The problem of financing capacity in the context of state-owned hospital emerges when the public health insurance scheme or BPJS failed to deliver its payment to the hospitals, on time. The private hospital did not see this as a problem. Because BPJS has guaranteed 1% monthly interest to recompense for the suspension.
But for the government hospital, the situation is a bit problematic. Before the hospital’s claims are paid by BPJS, the hospital has to borrow from the bank. The 1% interest from BPJS will cover the cost of the loan, in most cases, it is better-of for the hospital because the bank would take interest less than 1%.
The problem is, to make a loan or to borrow from the bank, the government-owned hospital has to acquire a permit from the legislative, or the house of representative. The regulation declares when a government hospital borrows for a short term loan, it does not need any permission from the legislative. But the short terms loan are limited to not excelling one fiscal year period.
When the loan surpassing 31 December, the end of the fiscal year, then it is no longer classified as a short terms loan, it is now a middle term loan instead. To which the hospital owes permission from the legislative. Of course, the interplay with the legislation should not be a predicament, since they are the representative of the public. But the institutional circumstance in each state is different. The permit might open a chance for the oknum to extort illicit interest from the hospital.
This is a real case that I personally encounter. It is a problem and if it is true that the situation is caused by the stiffness of regulation, then the government have to address it. But is that the case? Could it be just a matter of misperception or a misinterpretation of some executor in the field? In any cases, the hospital needs financial flexibility to deal with the problem of delayed payment from BPJS. Thus, this barrier to acquiring loans is a threat to the effectiveness of government hospitals services.
We need to address this problem. First, by answering the basic question, did this inflexibility does exist? Second, does it exist due to the regulation that ordering the legislative permit? Third, how does this stiffness affect hospital capacity on serving the public? The last is how to deal with it.
Satoria 