Reviewing the costs of Cooperative Vaccination

Timboel Siregar BPJS Watch Advocacy Coordinator and OPSI-KRPI General Secretary

IO – Vaccination is a necessary move to generate herd immunity among the people so that we can obstruct COVID-19 infection, reduce the number of people suffering from COVID-19, and ensure that the public can remain economically and socially productive. We continue the effort to achieve the Government target vaccination for 181 million citizens, even though there are various obstacles, including the people’s awareness and willingness to get themselves vaccinated, the vaccine supply available, and the budget to buy vaccine. 

Faster vaccination is meant to gain the support of the people, as it will help them recover their health and recover the national economy faster. The people’s mobility can be increased so that they can recommence moving goods and services – with strict observance of health protocols of 5M (mencuci tangan, menggunakan masker, menjaga jarak, menjauhi kerumunan, mengurangi mobilitas – washing hands, wearing masks, maintaining physical distance, staying away from crowds, reducing mobility) – to ensure that we achieve the targeted economic growth of the year in the 4.5% to 5.5% range. 

Government vaccination is still ongoing in stages, as planned: first in line for vaccinations are health workers and medical students, then the State’s security workers (members of the police and the army) and Civil Apparatus providing public services and frequently in contact with them, followed by the elderly. 

The remainder of the people, including private formal workers, are still waiting their turn. In order to accelerate the vaccination of these formal workers throughout Indonesia and their families, the Government provides a Cooperative Vaccination scheme funded by employers. The Cooperative Vaccination is a good idea to get these workers and their family immune to COVID-19, in turn maintaining their health and productivity. 

Provisions concerning Cooperative Vaccination are regulated in the Regulation of the Minister of Health No. 10 of 2021 concerning the Implementation of Vaccination in order to Mitigate the COVID-19 Pandemic. Specifically, the Regulation details in its Article 43 Paragraph (1) that the costs of Vaccination Programs for COVID-19 priority vaccine beneficiaries are covered by National and Regional Budgets, while Cooperative Vaccination (also called “Independent Vaccination”) for formal workers, funded by employing companies. The Government officially sets the vaccine of purchase price for Cooperative Vaccination at IDR 321,660.00 per dose and its maximum vaccination service fees at IDR 117,910 per dose. In other words, it will cost the companies IDR 439,570.00 for each single dose per worker, and IDR 879,140.00 for the complete vaccination regime of two injections per worker. The maximum vaccination service fee for Cooperative Vaccination provided by privately-owned health facilities includes a margin of 15%, but does not cover Income Tax.

This pricing range is set in a Decree of the Ministry of Health Number HK.01.07/ MENKES/4643/2021, concerning the Setting of Purchase Price for (COVID-19) Vaccine Produced by Sinopharm through Direct Appointment of PT Bio Farma (Persero) for the Procurement of COVID-19 Vaccine and the Maximum Service Fees for Cooperative Vaccination. 

This Government-set price level is naturally much higher than the price for Vaccination in the Program wholly funded by the Government. This IDR 879,140.00 per worker price level will burden businesses, especially those with many workers (work-intensive businesses). However, I hope that all entrepreneurs who can afford it to provide Cooperative Vaccination to workers and their immediate family members, without asking these workers to pay any costs whatsoever. This request is made in line with the mandate of Article 3 Paragraph (5) of the Regulation of the Minister of Health No. 10 of 2021, which states that workers, immediate families of workers, and other individuals related to the worker’s family as beneficiaries of COVID-19 vaccine in the Cooperative Vaccination scheme do not pay anything. The budget spent by entrepreneurs for vaccination should be counted as an HR investment, as it is an effort to preserve workers’ health and productivity. 

The COVID-19 vaccination is part of the Government’s effort to involve entrepreneurs in work safety efforts, as mandated by law as early as Law No. 1 of 1970. Article 14LettercofLawNo.1of1970 states that entrepreneurs must provide work safety to their workers without any cost to the workers whatsoever. Similarly, Law No. 13 of 2003 concerning Employment obliges entrepreneurs to provide Work Health, Safety, and Environment measures for their workers. I believe that this high price will make many companies reluctant to implement Cooperative Vaccination in their place of business, slowing down the overall speed of vaccination. Even though vaccination is extremely important, entrepreneurs will naturally prioritize their outward cash flow towards production and worker wages, and they hope to get into Government vaccination Program and let the Government funds the vaccination of their workers and families. Currently, many of the entrepreneurs hit by COVID-19 have not recovered and their cash flow is still low. The Government should review the high cost of Cooperative Vaccination and allow Cooperative Vaccination to be performed in health facilities where Governmental Vaccination Program is implemented. The provisions of Article 33 of Minister of Health Regulation No. 10 of 2021 allows the Government to cooperate with private businesses in terms of providing health workers and facilities for COVID-19 vaccination. This can be interpreted to mean that the Government may allow Cooperative Vaccination to be implemented in health facilities for the Government Vaccination Program, which will reduce its costs. Article 33 can override the provisions of Article 22 Paragraph (1) and Paragraph (2), which states that Cooperative Vaccination services may only be provided in health service facilities belonging to individual people or corporations that satisfy specific requirements, and that are not facilities where the Government Vaccination Program is implemented. The Government can surely reduce the vaccine costs at IDR 321,660.00 per dose after proper discussion with entrepreneurs, so that a more reasonable figure for entrepreneurs can be determined. Ultimately, ensuring COVID-19 vaccination for all Indonesian citizens is the Government’s responsibility. With limited vaccine supply and limited National/Regional Budget available to fund vaccination, entrepreneurs’ financial participation through the Cooperative Vaccination scheme is a necessity. However, the Government must also correctly assess entrepreneurs’ funding ability, and like the name, cooperate with them in the funding as well as implementation 

of Cooperative Vaccination. According to Article 22 Paragraph (1) of the National Social Security System (Law No. 40 of 2004), private workers and their immediate families as participants in the National Health Security program have the right to obtain both preventive and promotive services for illnesses. Vaccination is a means to prevent illness. Therefore, Cooperative Vaccination can be implemented as part of the NHS program, allowing participants to be free from any billing for the Cooperative Vaccine scheme. 

We hope that both entrepreneurs and the Government properly support Cooperative Vaccination by reducing vaccination costs, tying in the Vaccination scheme with the ongoing NHS program, implementing vaccination in all medical facilities that satisfy requirements, and ensuring that all formal workers and their families are properly vaccinated in the end. This will ensure that the vaccination target can be achieved within the year as planned by President Joko Widodo, that all of our citizens are ultimately protected from COVID-19.