Regional Administrations Urged to Help Fund JKN-KIS
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JAKARTA, KOMPAS – Regional administrations have been called on to be more actively involved in funding the National Health Insurance- Healthy Indonesia Card (JKN-KIS) program and in improving the quality of healthcare services.
Vice President Jusuf Kalla urged all policymakers, especially in regional administrations, to work together to improve the quality of public health care. “Promotional and preventive efforts must be prioritized in health care,” Kalla said in his opening speech on Thursday (1/17/2019) at the “Sustainable Funding for National Health Insurance Towards Universal Health Care in Indonesia” seminar in Jakarta.
Kalla said that the Healthcare and Social Security Agency (BPJS Kesehatan) had a budget deficit of Rp 16 trillion (US$1.13 billion), but the central government could only cover Rp 10 trillion. The deficit was due to claims from healthcare facilities across the country, including a claim for Rp 150 billion from the Indonesian Red Cross (PMI). One hospital could make a claim for several billion rupiahs.
Regional administrations must therefore be actively involved in improving the quality of health care in their regions. “The high number of patients queuing for healthcare services under the BPJS Kesehatan program should not be the benchmark of a regional administration’s success in improving health care. Instead, this highlights the failure of our [disorganized] environment,” said Kalla.
David Evans, the former director of the World Health Organization’s health systems financing, said that almost all countries complained about financing health insurance programs, even developed countries like Switzerland. “All countries feel that [their health insurance system] is inadequate due to the increasing population,” said Evans.
Therefore, the concept of financial sustainability must be implemented through priority policies. For instance, several countries had imposed taxes on products with health hazards, such as cigarettes and sugary beverages. The higher state income from such taxes would ensure better public health.
Other countries involved the private sector to relieve the state’s health insurance burden. “India, for instance, involves its diaspora – or Indians living abroad – to help fund health care for the domestic population,” Evans said.
He underlined that innovation was critical in resolving healthcare financing problems, including the use of modern technologies.
Cost reduction
University of Indonesia medical school lecturer Rina Agustina said that unhealthy lifestyles placed a higher burden on the JKN-KIS program and contributed to its continuing deficit. “Healthy Community programs will remain empty slogans without optimum implementation,” she said.
World Bank health expert Pandu Harimurti stressed that the JKN-KIS should focus not only on curative activities, but also on launching preventive campaigns. Public perception must change for the people to adopt healthier lifestyles. This could include raising public awareness that detecting diabetes early was cheaper than treating it. “With earlier diagnoses, people would start managing their blood sugar levels,” said Pandu.
In addition, the government should use its healthcare funding more efficiently and accurately through better coordination between policymakers in implementing the JKN program.
Former health minister Nafsiah Mboi said that healthy lifestyles, including ensuring a clean water supply, had a great impact on improving the quality of health care. Hygiene and sanitation in the country yet to reach adequate levels from 1990 to 2017. (PDS/LAS)