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While waiting for an appointment with an orthopaedic doctor in a Penang hospital in Malaysia with my family last week, I read last year’s edition of The Jakarta Post, which quoted President Joko “Jokowi” Widodo complaining that around 2 million Indonesians make overseas medical trips every year, including 1 million to Malaysia and 750,000 to Singapore.
This costs the country Rp165 trillion (RM46 billion) in capital outflows.
The President said there were two main reasons for the outbound flow: there is a chronic shortage of medical specialists and the physical infrastructure for healthcare delivery is poor.
I don’t want to get into a debate with the President. Even the Indonesian Medical Association (IDI) say the country’s doctors are just as good as foreign doctors in Malaysia or Singapore.
That said, the reasons for going abroad for medical treatment should be more substantial than what the President and Indonesian doctors have said.
I went to Penang to accompany my son, who hadn’t improved at all after having pinched nerve surgery last month by a celebrity orthopaedic surgeon at a private hospital in Jakarta.
The surgeon told him he’d be back to normal in no time, but he was still in pain despite the surgery, which is something he never imagined before.
In 2010, I also took my wife to this island to replace a rod that had been implanted in her back by a devout Indonesian doctor nine years before.
A CT scan here found that the rod had moved from its original position despite a lifetime guarantee from the Indonesian surgeon.
Malaysian orthopaedic surgeon Oh Kim-Soon told my wife that the rod had moved from its original position, which was causing her severe pain.
The second surgery in Penang was a big step forward for my wife in terms of managing her pain, although she was still very unlikely to be able to walk as she wished.
She’s been in a wheelchair for 23 years, but now she’s ready to get back on her feet.
An Indonesian patient sitting next to me said he was hoping that our country would soon allow foreign doctors to operate in Indonesia.
He was perplexed as to why despite the fact that the House of Representatives had passed the Health Law, which allows foreign medical specialists to practice in the country, the IDI and many Indonesian doctors were against the liberalisation of the health sector.
“Just look at how far we’ve performed in soccer now that we’ve brought in foreign players. Having them around has stimulated our local players to work harder,” said the man who flew from his hometown Medan, North Sumatra, to Penang for spinal surgery.
Then, I went with my son to see the doctor. The Malaysian doctor said that after looking over the MRI scan taken in Jakarta, he found that my son didn’t need surgery at all — just standard treatment.
He was convinced by a second MRI taken at the hospital. Then he suggested medication instead of surgery, but said it would be more challenging because of the previous surgery.
I actually suggested to my son that he go to Penang to get a second opinion before accepting the surgery option, but he wasn’t interested.
He said he trusted his doctor and that lots of celebrities had said the doctor’s surgery was amazing. I reminded him about his mom’s experience with the surgery in Jakarta.
Aside from Penang, Singapore is a favourite destination for medical treatment among Indonesians, but the cost of medical treatment, as well as other expenses, there has skyrocketed as the rupiah has continued to depreciate against the Singapore dollar.
My conversations with fellow Indonesians at the Penang hospital and airport suggested that they had less confidence in Indonesian doctors, based on their own experiences.
My sister-in-law was shocked last year when a doctor in Penang concluded that she was not suffering from breast cancer at all while in Medan, she had to undergo chemotherapy after her doctor diagnosed her with the cancer.
My two brothers also went to Penang for heart surgery and kidney treatment because they weren’t happy with the care they were getting from their doctors at home.
Many other patients who choose overseas medical treatment would say the same things.
The Post’s report concluded that the problems are more than infrastructure.
Questions still need to be answered whether the government’s various efforts will be enough to discourage patients from seeking treatment abroad.
According to many patients, the problem with the growing outbound medical tourism goes beyond the need for medical specialists and poor infrastructure in the country.
An online publication in Penang quoted a journal concluding that Malaysian doctors are more effective and accurate in medical treatment and prescription.
The cost of treatment, including consultations, surgery and medicine, is considered cheaper. The price is even more affordable than that in Medan, Jakarta or Singapore.
Medical staff in Penang also speak Indonesian, which makes it easier for patients to communicate effectively.
“As many as 60 percent of medical tourists stated they had experienced a misdiagnosis at a domestic hospital. This situation makes them look for better and more reliable medical services abroad,” the report says.
In addition to the reasons above, another study also stated that the high demand for treatment in Malaysia was because health services accommodated the specific medical needs of patients.
In July last year, the House passed the new Health Law, which allows foreign medical specialists to practice and be based in the country. One of the purposes is to discourage Indonesians from seeking overseas treatment.
The health community has opposed to the liberalisation policy and took to the streets to convey its aspirations.
In fact, Indonesia has opened its doors to foreign hospitals, although they still have to hire Indonesian doctors only.
From my personal experience, the government should do more by allowing foreign doctors to operate in the country.
Just talk to Indonesian patients at Penang’s hospitals or at the airport. They will testify how they are satisfied with the services they cannot find at home, even at about the same price the Indonesian hospitals will charge them.
That is why 1 million Indonesians flock to Malaysia every year.
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