World's largest healthcare scheme to roll out in Indonesia

[Reashot Xigwin]

State-owned insurance companies in Indonesia are bracing for the rollout of what will be the world's largest healthcare scheme, meaning better access to health services for millions of Indonesians who previously could not afford them.

File photo: A patient receives medical attention at a hospital in Yogyakarta, Indonesia. (AFP/Bay Ismoyo)

JAKARTA: State-owned insurance companies in Indonesia are bracing for the rollout of what will be the world's largest healthcare scheme, meaning better access to health services for millions of Indonesians who previously could not afford them.

Roughly a third of Indonesia's population lives under the poverty line and has no or very little access to healthcare.

A new healthcare scheme to take effect on January 1 will provide millions of the poor with free healthcare, including treatment for major health conditions and chronic diseases.

"One time my child was treated in a hospital for three days and the bill was so expensive. If we are covered by the healthcare insurance scheme, I'd be happy because it means free medical treatment," said Munah, a patient.

The new healthcare system is designed as a cross subsidy scheme.

Professor Hasbullah Thabrany, chairman of the centre for health economics and policy studies, said: "The higher income will pay a nominally higher contribution because the percentage is about the same. Lower income will pay a nominally lower contribution, but when it comes to the benefit, (both groups) will get the same medical benefit.

“So by this design, the rich can share to the poor, the healthy can share to the sick and the young will also share to the old people."

Five per cent of each person's salary will go to the insurance premium while the poor will be given free health insurance.

A new umbrella agency called the Social Security Organising Body will manage the health coverage for Indonesians already subscribed to the various state insurance schemes.

The agency will be quasi-public and aims to get rid of bureaucratic red tape and late insurance claim payments that plague the current healthcare system.

It will have an estimated 117 million subscribers to begin with and will gradually cover all Indonesians by 2019.

The scheme will also insure domestic workers and contract-based workers who currently do not qualify for workers' insurance.

In anticipation of an influx of people seeking free healthcare at hospitals in the next two years, the Jakarta administration is also stepping up its health services.

"In Jakarta there's a policy that will take effect in 2015 which requires all local health clinics in the district level to have medical wards. Right now not all of the city's health clinics have wards," said Health Clinic head Dr Dyah Eko.

The new health scheme is a mammoth project -- in the first stage, it will cover 86 million uninsured citizens who are considered poor, which is twice the number compared to uninsured Americans covered under Obama's new Affordable Care Act.

However, experts acknowledge that the current state subsidies for the poor are still not enough and that efforts are being made to increase state subsidies for the poor to better suit average market medical costs.

- CNA/ec

World's largest healthcare scheme to roll out in Indonesia - Channel NewsAsia

 

[Dubious]

Awesome!! Good Luck Indonesia!!

 

[Reashot Xigwin]

Awesome!! Good Luck Indonesia!!

Good Luck is something that will be needed.

 

[Dubious]

Good Luck is something that will be needed.

Yup it is a big project catering for an enormous population....

 

[Reashot Xigwin]

Still crossing my fingers

 

[Reashot Xigwin]

Indonesia's innovative healthcare scheme

System is expected to be the world's largest with 247 million covered by 2019, but critics have their doubts.

Jack Hewson Last updated: 16 Jan 2014 11:04

Bapak Untung, 51, is now able to receive specialist heart treatment in the capital Jakarta [Jack Hewson/Al Jazeera]

Jakarta, Indonesia - Andre Soni Asmara isn't sure of the exact cause of the sporadic pain he feels in his chest, or the frequent tiredness he experiences. For the past two years, he has suspected heart disease, which is hereditary in his family. His symptoms worry him, but he is more concerned for his son, Rizky.

Telling his story on the front steps of the specialist National Cardiovascular Centre in Jakarta, Andre fights back tears as he recounts the battle to save his four-year-old boy's life. Rizky was born under-weight in June 2009 and experienced heart failure shortly thereafter. He has needed intermittent hospital treatment ever since.

