procedures, as well as
evaluation and quality control. In terms of administration and management, this
item is still less than optimal in practice. Example, when Patients want to
take care of public health insurance or lower-income patients go to the
hospital when still found no fast service practice, patients are sometimes
complicated with intricate administration, whereas aspects of their lives
cannot be ignored by health care providers.
Furthermore, items of human
resources in the health sector should be improved the quantity and quality, in
order to compete the global market later. Health human resources must uphold
the values of integrity, professionalism, loyalty in carrying out their
duties. However, in practice, there are still many of them are business
oriented in providing health services. Likewise infrastructure is far from the
word "Fine". In areas that are difficult to reach, for example,
people have to travel long distances just to get health care. Not only the
quantity that needs to be added but also the quality must be preferred.
Policies/programs, procedures must be managed and be efficient in its
implementation, as well as evaluation of the quality control also very needs
attention. It aims to provide an evaluation of health services as well as to
enforce a good quality service on an ongoing basis from the service center
level (Ministry of Health) to service level to the bottom (Public Health
Center).
All of the above can be
summarized into the aspect of service quality. Quality of health services is
one of the basic necessary of every person. This concept has been the nation's
capital to compete in the ASEAN later. It is undeniable, in the practice of
health care services is now a challenged agency continues to deliver
innovations with emphasis on the principles of efficiency and productivity
without prioritizing on benefit. Moreover, the free market will be faced, in
which goods and services from other ASEAN countries easily fit into this
country.
Answering the future
challenges, health care providers need an effective and efficient marketing. In
achieving effective, efficient and productive marketing, healthcare providers
need to consider some aspects, they are aspects of supply, demand and the
expected input regarding the status of the health of consumers as users of
services or products. Offer as an input in question is the health of the goods
or services to be promoted to the public, in terms of curative, rehabilitative,
preventive and promotion. Another aspect of the targeted marketing of health
care is a demand of the society. At this stage, the marketing strategy is
implemented with focusing on 3W + 1H (Who
will provide services, What will be offered,
where-where is target marketing, How do we compete
with competitors).
At this stage of this
process, the development of all resources and integrating all activities of the
healthcare providers to meet the needs and expectation of consumers must be
improved. If this is not done, then the market will be dominated by the other
ASEAN countries easily going into Indonesia to market their goods and services.
The next stage is the
evaluation of the achievement of marketing that has been prepared, by comparing
the target with the achievements obtained. Obviously, the results obtained will
satisfy the consumer's perspective if the process carried out is also really effective.
However, the problem is being faced in the implementation of process of health
care away from the quality of it. Where, health services should be oriented to
customer satisfaction as the goal orientation of the organization. However, if
the consumers are satisfied with the services received, then in the future they
continue to use the same services that they had trusted in terms of quality.
Thus, what types of
products and services can become Indonesia’s special quality in free trade
later. Clearly the implementation, any goods or services in the health sector
is still not satisfactory for consumers. For example, services in the hospital,
sometimes still discriminating against patients based on the economic status of
the patient. Not only that, in terms of medical care was not uncommon for
patients visiting to the hospital with complaints of disease A, but after
discharge from hospital, patients even complain of illness B. This is taken
into consideration for the health service. From the previous two examples that
represent a challenge for health service delivered in this country, we can draw
conclusions and make it as a correction, so that future WOW services in the
field of health care can be maximized while remaining oriented to customer
satisfaction. Goods and services provided must be easily accessible, many
quality options, have a quality service, affordable prices, technology
sophistication, as well as any re-consultation when consumers must have a high
satisfaction guarantee. Not just running the existing system, but ensure that
the system is still running with optimum that is the key to compete with other
countries.
The WOW service is not
difficult to be realized, while there is a willingness and seriousness of
stakeholders who are responsible for it. Should be appreciated, the government
is currently revitalizing health services based on the national health
insurance system with the Social Security Agency (BPJS) holding the control.
BPJS is trying to empower people to be self-sufficient in financing their own
health. But back again to the beginning of the problems is the quality of
service that is still far from expectations.
If the healthcare
providers have implemented the above matters to the maximum, then the
comprehensive health care quality and patient-oriented satisfaction are easy to
achieve. Furthermore, the principle of integrity, flexibility, effectiveness,
efficiency and a strong commitment from every individual to healthcare
providers at the national level, then gently healthcare conditions can sustain
this nation in answering the AEC in 2015 even amid the global competition of
the health sector. Thus, we will be as a player in our beloved country instead
of a spectator's market being dominated by products and health services from
other countries.
Field Epidemiology Training Program Departement
Airlangga University
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