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by: Claudia Rokx, George Schieber, Pandu Harimurti, Ajay Tandon, Aparnaa Somanathan
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In 2004 the Indonesian government made a commitment to provide its
entire population with health insurance coverage through a mandatory
public health insurance scheme. It has moved boldly already provides
coverage to an estimated 76.4 million poor and near poor, funded
through the public budget. Nevertheless, over half the population still
lacks health insurance coverage, and the full fiscal impacts of the
government’s program for the poor have not been fully assessed or
felt. In addition, significant deficiencies in the efficiency and
equity of the current health system, unless addressed will exacerbate
cost pressures and could preclude the effective implementation of
universal coverage (UC) and the desired result of improvements in
population health outcomes and financial protection.
For Indonesia to achieve UC, systems’ performance must be
improved and key policy choices with respect to the configuration of
the health financing system must be made. Indonesia’s health
system performs well with respect to some health outcomes and financial
protection, but there is potential for significant improvement.
High-level political decisions are necessary on key elements of the
health financing reform package.
The key transitional questions to get there include:
- the benefits that can be afforded and their impacts on health
outcomes and financial protection;
- how the more than 50 percent of those currently without coverage
will be insured;
- how to pay medical care providers to assure access, efficiency, and
quality;
- developing a streamlined and efficient administrative
structure;
- how to address the current supply constraints to assure
availability of promised services;
- how to raise revenues to finance the system, including the program
for the poor as well as currently uninsured groups that may require
government subsidization such as the more than 60 million informal
sector workers, the 85 percent of workers in firms of less than five
employees, and the 70 percent of the population living in rural
areas.
- Shipping Weight: 0.74 lbs (0.34 kgs)
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