"He was turning blue when he was born, he needed round-the-clock care and had to have fluid drained from his lungs. I was worried sick," Andre says.

To fund his son's treatment Andre was forced to borrow 70m rupiah ($5,917) - more than three times what he earns in a year as a self-employed interior designer. "When I came to the hospital they refused me treatment [unless I met all the costs]. For ICU, it's 4m rupiah just for one day. I asked them, 'Can the poor not be sick?' If you're poor you can't be sick in this country because you can't afford it," Andre says.


The 44-year-old says the stress of meeting his son's medical bills has triggered his own health condition. "I've had to make a choice, and I decided I would be prepared to die so my son can have the treatment," says Andre.


Doubts voiced over Indonesia health scheme

Until now, he would rather not know the reason for the discomfort in his chest because he's unable to pay the cost of his own therapy. But this is set to change.

As of January 1, Andre is able to register for a new national health insurance programme managed by Indonesia's Social Security Organising Body (BPJS). The scheme is set to become the world's largest by 2019, when the government projects all 247 million Indonesian citizens will be covered.

'Sandwich people'

Indonesia's multiple existing health insurance carriers will be united under the BPJS umbrella, changing little for those who are already covered by insurance. But for 80 million Indonesians who, like Andre, are not deemed poor enough to qualify for the current Jamkesmas healthcare system and are not rich enough to buy private insurance, BPJS will mean affordable access to therapies for life-threatening illnesses.

One of the primary aims of BPJS is to provide coverage for those between the rich and extremely poor, whom policy analysts refer to as the "sandwich people". Now those who are self-employed or work in the "informal sector" will be able to pay contributions of between 25,000 rupiah ($2.10) and 60,000 ($5.10) rupiah a month to gain access to any service deemed medically necessary, from a routine checkup to open-heart surgery.

Integration of the service also means patients will have more choice in where they can access treatment, as long as they can afford to travel.

On the third-floor ward of the National Cardiovascular Center, 51-year-old Bapak Untung is being treated for acute decompensatory heart failure. He has suffered severely swollen feet, breathlessness and fluid in his lungs, exacerbated by the inadequate treatment he received from his local hospital in Bogor, 70 kilometres away in West Java. All he requires is a simple drug treatment to reduce the fluid in his lungs, but this was unavailable to him in his hometown.

Andre Soni Asmara was forced to borrow $5,920 for his five-year-old son's heart treatment [Jack Hewson/Al Jazeera]

After hearing about BPJS through a friend, he immediately took advantage of the access to specialist treatment in the capital, Jakarta.

"If this system had existed a long time ago, I probably would be better by now," Bapak says. "I think this programme is a bit late, but I'm very relieved it's here. Better late than never."

Long time coming

It's taken the government 10 years to set up BPJS - mandated by the Law on the National Social Security System passed in 2004, which ruled that all Indonesians must be covered by social insurance.

Critics claim government delays have been partly attributable to opposition from employers, for whom paying mandatory insurance premiums will increase labour costs. "President Susilo Bambang Yudhoyono's government has not been keen to implement because his cabinet is too neoliberal - they don't think it will be a good programme for business," says Hasbullah Thabrany, a health-policy expert from the University of Indonesia.

In an effort to expedite the Yudhoyono administration's glacial progress, in 2010 the government was successfully sued by the Social Security Action Committee (KAJS), which advocates for workers' rights.

"The central Jakarta Court decided that the government had failed and neglected [its duties], and the government was sentenced to implement the law as soon as possible," Hasbullah says, chuckling. "Maybe only in Indonesia do you hear about cases like that."

The professor welcomes the arrival of the scheme, but sees several obstacles in its rollout. He is primarily concerned by the lack of public information that has been made available about BPJS. According to Hasbullah, there has been a limited campaign through TV and radio advertisements, but public knowledge about the programme is poor.

The central Jakarta Court decided that the government had failed ... and was sentenced to implement the law as soon as possible. Maybe only in Indonesia do you hear about cases like that.

