The City Health Agency says its remaining hospital bills of Rp 24 billon (US$2.7 million), which was allocated for medical services provided to poor people (Gakin) in 2007, would affect its budget this year.

The head of the insurance program, Yuditha Endah Trisnaningtyas, said that after the agency paid what it owed, it would have only Rp 195 billion left to finance the insurance scheme for this year.

This budget is far lower than last year's when the agency had to cough up Rp 305 billion.

"We have no choice but to cover our debts with this year's allocation," she told The Jakarta Post on Thursday, referring to the impact of the 2007 claims on the 2008 budget.

She was concerned in particular that programs that make medicine available to victims of disasters and pandemics in the city would have shortfalls.

In 2005, the administration launched Gakin cards to identify residents eligible for low-cost or free health care and food.

The administration also allows residents to apply for a relief letter (SKTM) stating that they are eligible for discounted or free medical care.

Patients may use a SKTM to have fees for medical services waived in part, Gaskin-eligible patients don't have to pay any fees at all.

To obtain an SKTM, applicants must request notification letters from their neighborhood unit chief and subdistrict officials. They also need a verification letter from the community health center nearest them confirming their financial status.

The agency's head, Wibowo Sukijat, said he was still optimistic the agency would survive the year.

He said major flooding last year was the main reason the agency found itself strapped.

"The floods were beyond our capacity. It was unexpected. We allocated a lot of money to assist poor families," Bowo said.

He said the poorest people were suffering the most due to the agency's debts, because some hospitals refused to provide free-of-charge services.

"We know that the poor families suffer a lot. We have heard that many hospitals are refusing to accept the Gakin card. We hope we will receive the funds we need soon to pay the arrears," Yuditha said.

Meanwhile, a member of City Council Commission E which oversees public welfare, Selamat Nurdin, said the administration didn't need to be overly concerned about lack of funds at this point since it still had the option of asking for additional funds via the budget revision mechanism.

"We will discuss budget adjustments in July or August," Selamat said, adding that the agency could ask Governor Fauzi Bowo to see that all required funding was in place.

"We can allocate about Rp 55 billion to 100 billion. The amount of the budget goes up every year due to the people's low purchasing power and increasing health care needs," he said.