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.
Dean Skelos, Albany Senate Leader, Aided Son at All Costs, U.S. Says
Over the last five years or so, it seemed there was little that Dean G. Skelos, the majority leader of the New York Senate, would not do for his son.
He pressed a powerful real estate executive to provide commissions to his son, a 32-year-old title insurance salesman, according to a federal criminal complaint. He helped get him a job at an environmental company and employed his influence to help the company get government work. He used his office to push natural gas drilling regulations that would have increased his son’s commissions.
He even tried to direct part of a $5.4 billion state budget windfall to fund government contracts that the company was seeking. And when the company was close to securing a storm-water contract from Nassau County, the senator, through an intermediary, pressured the company to pay his son more — or risk having the senator subvert the bid.
The criminal complaint, unsealed on Monday, lays out corruption charges against Senator Skelos and his son, Adam B. Skelos, the latest scandal to seize Albany, and potentially alter its power structure.
The repeated and diverse efforts by Senator Skelos, a Long Island Republican, to use what prosecutors said was his political influence to find work, or at least income, for his son could send both men to federal prison. If they are convicted of all six charges against them, they face up to 20 years in prison for each of four of the six counts and up to 10 years for the remaining two.
Senator Kenneth P. LaValle, of Long Island, who serves as chairman of the Republican conference, emerged from a closed-door meeting Monday night to say that conference members agreed that Mr. Skelos should be benefited the “presumption of innocence,” and would stay in his leadership role.
“The leader has indicated he would like to remain as leader,” said Mr. LaValle, “and he has the support of the conference.” The case against Mr. Skelos and his son grew out of a broader inquiry into political corruption by the United States attorney for the Southern District of New York, Preet Bharara, that has already changed the face of the state capital. It is based in part, according to the six-count complaint, on conversations secretly recorded by one of two cooperating witnesses, and wiretaps on the cellphones of the senator and his son. Those recordings revealed that both men were concerned about electronic surveillance, and illustrated the son’s unsuccessful efforts to thwart it.
Adam Skelos took to using a “burner” phone, the complaint says, and told his father he wanted them to speak through a FaceTime video call in an apparent effort to avoid detection. They also used coded language at times.
At one point, Adam Skelos was recorded telling a Senate staff member of his frustration in not being able to speak openly to his father on the phone, noting that he could not “just send smoke signals or a little pigeon” carrying a message.
The 43-page complaint, sworn out by Paul M. Takla, a special agent for the Federal Bureau of Investigation, outlines a five-year scheme to “monetize” the senator’s official position; it also lays bare the extent to which a father sought to use his position to help his son.
The charges accuse the two men of extorting payments through a real estate developer, Glenwood Management, based on Long Island, and the environmental company, AbTech Industries, in Scottsdale, Ariz., with the expectation that the money paid to Adam Skelos — nearly $220,000 in total — would influence his father’s actions.
Glenwood, one of the state’s most prolific campaign donors, had ties to AbTech through investments in the environmental firm’s parent company by Glenwood’s founding family and a senior executive.
The accusations in the complaint portray Senator Skelos as a man who, when it came to his son, was not shy about twisting arms, even in situations that might give other arm-twisters pause.
Seeking to help his son, Senator Skelos turned to the executive at Glenwood, which develops rental apartments in New York City and has much at stake when it comes to real estate legislation in Albany. The senator urged him to direct business to his son, who sold title insurance.
After much prodding, the executive, Charles C. Dorego, engineered a $20,000 payment to Adam Skelos from a title insurance company even though he did no work for the money. But far more lucrative was a consultant position that Mr. Dorego arranged for Adam Skelos at AbTech, which seeks government contracts to treat storm water. (Mr. Dorego is not identified by name in the complaint, but referred to only as CW-1, for Cooperating Witness 1.)
Senator Skelos appeared to take an active interest in his son’s new line of work. Adam Skelos sent him several drafts of his consulting agreement with AbTech, the complaint says, as well as the final deal that was struck.
“Mazel tov,” his father replied.
Senator Skelos sent relevant news articles to his son, including one about a sewage leak near Albany. When AbTech wanted to seek government contracts after Hurricane Sandy, the senator got on a conference call with his son and an AbTech executive, Bjornulf White, and offered advice. (Like Mr. Dorego, Mr. White is not named in the complaint, but referred to as CW-2.)
The assistance paid off: With the senator’s help, AbTech secured a contract worth up to $12 million from Nassau County, a big break for a struggling small business.
But the money was slow to materialize. The senator expressed impatience with county officials.
Adam Skelos, in a phone call with Mr. White in late December, suggested that his father would seek to punish the county. “I tell you this, the state is not going to do a [expletive] thing for the county,” he said.
Three days later, Senator Skelos pressed his case with the Nassau County executive, Edward P. Mangano, a fellow Republican. “Somebody feels like they’re just getting jerked around the last two years,” the senator said, referring to his son in what the complaint described as “coded language.”
The next day, the senator pursued the matter, as he and Mr. Mangano attended a wake for a slain New York City police officer. Senator Skelos then reassured his son, who called him while he was still at the wake. “All claims that are in will be taken care of,” the senator said.
AbTech’s fortunes appeared to weigh on his son. At one point in January, Adam Skelos told his father that if the company did not succeed, he would “lose the ability to pay for things.”
Making matters worse, in recent months, Senator Skelos and his son appeared to grow wary about who was watching them. In addition to making calls on the burner phone, Adam Skelos said he used the FaceTime video calling “because that doesn’t show up on the phone bill,” as he told Mr. White.
In late February, Adam Skelos arranged a pair of meetings between Mr. White and state senators; AbTech needed to win state legislation that would allow its contract to move beyond its initial stages. But Senator Skelos deemed the plan too risky and caused one of the meetings to be canceled.
In another recorded call, Adam Skelos, promising to be “very, very vague” on the phone, urged his father to allow the meeting. The senator offered a warning. “Right now we are in dangerous times, Adam,” he told him.
A month later, in another phone call that was recorded by the authorities, Adam Skelos complained that his father could not give him “real advice” about AbTech while the two men were speaking over the telephone.
“You can’t talk normally,” he told his father, “because it’s like [expletive] Preet Bharara is listening to every [expletive] phone call. It’s just [expletive] frustrating.”