- Hasbullah Thabrany, University of Indonesia

In his consultations with the government, Hasbullah recommended an allocation of at least 1tn rupiah ($83m) for public education, and the "socialisation" of the programme, but he says the Department of Health has set aside only 20bn rupiah ($1.7m).

"I suppose with many people on the street, for example a taxi driver - a good example of the sandwich people, [who until now have not been able to get coverage] - they don't know about this, about the national insurance," he says.

"More than 50 percent will not be aware that they have cover. If you ask me to grade this, I would give it a grade C - a fail [in the Indonesian education system] for socialisation."

Enough money?

Hasbullah also anticipates the 19.9tn rupiah ($1.7bn) that has been allocated to the health ministry for 2014, will only meet 40 percent of the market costs of care.

Hasbullah says while the new system will push much of the burden of payment to employers and healthcare providers, and the health budget will be inadequate to maintain, let alone improve, the quality of care.

Defending the financing for the scheme, Deputy Health Minister Ali Ghufron Mukti said he was presiding over the largest health budget in Indonesia's 69-year history, and more funds would be allocated in the coming years.

"I think that we will spend more money in the future. It is necessary to increase our health infrastructure. So we are planning step-by-step, so if not today, then tomorrow or the day after tomorrow," he says, adding the process of spreading the word would be spread over five years.

"Indonesia is a big country, we cannot socialise the programme in one or two days. We have a roadmap, and we hope this roadmap will finish in January 2019," he said.

According to the Department of Health Indonesia's population is currently cared for by 85,000 general practitioners and 25,000 specialist doctors. While this meets adequate standards of coverage determined by the United Nations, there remain concerns over the regional distribution of doctors.

In Jakarta there is a high concentration of specialists, but outside of the archipelago's major cities specialist numbers are much lower and the quality of facilities can be hazardously poor. The task of coordinating the merger of Indonesia's half dozen existing state health insurance providers will also present significant challenges.

For Andre his optimism and relief that BPJS has finally arrived is tempered by his doubts about the healthcare programme's future.

After working as a journalist between 2000 and 2004, his work reporting on an endless succession of corruption scandals leaves him unsure whether or not the government is capable of presiding over the world's largest health insurance scheme.

"All the bureaucracy here is very bad. Unless you're rich, you can't take anything for granted," Andre says.

Indonesia's innovative healthcare scheme - Features - Al Jazeera English

 

[naveen mishra]

yes medical is highly expensive here.....as compare to average income of people.....
that really needed .........

 

[AUz]

Great!

Best of luck to Indonesia!

 

[KingMamba]

You wrote scheme and made it sound like a bad thing though.

 

[Reashot Xigwin]

Bill Gates supports Indonesia Health Fund establishment
Wed, March 12 2014 12:55 |


Bill Gates. (REUTERS/Tobias Schwarz )

"The presence of Bill Gates in Indonesia early next month will give a good impetus to local business makers to join Indonesia Health Fund," Coordinating Minister for People`s Welfare Agung Laksono said.

Jakarta (ANTARA News) - American business magnate, investor, computer programmer, inventor and philanthropist William Henry "Bill" Gates III will soon arrive in Jakarta to support the establishment of Indonesia Health Fund (IHF), a minister has stated.

"The presence of Bill Gates in Indonesia early next month will give a good impetus to local business makers to join Indonesia Health Fund," Coordinating Minister for Peoples Welfare Agung Laksono stated here on Tuesday.

Agung explained that IHF is expected to help the Government of Indonesia overcome numerous health problems, particularly those endured by the poor community in the country.

Therefore the minister has encouraged all business makers in the country to participate in the Indonesia Health Fund program to overcome health problems in Indonesia.

Agung added that Bill Gates is expected to arrive in Indonesia early in April 2014 and is scheduled to visit a number of community health centers and donate funds for the IHF.

Meanwhile, Mayapada Group Chairman and CEO Dato Sri Taher stated that Bill Gates initiative to donate funds for IHF could be an example for business makers in Indonesia to follow.

