BPJS Kesehatan Needs Better Management

KOMPAS/LAKSANA AGUNG SAPUTRA

President Joko Widodo chats with Muji Purwaningsih, mother of a 2-month-old baby patient, Madiva Halmahera Azahra, at the Abdul Moeloek Regional General Hospital, Bandar Lampung, Lampung Province, Friday (15/11/2019). The President made an impromptu visit to the hospital to have a look at services for patients participating in the National Health Insurance program.

BANDAR LAMPUNG, KOMPAS — President Joko Widodo wants an improvement in the governance of the National Health Insurance-Healthy Indonesia Card program. The President said there was mismanagement in the program administered by the Health Care and Social Security Agency (BPJS Kesehatan).

"We have already paid [bills for] 96 million [participants]. That amount was paid using the state budget, but the BPJS Kesehatan suffers a deficit. That\'s because of mismanagement. This means those who should pay, did not pay. The problem is on the billing side. It must be intensified. If this is not done, [there will be] a deficit. So, inevitably the premium must be increased. Once again, the management at BPJS Kesehatan must be improved," the President said after visiting the RSUD Abdul Moeloek Regional Hospital in Bandar Lampung on Friday (15/11/2019).

According to BPJS Kesehatan data, the number of participants in the country’s universal healthcare program, which is called the National Health Insurance-Healthy Indonesia Card (JKN-KIS), totaled 222.29 million as of Oct. 31, of which 60 percent were low-income earners that received assistance from the government to pay for their insurance premiums (PBI). Some 96 million participants were subsidized by the central government and more than 37 million participants were subsidized by local administration.

"The number of people who get free health services should be around 133 million. Where are they? I want to be sure about it. But, if you look at the percentage here [at RSUD Abdul Moeloek] earlier, those who pay for health services are more [than those who get it for free]," said the President.

KOMPAS/HENDRA A SETYAWAN

A person holds up a mobile phone showing the home page of the Health Care and Social Security Agency (BPJS Kesehatan) application for all Healthy Indonesia National Health Card-Health Insurance (JKN-KIS) policyholders on Monday (4/11/2019) at the offices of BPJS Kesehatan in Pancoran, Jakarta. The premiums for all BPJS Kesehatan policies will be increased in January 2020 under the amendment to Government Regulation No. 82/2018 as stipulated in Presidential Regulation No. 75/2019. Class I premiums will be increased to Rp 160,000, Class II premiums to Rp 110,000 and Class III premiums to Rp 42,000.

Spending of benefits

Indonesia Health Economics Association chairperson Hasbullah Thabrany said two key aspects needed to be addressed in the JKN-KIS, namely the amount of premiums and the spending of benefits.

The government has increased the premiums through the issuance of Government Regulation No. 75/2019 on the health insurance. "If that cannot cover the deficit, the government must cover it using the state budget," he said.

Budget spending also needed to be wiser. Health services needed to be optimized rather than maximized, so that participants could get services through a cost-effective use of funds.

There also needed to be breakthroughs in fixing existing problems, such as the effort to improve collection of premiums from nonemployee participants, the optimized use of local cigarette excise and smooth payments for health services provided by hospitals.

According to BPJS Kesehatan president director Fachmi Idris, there are four strategies to optimize the JKN-KIS. First, strengthening health insurance regulations. Second, developing health insurance programs. Third, strengthening health insurance providers. Fourth, strengthening the health insurance supervision system.

KOMPAS/ISMAIL ZAKARIA

People wait to be served on Tuesday (12/11/2019) at the office of the Health Care and Social Security Agency (BPJS Kesehatan) in Mataram, West Nusa Tenggara. BPJS Kesehatan Mataram achieved 87.5 percent of its universal healthcare target by September 2019.

Regarding the efforts to broaden universal health coverage, BPJS Kesehatan carried out various innovations. To facilitate participant registration, there are more ways to register. With the use of digital technology, participants can register by accessing the JKN Mobile application, the BPJS Kesehatan website and e-Dabu for business entity registration.

Registrations can also be done by calling the BPJS Kesehatan service center and through JKN officials assigned to the community.

A number of regions are also innovating to increase universal health coverage. In Yogyakarta, for example, all citizens who have a Yogyakarta City resident card can register for JKN-KIS third-class services and the fees will be paid by the Yogyakarta city administration. (VIO/LAS/TAN/NCA)