Two FEB UI Lecturers: Covid-19, Expensive Cost of Losing Doctors
Nino Eka Putra ~ PR of FEB UI
DEPOK – (26/8/2020) Two lecturers at the Faculty of Economics and Business, Universitas Indonesia from the Management Department, Sri Rahayu Hijrah Hati, Ph.D., and the Department of Economics, Ibrahim Rohman, Ph.D., released their writings published by Kontan.co.id, on Wednesday (26/8/2020). Here’s the article.
“Covid-19: Expensive Costs of Losing Doctors”
It cannot be denied that handling the Covid-19 coronavirus pandemic in developing countries like Indonesia has its own challenges. Two main considerations for implementing lock down or Large-Scale Social Restrictions (PSBB) as an effort to contain the spread of the virus, are generally related to the choice and tug- of- war between the magnitude of the economic and health impacts.
On the one hand, the opening of economic activities is the main key to saving low-income groups who depend on daily income and wages. On the other hand, the opening of economic activities is generally associated with the spread of the pandemic becoming more sporadic, which also ultimately takes the toll on doctors and nurses who are struggling at the forefront.
Based on the report from the Indonesian Doctors Association (IDI), as of August 16, 2020, 78 doctors had died due to Covid-19. What is quite concerning, the death rate for doctors in Indonesia is around 2.4% or 6 times the death rate for doctors in the United States, which is the country with the largest number of Covid-19 cases in the world.
News of the death of a doctor due to the Covid-19 virus sounds normal to us, because the media almost reports this case every day. However, when the number of doctor deaths has passed 70, there are several facts that should become a wake-up call that we are losing a very important resource for the Indonesian people.
It takes a long time for a medical student to get a license to practice as a general practitioner, let alone a specialist. They have to spend 3.5 – 4 years to get a bachelor’s degree in medicine.
Furthermore, a medical undergraduate must spend two years undergoing a medical professional program or commonly known as KOAS. In addition, they must also undergo an internship program for approximately one year to obtain a Registration Certificate (STR) issued by the Indonesian Medical Council.
To become a specialist, they have to spend an additional year in specialist education. Therefore, overall a student has to spend 12 years to become a specialist, assuming the student continues his education without interruption.
In terms of costs, medical school tuition is quite expensive. At a public tertiary institution in Jakarta, the estimated entrance fee is around Rp 35 million in addition to the tuition fee of Rp 10 million – Rp 75 million per semester.
For specialist education, the admission fee can range from Rp 8.5 million – Rp 25 million on top of the tuition fee which ranges from Rp 18.5 to Rp 76 million depending on the specialist doctor program taken by students.
At one of the private universities in Jakarta, the fees can be even more expensive: someone has to provide at least Rp 300 million in the first semester, IDR 250 million for the second semester, and the remaining tuition fees for the rest of the education time.
Overall, with a rough calculation, students have to spend around Rp 266 million to Rp 1.4 billion to become a specialist in public universities and around Rp 1.1 billion to Rp 2.2 billion in private universities. Currently specialist education can only be taken at medical faculties at public universities.
Lack of medical personnel
Lack of medical personnel. The fact that we have one of the highest doctor mortality rates in the world is also a contradiction given that Indonesia has a fairly low ratio of doctors to population in ASEAN. Based on data from the World Bank in 2019, Indonesia only has 4 doctors per 10,000 population, lower than the Philippines, Thailand, Malaysia and Singapore which respectively have 6, 8, 15 and 23 doctors per 10,000 population. Even compared to younger members of ASEAN, the ratio of the number of doctors in Indonesia is only better than Cambodia (2), on par with Laos (4) but still below Vietnam (6).
In addition, there is a tendency for health sector development to lag slightly behind in comparison to economic development. Although Indonesia has risen to status as an upper middle-income country as of 1 July 2010, the ratio of the number of doctors per population in Indonesia is still lower than the average ratio in lower middle-income countries, which is 6 per 10,000.
In terms of demographics, the average student candidate who attends medical faculty is the creme de la creme among peers. Half of the 20 undergraduate programs with the highest examination scores in science and technology are medical schools based on the National Selection for State University Entrance examination scores.
Just to illustrate how high the entry requirements for the medical faculty are, if someone gets a SNMPTN score of 724, then he will have the highest score in a number of 496 undergraduate programs in Indonesia. However, this score is not sufficient to place them in the Faculty of Medicine, Universitas Indonesia based on the minimum threshold for 2019 exam results.
Thus, it can be explained that roughly the loss of 78 doctors is equivalent to the loss of 936 years of productive study time and around Rp 21 billion to Rp 110 billion (assuming tuition fees at state universities) to Rp 90 billion – Rp 179 billion (if tuition fees in private universities) educational investment. Of course, for the family that was left behind, the loss of a loved one cannot be measured materially.
With the massive news about Covid-19, people might think that our health problems are only related to this pandemic. Even though there is still a very long time ahead in which the loss of doctors will affect the sustainability of health services. It should not be forgotten that apart from doctors, Indonesia also has a low ratio of nurses in ASEAN (2.4), compared to Thailand (3) and Malaysia (3.5).
The high mortality ratio among medical personnel is also related to the scarcity of personal protective equipment (PPE), especially in the early days of the pandemic. If at that time, the government bought all PPE produced domestically and used it for all medical staff instead of exporting, perhaps the death of doctors and health workers could be reduced.
The community must also actively prevent the spread of the Covid-19 virus by complying with health protocols to prevent the loss of more medical personnel. (hjtp)
Source: https://anal.kontan.co.id/news/covid-19-biaya-mahal-hilangnya-dokter
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