Kualitas Dokter Menentukan Tarif Rumah Sakit di Jakarta
JAKARTA, Saco-Indonesia.com — Rencana penghapusan kelas-kelas pada rumah sakit di Jakarta dapat diimbangi dengan penentuan tarif sesuai kualitas dokter. Dengan demikian, penentuan tarif itu akan dirasa adil bagi masyarakat, dan kesejahteraan dokter pun dapat meningkat.
Kepala Dinas Kesehatan DKI Jakarta Dien Emmawati mengatakan, rencana penghapusan kelas di rumah sakit di Jakarta itu berkaitan dengan rencana untuk menyamaratakan tarif rumah sakit. Jika kelas-kelas di rumah sakit sudah disamakan, maka penentuan tarif akan didasarkan pada kualitas para dokternya.
"Bisa diarahkan ke sana, kalau rumah sakit tipe C punya kualitas (tipe) A, maka (angkanya) bisa masuk tipe A. Tapi itu regulasinya di Kemenkes (Kementerian Kesehatan)," kata Dien di Balaikota Jakarta, Senin (3/6/2013).
Perubahan regulasi untuk rumah sakit di Jakarta mencuat berbarengan dengan evaluasi Kartu Jakarta Sehat (KJS). Program KJS merupakan program unggulan Gubernur DKI Jakarta Joko Widodo. Evaluasi KJS berlangsung sejak akhir Mei 2013 dan dilakukan karena ada sejumlah rumah sakit yang keberatan dengan tarif yang ditentukan.
Evaluasi itu akan memakan waktu sekitar tiga pekan dan fokus pada sistem pembayaran berdasarkan tarif Indonesia- Case Based Group (INA-CBG) atau sistem pembayaran kepada pemberi pelayanan kesehatan yang dikelompokkan berdasarkan ciri klinis dan pemakaian sumber daya yang sama. Rumus penghitungan telah disediakan oleh Kementerian Kesehatan, tetapi penentuan tarif menjadi kewenangan daerah karena disesuaikan dengan kemampuan daerah. Kecilnya tarif INA-CBG disebabkan belum semua rumah sakit di Jakarta masuk dalam basis data National Center for Case Mix (NCC), yaitu baru 20 persen.
G.O.P. Hopefuls Now Aiming to Woo the Middle Class
WASHINGTON — The last three men to win the Republican nomination have been the prosperous son of a president (George W. Bush), a senator who could not recall how many homes his family owned (John McCain of Arizona; it was seven) and a private equity executive worth an estimated $200 million (Mitt Romney).
The candidates hoping to be the party’s nominee in 2016 are trying to create a very different set of associations. On Sunday, Ben Carson, a retired neurosurgeon, joined the presidential field.
Senator Marco Rubio of Florida praises his parents, a bartender and a Kmart stock clerk, as he urges audiences not to forget “the workers in our hotel kitchens, the landscaping crews in our neighborhoods, the late-night janitorial staff that clean our offices.”
Gov. Scott Walker of Wisconsin, a preacher’s son, posts on Twitter about his ham-and-cheese sandwiches and boasts of his coupon-clipping frugality. His $1 Kohl’s sweater has become a campaign celebrity in its own right.
Senator Rand Paul of Kentucky laments the existence of “two Americas,” borrowing the Rev. Dr. Martin Luther King Jr.’s phrase to describe economically and racially troubled communities like Ferguson, Mo., and Detroit.
“Some say, ‘But Democrats care more about the poor,’ ” Mr. Paul likes to say. “If that’s true, why is black unemployment still twice white unemployment? Why has household income declined by $3,500 over the past six years?”
We are in the midst of the Empathy Primary — the rhetorical battleground shaping the Republican presidential field of 2016.
Harmed by the perception that they favor the wealthy at the expense of middle-of-the-road Americans, the party’s contenders are each trying their hardest to get across what the elder George Bush once inelegantly told recession-battered voters in 1992: “Message: I care.”
Their ability to do so — less bluntly, more sincerely — could prove decisive in an election year when power, privilege and family connections will loom large for both parties.
Questions of understanding and compassion cost Republicans in the last election. Mr. Romney, who memorably dismissed the “47 percent” of Americans as freeloaders, lost to President Obama by 63 percentage points among voters who cast their ballots for the candidate who “cares about people like me,” according to exit polls.
And a Pew poll from February showed that people still believe Republicans are indifferent to working Americans: 54 percent said the Republican Party does not care about the middle class.
