Anticipating Impact of Health Insurance Premium Increases
People are expressing their opinions over the planned increase of National Health Insurance (JKN) and Healthy Indonesia Card (KIS) premiums.
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People are expressing their opinions over the planned increase of National Health Insurance (JKN) and Healthy Indonesia Card (KIS) premiums. Participants of the programs hope there will be improvements in service.
JAKARTA, KOMPAS — The government will double National Health Insurance (JKN)- Indonesian Health Card (KIS) premiums beginning in January 2020. The plan has met mixed responses, with some participants expressing no rejections. However, they hope there will be improvements in service, particularly with regard to long lines.
Maya, 59, a resident of South Gandaria, South Jakarta, has received treatment at community health centers (Puskesmas) in South Gandaria subdistrict and Cilandak district for her teeth, ears and general health checks. The service provided is fairly good, although she has to wait several hours.
When she learned that the government planned to double JKN-KIS premiums starting next year, Maya, who was originally a recipient of first-class services, lowered her participation status to second class in October.
“The premium for BPJS Kesehatan [Healthcare and Social Security Agency] for first class services has been raised to Rp 160,000, which is too high for me. So I’ve shifted to second class, which costs Rp 110,000,” she said at Puskesmas Cilandak, Jakarta, on Monday (4 November 2019). This increased rate can be accepted and is not too high for her.
In the beginning, JKN-KIS first-class participants had to pay Rp 80,000 per person monthly. Pursuant to Presidential Regulation No.75/2019 on the amendment to Presidential Regulation No.82/2018 on healthcare security, the premium for first-class participants is now Rp 160,000. Second-class participants, who previously were required to pay Rp 51,000 per person monthly, will have to pay Rp 110,000 next year.
Many others are lowering their participation class, including Yanto, 60, a South Gandaria resident, before the new rates take effect on 1 January 2020. Although the new second-class premium is higher than the old first-class rate, he can still accept the increase.
Apart from the service class lowering, head of the Advocacy Division of BPJS Watch Timboel Siregar warned of the premium increase’s potential to raise the number of inactive participants, who are registered but fail to pay premiums on a routine basis. The situation will prevail among independent participants from poor and disadvantaged groups who aren’t recipients of premium aid (PBI). “Too high premiums reduce the capacity and willingness to pay,” he said.
Long queues
Health Minister Terawan Agus Putranto has promised that the adjustment of premiums will be accompanied by the betterment of service quality. “The reordering of first-level health facilities FKTP) is given due attention,” he said.
The service provided in FKTP, added Terawan, should be better, including the treatment of 144 basic diseases. The quality and competence of medical and health personnel will be improved.
Beyond medical service, residents’ major complaints are among others the long queues and the unavailability of most drugs. People have to line up for hours for registration, medical consultations and collecting drugs from pharmacies.
Matrais, 68, a JKN-KIS participant, when met at the Regional General Hospital (RSUD) of Tarakan, Central Jakarta, for his heart examination, spent 3.5 hours in registration. To consult the doctor, he had to line up again for hours for a 15-minute examination. Matrais, who arrived at the hospital at 8:30 a.m., went home at 4 p.m. after obtaining drugs.
He spent over five hours from registration to drug collection. This Tuesday, he has been asked to return to have an ultrasonographic examination and collect laboratory check results.
The same long line had also to be faced by Yusran, 53, a resident of Tanjung Balai, North Sumatra, when he was treated as a referral outpatient at RSUD-Pirngadi, Medan. He spent over five hours from registration to drug collection. This Tuesday, he has been asked to return to have an ultrasonographic examination and collect laboratory check results.
With such a long queue, S, Purba, 55, a Medan resident being treated at RSUD-Pirngadi, said the JKN-KIS premium increase was very burdensome considering the service quality. For him, lining up for the physician was a tough job because after registering at 10 a.m. the doctor only turned up at 1 p.m. “Waiting for three hours at the dental polyclinic and no doctor was around. In fact, the availability of doctors during service hours is a basic need,” he said.
While the long line for drugs is the complaint of most residents, Ismail 48, a patient using JKN-KIS from Cicurug, Sukabumi, West Java, claimed to have no problem with the increased JKN-KIS premium as long as service is improved. The trouble is that as a JKN-KIS participant he has often found no drugs prescribed by the doctor in the hospital’s pharmacy. “I’ve been forced to buy medicines outside the hospital not covered by BPJS Kesehatan insurance,” he said.
The JKN-KIS premium hike also has the potential to create a manpower cost burden for employers amid the sluggish Indonesian economy. Moreover, the monthly pay limit serving as the basis for calculating the premiums of wage earners as participants increases from Rp 8 million to Rp 12 million. Employers will be required to prepare additional funds for the payment of their workers’ premiums.
“We have no objections as long as the economic and business conditions in Indonesia are fairly good,” said Chairman of Manpower and Social Security of the Indonesian Entrepreneurs Association, Harijanto. (AYU/DAN/NSA/SAYA/RTG/JUD/TAN)