Health Insurance Needs Improving

KOMPAS/WISNU WARDHANA DHANY

A group of women chats on 4 Nov. 2019 in the driveway leading to the emergency unit of Tarakan Hospital in Central Jakarta. Members of the National Health Insurance-Indonesia Health Card (JKN-KIS) still endure long queues at hospitals and other health centers.

JAKARTA, KOMPAS — The quality of the services provided under the National Health Insurance-Health Indonesia Card (JKN-KIS) is yet to meet expectations. This is partly due to the uneven availability of facilities and infrastructure, as well as medical workers. Immediate improvements must be made in light of the planned increase in premiums.

“Universal health coverage must be managed thoroughly, including the quality of health services,” said Indonesian Doctors Association (IDI) secretary-general M. Adib Khumaidi in Jakarta on Thursday (14/11/2019). National Health Day, which fell on Nov. 12, should be used as an occasion to upgrade healthcare services.

The JKN-KIS’s service quality has been a frequent target of customer complaints, primarily regarding the waiting time at health facilities. Eko, 40, who lives in Serpong, South Tangerang, said that he visited South Tangerang General Hospital at 9 a.m. on Monday, but that the number on his waiting room ticket was already at 261.

An increase in the premiums must be followed with increased service quality for [all] customers/

According to National Social Insurance Council chairman Tubagus Achmad Choesni, the national health insurance must provide coverage to all citizens and improvements must be made in service quality. “An increase in the premiums must be followed with increased service quality for [all] customers,” he said.

The improvements in service quality must include ending any and all forms of patient discrimination, regardless of the reason, and cutting down waiting times at hospitals. Improvements should also be made in registration, processing premium payments, paying hospitals and information access.

KOMPAS/HENDRA A SETYAWAN

KOMPAS/HENDRA A SETYAWAN (HAS)04-11-2019==People wait to be served on 4 Nov. 2019 at the Health Care and Social Security Agency (BPJS Kesehatan) in Pancorang, Jakarta.

Uneven service

The Healthcare and Social Security Agency (BPJS Kesehatan) stated that the number of partner medical facilities continued to grow, and had reached 27,315 facilities on 1 Oct. The figure consisted of 10,013 puskesmas (community health centers), 5,253 doctors, 6,645 Pratama health clinics and 2,266 hospitals.

Daniel said he hoped that improving the management of the JKN-KIS program would also improve payments to hospitals as well as health services.

Meanwhile, the Health Ministry stated that the doctor-to-population ratio was 50.2 doctors per 100,000 population, above the recommended World Health Organization (WHO) ratio of 45 doctors per 100,000 population. Indonesia also had a sufficient number of medical specialists at 12.7 specialist doctors per 100,000 population, higher than the recommended ratio of 12.2 per 100,000 population. However, only 11 provinces in the country met the ideal ratio.

Adib said that the uneven distribution of doctors was also a problem, and suggested that the government needed to issue a regulation on physician distribution.

“The government needs to view doctors as an investment. So any regions that have a shortage of doctors should be given a budget for medical education,” he said.

Health Minister Terawan Agus Putranto said that the disparity in physician distribution, especially specialist doctors, would be addressed through a specialist doctor development program as stipulated in Presidential Regulation No. 31/2019, which was issued after the Supreme Court annulled the regulation on the mandatory work of specialist doctors.

Health insurance chairman Daniel Budi Wibowo of the Indonesia Hospitals Association said that evaluating the capabilities and competency of hospitals was a challenge under the JKN-KIS scheme.

Daniel said he hoped that improving the management of the JKN-KIS program would also improve payments to hospitals as well as health services.

“The referential system is not optimum because hospitals and medical workers are not evenly distributed, and neither are medical equipment and quality medicines,” he said.

Daniel said he hoped that improving the management of the JKN-KIS program would also improve payments to hospitals as well as health services.

BPJS Kesehatan president director Fachmi Idris said that he planned to improve the hospital payment system after the premiums were increased.

BPJS Kesehatan currently owes its partner hospitals Rp 21.1 trillion in arrears. (TAN/DIV/NCA)