Future improvements
Next year, the JKN program will celebrate its tenth anniversary. While it has provided many benefits, it needs to make significant corrections to ensure that it can continue to provide the people of Indonesian access to proper health services. Improving health care services is at the core of future improvement efforts. Systematic service improvements will help the agency maintain its surplus.
This will depend on two things – increasing revenue, more specifically from premium contributions, and improving services by carrying out quality and cost control.
Revenue increases will primarily hinge on a growth in active membership. As of the end of October, 238,430,655 (87.3 percent of the total population) have signed up. Of these, 189,838,682 are active participants and 48,591,973 inactive. This means there are still around 12.6 percent of the population who have yet to join the program, and they are mostly members of the middle and upper class who purchase private health insurance. They should be persuaded to join JKN as participants, and not viewed with suspicion.
If they still refuse, the government should take a firmer stance to force them into membership, and work together to help JKN fund health care services for the sick. Likewise, participants who are in arrears must be encouraged to pay their dues. The government can enforce Government Regulation 86/2013 which imposes sanctions in the form of denial of public services for the still unregistered. The government can offer a discount for arrears payment as an incentive.
Service-wise, the government must increase the benefits of health services guaranteed by JKN program and ensure that all health care facilities – both FKTPs and hospitals – participate in the scheme. Adopting digital technology to improve services will make it easier for participants to use JKN, especially vulnerable groups – the elderly, the underprivileged, the disabled and newborns. They must become part of the improvements to be made.
Read: Digitalization, for better access to non-BPJS Kesehatan health services
Services at health care facilities must be supported by the feasibility of INA-CBG scores (bundled pricing for hospitals) and capitation (payments to FKTP). The government must increase the value of INA-CBG and capitation to improve the quality of services and the welfare of health workers.
Furthermore, Basic Health Needs (KDK) and Standard Inpatient Class (KRIS) must be studied comprehensively, involving members of the community and all stakeholders so that they do not become counterproductive. Improving JKN services is a must to ensure the welfare of all Indonesian people.