"With the establishment of IHF, the business makers in Indonesia are expected to be willing to allocate some of their profits toward the needs of the people at large," Taher noted.

He pointed out that the donation from the business makers could then be used to overcome major health problems like malaria, tuberculosis (TBC), dengue fever, and others including family planning programs.

According to World Health Organization (WHO), around 50 percent of Indonesian population live in malaria prone areas.(*)
Editor: Heru

COPYRIGHT © 2014

Bill Gates supports Indonesia Health Fund establishment - ANTARA News

Still here hoping it will fly.

 

[Arya Desa]

National healthcare is both inefficient and puts the lives of people in jeopardy. Government-selected death panels will decide if people live or die. Many people will die in the waiting room lobbies, or die from not seeing a specialist on time. Doctors unanimously agree that national healthcare is more bureaucracy and will result in the death of many , along with a diminished healthcare sector. Shame on indonesia for putting political gains over their own people.

 

[Reashot Xigwin]

Indonesia Wasn’t Prepared For Its Healthcare Scheme

• News & Review
• Social

Posted on 16 hours ago by Stella Nathania Wibowo

The 2nd Congress of Indonesian Diaspora was held in Jakarta last month (18th – 20th Aug 2013), where a discussion about the Indonesian public healthcare system was held.

The new national healthcare scheme under the law on Social Security Agency (Badan Penyelenggara Jaminan Sosial, BPJS) in Indonesia has caused a wave of patients surging into Jakarta hospitals since it came into effect last November. What is worrying is that there haven’t been enough healthcare providers to deal with the overwhelming number of mostly underprivileged patients now seeking treatment.

In May, a baby girl named Dera died of respiratory complications after being refused admission by 10 hospitals in Jakarta who claimed there was no more space for treatment in their wards. Although there has been a 70 percent increase in the number of treated patients in Jakarta hospitals since November, critics blame the government’s new healthcare scheme for the girl’s death.

As the fourth most populous country in the world, with 247 million people, Indonesia ranks among countries with the lowest number of hospital bed per person at 6 beds for every 10,000 people. This is four times below the global average according to the World Bank, with India and Thailand at 9 and 21 beds per 10,000 respectively.

In order to meet global standards by 2015, U.S. business consultancy Frost & Sullivan estimates that Indonesia will need to add 400,000 more hospital beds.

Hope for Progress

To alleviate the hospital overcrowding problem, the government will need to educate the public on the use of puskesmas (community health centre) and local clinic services, instead of going directly to hospitals, as a first resort to deal with their illnesses.

Fortunately, the government is not alone in confronting Indonesia’s healthcare problems. The private sector makes up about 60 percent of the country’s total healthcare expenditure. Indonesia’s largest listed pharmaceutical company, Kalbe Farma is investing 20 billion rupiah ($2 million) a year to build more clinics in Jakarta through 2018.

Furthermore, the implementation of BPJS law has resulted in golden opportunities for the private sector to increase their investments in hospitals and provide quality treatments to cater for the wealthier Indonesians who prefer not to queue in the public hospitals.

Companies like Kalbe Farma Group, Sinar Mas Group, Lippo Group, and Ciputra Group see a lucrative business in this area and are currently expanding their hospital businesses to increase the healthcare capacity in Indonesia for the increasing number of middle income households.

Overall, Indonesia’s public and private health care expenditure has increased by a compound average growth rate of 14.6 percent since 2007 under the BPJS law, totaling $26.9 billion in 2012. This growth is expected to continue, with Frost & Sullivan forecasting total healthcare expenditure to reach $60.6 billion by 2018.

The government said it would double its coverage expenditure to $1.64 billion next year for the poor and so-called “near poor”.

