The state has scheduled to double the premiums for their universal healthcare system to tackle a rapidly rising deficit experienced during the first five years of its operation that taxpayers have to pay now. It will be an unpopular choice, but courageous steps are required to preserve health facilities for everyone.
Universal healthcare system of Indonesia, covering dental care, medicine, physiotherapy, and chronic care, is one of the most gracious and biggest in many respects. It has covered over 223 million individuals and has intended to serve 90% of the country’s 270 million inhabitants. While the system has effectively delivered healthcare services to more individuals, its facilities and funding are shrinking.
Presidential Regulation No 82/2018 enables for a two-year adjustment of insurance premiums. Nevertheless, the plan to raise them, agreed by multiple public stakeholders ranging from the Ministry of Finance to Vice President Jusuf Kalla, has spurred criticism, especially by politicians who insist that premium hikes must run in conjunction with enhanced quality of health facilities.
Quality is one thing, but insurance management is another urgent problem to be tackled to ensure that universal health care is more efficient and sustainable. According to a detailed audit carried out by the Development Finance Comptroller, hospitals have overestimated their class category so that they can charge more and higher premiums, while businesses understate their workers ‘ numbers and wages so that they can pay lesser premiums.
Acknowledging these two problems alone would drastically boost the finances of BPJS Kesehatan, as would raising awareness among non-wage respondents who have placed a heavy strain on the organization by registering only when ill and not paying premiums when healthy.
When it comes to price increase, nothing is ever easy, but accountability is evident. BPJS Kesehatan requires more revenue to provide health services to Indonesian people that they deserve. Having said that, to make its activities more efficient and effective for a healthier and more productive Indonesia, BPJS Kesehatan requires to improve monitoring and implementation.