Financial Sustainability and Coverage Effectiveness of the Indonesian Health Insurance System

Indonesia introduced a national health insurance programme (known as JKN) in 2014, based on the National Social Security (SJSN) Law No. 40 which was passed in 2004. This required the integration of the various public health insurance schemes existing at that time into a single insurance system. Accordingly, a single health insurance carrier, namely BPJS Kesehatan, has been established to operate the JKN scheme from 2014 onwards.

The JKN programme currently covers 170 million people, 91 million of which are classified as poor and receiving contribution subsidies from the government. The scheme aims to achieve Universal Health Coverage (UHC) for the entire population of 250 million by 2019. In contrast to the various health insurance schemes that existed before the reform, JKN promotes equity as it provides the same services for all population groups, irrespective of income or employment status. Per law, JKN has a comprehensive benefit package that covers services from infectious diseases to open-heart surgery, dialysis and cancer therapies, including medicines.

Based on the results of this study, GIZ SPP aimed to examine the spending on medicines as the main driver for OOP under the JKN scheme. In view of the equity promoted by JKN, as well as financial sustainability of any universal healthcare system, it seems crucial to address the current pharmaceutical policy and medicine management strategy. The final recommendations of such exercise would aim to: a.) ensure financial sustainability and cost containment within JKN and b.) to effectively protect patients from OOP. 

On 16 January 2018, the webinar "Benefit Package Design for Universal Health Coverage: The case of Indonesia" discussed the recent finds from the publication was organised by GIZ, and held by You can access the recording here and the slide presentation here