The shortage of capacity, medical professionals, as well as nurses in Indonesia will not be gone so soon, therefore an expansion of healthcare through universal insurance scheme together with a rapid development of new hospital facilities is a critical process at this time. It is an ambitious undertaking by the government, and problems will certainly rise in the future, but the role played by private sector cannot be trivialised. Furthermore, the government need to work closely with private sector in the sharing of information and coming up with strategic solutions for the immediate availability of healthcare to the people, especially the ones living in the rural areas.

(Photo credit: wikimedia.org)

Indonesia Wasn't Prepared For Its Healthcare Scheme | Global Indonesian Voices

 

[Reashot Xigwin]

Bill Gates Visits Jakarta to Pledge $40m to Indonesia Health Fund
By Vanesha Manuturi & Primus Dorimulu on 08:15 am Apr 08, 2014
Category Featured, Health, News
Tags: Bill Gates, Gates Foundation, Indonesia healthcare

Bill Gates, founder of Microsoft and co-chairman of the Bill and Melinda Gates Foundation, leaves after participating in Paris on April 1, 2014 in the presentation of the launching of “One Youth Ambassadors” a program gathering 100 young European volunteers who will campaign against extreme poverty particularly around the European Elections in May 2014. The organization One was co-founded by Irish singer and frontman of U2, Bono. (AFP Photo/Eric Piermont)

Microsoft founder and philanthropist Bill Gates has pledged $40 million to the Indonesia Health Fund, dedicated to combating diseases such as tuberculosis, polio, HIV-AIDS, and malaria both in and outside of Indonesia.

The fund was set up through a cooperation between the Seattle-based Bill and Melinda Gates Foundation and the Tahir Foundation, owned by Mayapada chief executive Dato’ Sri Tahir.

“In many countries, the very wealthy don’t have time to fund causes. To assemble this group and get [the wealthy] involved in giving is amazing,” Gates told the Jakarta Globe.

Gates, who is the richest person in the world according to Forbes, visited Jakarta on Saturday for the launch of the fund. He signed a memorandum of understanding with Tahir and eight other Indonesian business figures on Saturday, who each committed $5 million.

Other business figures include Intiland chief executive Hendro Gondokusumo, Samali Hotel and Resorts chief executive Adrian Bramantyo Musyanif, Ted Sioeng of Sioeng Group and Modernland president commissioner Luntungan Honoris.

“This is a milestone for health as a philanthropic cause here in Indonesia,” said Gates, who donates 95 percent of his income, about $4 billion annually, to the Gates Foundation. “Once you get involved in health, it’s hard not to stay involved,” he added.

Indonesia, along with 10 other countries, were officially certified by the World Health Organization to be polio-free last month.

Despite that achievement, malaria remains rampant in the country.

According to Gates, one of the biggest issues in combating diseases such as polio and malaria is giving everybody equal access to vaccines.

“Vaccines are magic. Smallpox was killing 2 million children every year, then some people went out and made sure every body got this vaccine. They eventually drove the cases to absolutely zero,” he said.

However, the problem is in funding these research and innovation efforts, Gates added.

“The rich countries don’t pay because they don’t have malaria and the poor countries don’t because they don’t have the money, and so it’s become a dilemma,” Gates said, adding that one of the ways to tackle the problem was to give a huge incentive for drug companies to invent new drugs and vaccines.

“Trials are very expensive and we demand super high quality and very complex trials to look for any side effect at all. It also requires incredible and specific skill.

“Companies must seek innovations in providing equal access to vaccines,” Gates said.

Another solution, according to Gates, is tiered-pricing.

According to the tiered-pricing model, the rich pay a higher price for the medicine, the middle classes pay the median price, and the poor pay nothing, he said.

“Historically, we haven’t done a good job at this. A new medicine will be introduced and poorer countries won’t receive it for 20 years.

“You wait until the cost of manufacturing goes down instead of figuring out how to do the tiered pricing from the beginning,” he added.

According to Gates, about 70 percent of children in Indonesia currently, have access to vaccines.

But while this is higher than most countries, he urged Indonesia to continue improving.

“If you actually step back and look at the last 50 years, this is an amazing period by any measure — lifespan, democracy — and Indonesia is two-thirds of the way towards achieving these things,” he said.

