Indonesian health minister warns country’s smoking epidemic threatens National Health Insurance Program

A worker smokes a cigarette during a break at a fabric factory in Solo, Indonesia Central Java province, August 11, 2016. REUTERS/Beawiharta/File Photo
A worker smokes a cigarette during a break at a fabric factory in Solo, Indonesia Central Java province, August 11, 2016. REUTERS/Beawiharta/File Photo

You are probably well aware that Indonesia has some of the highest smoking rates in the world, caused in large part by the government’s lax regulations on tobacco. Officials and smoking rights advocates (yes, seriously) who argue against stricter rules and higher tariffs on cigarettes usually talk about the economic benefits that tobacco brings to Indonesia, mainly focusing on the plight of poor tobacco farmers who might be put out of work if the government were to crack down on smoking (though some will admit to the crucial importance of tobacco taxes on government revenue).

The obvious answer to the economic argument for tobacco is that, in the long run, the devastating health consequences of nicotine addiction and the accompanying healthcare costs will far outweigh the short-term economic benefits the industry provides the country.

Indonesian Health Minister Nila Djuwita Moeloek put this argument into stark terms yesterday, making the case that the negative health impact of tobacco posed a serious threat to the sustainability of the National Health Insurance program (BPJS) initiated by President Joko Widodo’s administration.

“The cost of treating heart and arterial diseases vessels is said to have already reached Rp 6.59 trillion (for the government, annually). However, some days ago I met the Director of BPJS, and he said the costs actually reach Rp. 7.4 trillion (~$556 million),” Nila said yesterday at the opening of the 4th Indonesian Conference on Tobacco and Health (ICTOH) as quoted by Antara.

Nila said BPJS data was the most accurate since they could only disburse funds for tobacco-related diseases after patients had been correctly diagnosed.

The health minister said the latest data showed that Indonesia has the highest percentage of male adult smokers of any country in the world at a staggering 68.8%. She also said more than one-third of the entire population of Indonesia are smokers, as are 20% of teenagers between the ages of 13 and 15 years old.

The Indonesian parliament is still considering a proposed bill (RUU Tembakau) that would relax numerous regulations with the goal of increasing the growth and revenue of the country’s tobacco industry. The Health Ministry is strongly opposing the bill.

The government often likes to tout the drug emergency in Indonesia which they say is killing over 50 people per day on average (a number based on flawed statistics) but never says anything about the 595 people per day that die from smoking-related diseases. The only real difference is which one they profit from. But in the end, the government and the people will pay a much greater price.


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