That taint of callousness explains why Senator Ted Cruz of Texas declared last week that Republicans “are and should be the party of the 47 percent” — and why another son of a president, Jeb Bush, has made economic opportunity the centerpiece of his message.
With his pedigree and considerable wealth — since he left the Florida governor’s office almost a decade ago he has earned millions of dollars sitting on corporate boards and advising banks — Mr. Bush probably has the most complicated task making the argument to voters that he understands their concerns.
On a visit last week to Puerto Rico, Mr. Bush sounded every bit the populist, railing against “elites” who have stifled economic growth and innovation. In the kind of economy he envisions leading, he said: “We wouldn’t have the middle being squeezed. People in poverty would have a chance to rise up. And the social strains that exist — because the haves and have-nots is the big debate in our country today — would subside.”
Republicans’ emphasis on poorer and working-class Americans now represents a shift from the party’s longstanding focus on business owners and “job creators” as the drivers of economic opportunity.
This is intentional, Republican operatives said.
In the last presidential election, Republicans rushed to defend business owners against what they saw as hostility by Democrats to successful, wealthy entrepreneurs.
“Part of what you had was a reaction to the Democrats’ dehumanization of business owners: ‘Oh, you think you started your plumbing company? No you didn’t,’ ” said Grover Norquist, the conservative activist and president of Americans for Tax Reform.
But now, Mr. Norquist said, Republicans should move past that. “Focus on the people in the room who know someone who couldn’t get a job, or a promotion, or a raise because taxes are too high or regulations eat up companies’ time,” he said. “The rich guy can take care of himself.”
Democrats argue that the public will ultimately see through such an approach because Republican positions like opposing a minimum-wage increase and giving private banks a larger role in student loans would hurt working Americans.
“If Republican candidates are just repeating the same tired policies, I’m not sure that smiling while saying it is going to be enough,” said Guy Cecil, a Democratic strategist who is joining a “super PAC” working on behalf of Hillary Rodham Clinton.
Republicans have already attacked Mrs. Clinton over the wealth and power she and her husband have accumulated, caricaturing her as an out-of-touch multimillionaire who earns hundreds of thousands of dollars per speech and has not driven a car since 1996.
Mr. Walker hit this theme recently on Fox News, pointing to Mrs. Clinton’s lucrative book deals and her multiple residences. “This is not someone who is connected with everyday Americans,” he said. His own net worth, according to The Milwaukee Journal Sentinel, is less than a half-million dollars; Mr. Walker also owes tens of thousands of dollars on his credit cards.
But showing off a cheap sweater or boasting of a bootstraps family background not only helps draw a contrast with Mrs. Clinton’s latter-day affluence, it is also an implicit argument against Mr. Bush.
Mr. Walker, who featured a 1998 Saturn with more than 100,000 miles on the odometer in a 2010 campaign ad during his first run for governor, likes to talk about flipping burgers at McDonald’s as a young person. His mother, he has said, grew up on a farm with no indoor plumbing until she was in high school.
Mr. Rubio, among the least wealthy members of the Senate, with an estimated net worth of around a half-million dollars, uses his working-class upbringing as evidence of the “exceptionalism” of America, “where even the son of a bartender and a maid can have the same dreams and the same future as those who come from power and privilege.”
Mr. Cruz alludes to his family’s dysfunction — his parents, he says, were heavy drinkers — and recounts his father’s tale of fleeing Cuba with $100 sewn into his underwear.
Gov. Chris Christie of New Jersey notes that his father paid his way through college working nights at an ice cream plant.
But sometimes the attempts at projecting authenticity can seem forced. Mr. Christie recently found himself on the defensive after telling a New Hampshire audience, “I don’t consider myself a wealthy man.” Tax returns showed that he and his wife, a longtime Wall Street executive, earned nearly $700,000 in 2013.
The story of success against the odds is a political classic, even if it is one the Republican Party has not been able to tell for a long time. Ronald Reagan liked to say that while he had not been born on the wrong side of the tracks, he could always hear the whistle. Richard Nixon was fond of reminding voters how he was born in a house his father had built.
“Probably the idea that is most attractive to an average voter, and an idea that both Republicans and Democrats try to craft into their messages, is this idea that you can rise from nothing,” said Charles C. W. Cooke, a writer for National Review.
There is a certain delight Republicans take in turning that message to their advantage now.
“That’s what Obama did with Hillary,” Mr. Cooke said. “He acknowledged it openly: ‘This is ridiculous. Look at me, this one-term senator with dark skin and all of America’s unsolved racial problems, running against the wife of the last Democratic president.”