Bill Gates Visits Jakarta to Pledge $40m to Indonesia Health Fund - The Jakarta Globe

 

[Reashot Xigwin]

Indonesia needs a healthcare revolution
Vincent S.K. Chan, Jakarta | Opinion | Thu, June 05 2014, 10:51 AM

Opinion News
Some promising news lies in the pages of a recent study by the Health Ministry: Hypertension, one of Indonesia’s most common non-communicable diseases (NCDs), has decreased in prevalence between 2007 and 2013, according to the Ministry’s data. While new measuring systems may slightly skew the results, the study suggests that increased awareness about NCDs as serious health threats has contributed to a reduction in new hypertension cases.

Unfortunately, NCDs remain the number one cause of death in Indonesia, and worldwide. They continue to kill more than 36 million people annually, with nearly 80 percent of NCD deaths — that’s 29 million — occurring in low- and low-middle income countries like Indonesia. Each year, more than 2.5 million people in Southeast Asia die from a non-communicable disease. Why is such a serious health crisis not a major public priority?

Maybe NCDs would gain more attention if we understood them as more than a health threat: They are also a tremendous economic burden. In Indonesia, where the prevalence of infectious diseases like bacterial diarrhea, typhoid, dengue, and malaria is also high, NCDs place an additional strain on an over-burdened and underfunded healthcare system. NCDs increase poverty, impede development, threaten health systems and are a major cause of disability and health inequality, according to the ASEAN Noncommunicable Disease Network in 2013.

NCDs are also largely preventable. The majority of premature deaths in Indonesia could be prevented with lifestyle changes. Tobacco use, the harmful use of alcohol, unhealthy diet, and a sedentary lifestyle are primary risk factors for cardiovascular diseases, cancers, respiratory diseases, and diabetes — diseases that account for 80 percent of NCDs worldwide, according to WHO. Indonesians are living longer, and the middle class is growing. But this does not mean Indonesians are getting healthier. The aging population faces a host of chronic diseases that will continue to threaten Indonesia’s development.

But change is possible. It is in our capacity to be healthier. We can reduce risk factors for NCDs by limiting tobacco and alcohol use. We can improve our diet by cutting back on salt, saturated fat and sugar, and we can incorporate more physical activity into our daily lives. In fact, according to a report by Richard Horton published in The Lancet (2013), such changes may prevent more than 37 million deaths worldwide by 2025.

But in order to promote lifestyle change on a national scale — as well as effectively monitor and treat patients already suffering from NCDs — Indonesia needs a healthcare revolution. Since 2006, disease predominance has shifted from communicable diseases such as malaria and tuberculosis (TB) to NCDs.

Indonesia needs a clinical approach to NCDs that differs from that of acute illnesses. Intervention must be holistic; it must prioritize self-management, long-term treatment, and palliative care. New innovations in self-screening, for example, will help patients to monitor their own bodies for warning signs and help doctors to detect disease earlier for more effective treatment. Innovations in imaging technologies will improve detection and intervention procedures and increase NCD patient survival rates.

Collaboration is key to the healthcare revolution: Technological innovations from private companies provide crucial contributions to the efforts of healthcare providers and local national governments to provide appropriate healthcare. Those innovations, applied to the entire cycle of healthcare — from prevention, screening and diagnosis through to treatment and observation — should focus on combating NCDs.

In 2012, Philips Healthcare hosted a series of seven roundtable discussions on non-communicable diseases in cities across Southeast Asia. This was followed in 2013 with the joining of policy thinkers, academics, and clinicians to establish the ASEAN NCD Network, which published a report highlighting effective case studies in NCD prevention and treatment in our region.

