Life is Healthy

People on the city's free health plan should stop jeopardizing their health by smoking, city officials said. (EPA Photo/Jurnasyanto Sukarno)

Governor Fauzi Bowo on Tuesday announced a new proposal that would restrict the access of smokers to the city’s free health care program for low-income residents.

“How can they enjoy the free health care scheme when they know that smoking can cost them their health? That is just not fair,” he said.

Fauzi said deliberations were under way on a possible new city regulation that would alter the terms of the Gakin program, which provides free health care for less fortunate families across the capital.

He said the issuance of the SKTM, a letter normally issued by community leaders to confirm the low-income status of residents, could also be revised.

According to city records, more than 164,000 low-income households across Jakarta have a Gakin card, while an additional 50,000 households have SKTM letters.

Quoting data collected by city officials, Fauzi said that almost a quarter of the average low-income worker’s income was spent on cigarettes.

“When Gakin cardholders smoke, 22 percent of their income goes up in smoke,” the governor said, adding that the number of women and young people taking up smoking was increasing annually across the capital.

Fauzi said he was determined to tackle this problem head on.

“I am not eliminating the Gakin scheme; I just do not want to give free health care to smokers,” he said.

Dien Emawati, who heads the Jakarta Health Agency, said on Tuesday that the city administration’s plan would stress that Gakin cardholders and residents with SKTM letters were not allowed to smoke.

That message, she said, would be formally publicized and strictly implemented across state hospitals, clinics, subdistricts and urban wards.

“We guarantee free health care for the poor, but they need to give up smoking and stop jeopardizing their health,” she said. “If there is even one person who smokes in a family, the entire household is affected.”

Dien said deliberations over a gubernatorial decree to restrict the Gakin card and SKTM letters to nonsmokers were already under way, with talk of “trained field officials” being tasked with checking the teeth and mouths of those claiming low-income status to determine whether or not they were smokers.

Dien said discussions would cover a number of issues, including whether medical services would be immediately stopped for active smokers suffering from lung-related illnesses.

A large number of low-income residents, she said, already suffer from lung diseases such as pneumonia and acute respiratory infections.

Husna Zahir, chairwoman of the Indonesian Consumers Foundation (YLKI), told the Jakarta Globe that her organization agreed in principle with the city administration’s proposal and would support its implementation if it were passed.

She said the strict measure could help increase awareness about the financial and health impacts of smoking.

“Many poor people still prioritize cigarettes over food,” Husna said. “Smoking is one bad thing that can be prevented and stopped.”

According to data collected by the University of Indonesia in 2008, some 35 percent of all Jakartans were active smokers.

The university’s research also found that a family of smokers would spend on average Rp 113,000 ($12) every month for cigarettes. That is slightly more than the Rp 100,000 direct cash assistance package (BLT) given to low-income residents by the government.