PROS AND CONS BPJS KESEHATAN PREMIUM INCREASES
PER APRIL 1ST, 2016
Preface :
With a sharp deficit or mismatch recorded in three years of implementation, The Social Security Agency for Health (BPJS Kesehatan) projects a deficit of Rp 6.23 trillion in 2017. President director Fachmi Idris said that number may rise to Rp 10.05 trillion by 2018.
By 2019, he said on Thursday, February 9, a deficit of Rp 12.7 trillion is expected if the state health insurer does not raise its premium and service tariffs.
Based on Presidential Regulation Number 19 year 2016, BPJS Kesehatan is increasing its premium with the exception of the premium for Employee Wage-based starting April 1st, 2016 and BPJS cancels its premium increase for class III participant.
Cause BPJS deficit:
- BPJS participant delinquent pay premium
- BPJS Participant mostly only pay when they are sick
- Number of non-infectious disease patients increases. Example: Cardiovascular diseases, Diabetes, Cancer, Kidney Failure, Stroke and Thalassemia
Because of that, this policy makes pros and cons in various circle.
Pros:
- Can cover shortfall BPJS faces deficit
- Can speed up re-imbursement hospital claim
- Adjustment of doctors and patients ratio
Cons:
- Hospital services have not been maximized so that BPJS premium is not worth to raise.
- Premium is more expensive, especially for Class I and Class II participant
Solutions :
According to administration and health policy expert, Dr. Djazuli Chalidyanto, S,KM.,MARS from Faculty of Public Health, Airlangga University. He said that the increase of BPJS Kesehatan premium must be balanced with the efforts of disease risk control and improvement of health care facilities. Effort of disease risk control means promotive and preventive effort to apply clean and healthy life behaviour (PHBS). For Mr. Dzauli, if don’t apply PHBS in their daily life, then the health risks remain high. Eventually, BPJS Kesehatan will continue to experience deficit despite repeatedly increasing premiums.
The health service must be in terms of quantity, distribution, and quality. According to Chairman of the Association of Indonesian Public Health Experts from East Java Province, the problem of health services in Indonesia consists of three things. First, the number of facilities and medical personnel is limited. Second, the distribution is unequal. Third, the quality of service has not been optimal.
Community health centre or Puskesmas should intesified to give health promotion and health education (promotive and preventive) for increase awareness about health.
- The late-payers must pay a fine (denda) and if they ignore the rules, they are no longer eligible for health treatments.
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