Three programs identified by the Network are operating in Indonesia: The “See & Treat” Cervical Cancer Screening program, for example, has introduced the Visual Inspection with Acetic Acid (VIA) method to detect cervical cancer. This allows healthcare providers to detect pre-cancerous cells with the naked eye using a common household ingredient: vinegar. In a country where a woman dies as a result of cervical cancer every hour, the impact of this affordable and easily implemented innovation will be unprecedented. In fact, over a 15-year period, a similar program in India resulted in a 31 percent reduction in cervical cancer deaths.

Then there is the Ramadhan Diabetes Camps, initiated by Aman Pulungan for the comprehensive management of Type 1 diabetes among children. With initial funding provided by the World Diabetes Foundation (WDF), Aman and his colleagues helped to facilitate training for doctors and nurses in T1DM and Diabetic Ketoacidosis (DKA), roadshows at schools and family events, diabetes camps, and parent support groups and mass media campaigns to increase awareness about pediatric diabetes.

This is especially important during the month of Ramadhan: Diabetic children who wish to fast can learn how to count calories, inject the right dosage of insulin, and properly monitor their blood sugar levels.

Indonesia needs a healthcare revolution | The Jakarta Post

Still here.

 

[Indos]

Indonesia's National Health Insurance Program: Rising Financial Mismatch
03 March 2016 |

• Jaminan Kesehatan Nasional
• Badan Penyelenggara Jaminan Sosial
• National Health Insurance Program
• BPJS
• Health Insurance
• Healthcare
• Health

There is a growing mismatch between claims paid and premiums received by Indonesia's Healthcare and Social Security Agency (Badan Penyelenggara Jaminan Sosial, or BPJS Kesehatan). This year the deficit could reach IDR 9.8 trillion (approx. USD $731 million), leading to concern about the financial sustainability of the program and the need to search for additional and innovative ways to fund Indonesia's National Health Insurance (Jaminan Kesehatan Nasional, or JKN) program.

Last year the deficit was recorded at IDR 4 trillion (approx. USD $299 million), as claims paid reached a value of IDR 58 trillion, while premiums received stood at IDR 54 trillion. This year the deficit is estimated to grow sharply to IDR 9 trillion based on the following calculation: premiums collected are estimated at IDR 23,000 per client per month (up from IDR 19,225 last year), while the program's operational costs are estimated at IDR 36,000 per client, per month.

The central government of Indonesia plans to raise this year's premium from IDR 19,225 per client, per month to IDR 23,000. However, this plan is still being processed by Indonesia's Ministry of Law and Human Rights. However, the late implementation of the new tariff will not cause a rising mismatch according to M. Ikhsan, spokesman for BPJS Kesehatan because the agency will receive the difference between both tariffs (per 1 January 2016) in subsidy from the central government's 2016 State Budget.

Indonesia's National Health Insurance Program encounters a few basic problems. Firstly, the number of Indonesians making use of healthcare services provided under this program exceeds the number of people paying their monthly premiums (hence causing a claims ratio over 100 percent). Secondly, there is still a large number of healthy Indonesian workers in the private sector who do not participate in the program. Lastly, healthcare services in Indonesia - both quantitatively and qualitatively - are still not optimal (and this could make part of the program's participants reluctant to pay a higher monthly premium).

The Indonesian government targets to provide universal health care to all Indonesians by the year 2019. However, a study conducted by the University of Indonesia predicts that BPJS Kesehatan will have an accumulated deficit of IDR 173 trillion (approx. USD $1.9 billion) by that same year provided no changes are made to the existing payment scheme.

http://www.indonesia-investments.co...ce-program-rising-financial-mismatch/item6563

National healthcare is both inefficient and puts the lives of people in jeopardy. Government-selected death panels will decide if people live or die. Many people will die in the waiting room lobbies, or die from not seeing a specialist on time. Doctors unanimously agree that national healthcare is more bureaucracy and will result in the death of many , along with a diminished healthcare sector. Shame on indonesia for putting political gains over their own people.

Not in Indonesia case, I also have some family members that has used this service. If you see the deficit it makes you understand that we dont slow things when medical procedure is needed.

The monthly payment is so low actually, raising 100 percent is still not difficult even for poor family according to me.