SISTEM PEMBIAYAAN KESEHATAN DI INDONESIA

Summary

In this presentation, Andi Azis Muslim, a public health student from the University of Islam Negeri Alauddin Makassar, explores Indonesia's health financing system. He discusses two key systems: out-of-pocket (Vivo service) payments, where patients directly pay for health services, and health insurance, which includes systems like capitation and Diagnosis Related Groups (DRG). The presentation also covers the fundamental right to health in Indonesia, as enshrined in the Constitution, and elaborates on the National Health Insurance (JKN) program, which aims for universal health coverage, ensuring access to quality healthcare for all citizens.

Takeaways

• 😀 Indonesia has two main healthcare financing systems: out-of-pocket (Vivo service) and health insurance systems.
• 😀 Out-of-pocket payment (Vivo service) involves individuals paying directly for healthcare services, where the more services provided, the higher the income for healthcare providers.
• 😀 The health insurance system involves a third party, such as an insurance company, covering healthcare costs after the individual receives treatment.
• 😀 Health insurance can be structured through two models: capitation (fixed amount per patient) and diagnosis-related groups (DRG).
• 😀 Health is a fundamental right in Indonesia, guaranteed by the constitution and laws, with the state responsible for ensuring its provision.
• 😀 Article 28h of the 1945 Constitution of Indonesia guarantees the right to a healthy life, including access to quality healthcare services.
• 😀 The National Health Insurance Program (JKN) is part of Indonesia's efforts to provide universal health coverage, launched in 2014.
• 😀 The government ensures social security, including health insurance, for all citizens through the 1945 Constitution and various laws like the Health Act and the Social Security System Act.
• 😀 Indonesia's social security system is designed to meet the basic living needs of citizens, including health, work accidents, pensions, and death benefits.
• 😀 The overall goal of JKN is to make healthcare services more accessible and of higher quality for Indonesian citizens, moving towards Universal Health Coverage (UHC).

Q & A

What are the two main healthcare financing systems in Indonesia?

The two main healthcare financing systems in Indonesia are 'out-of-pocket' (Vivo service) and 'health insurance' systems.

How does the 'out-of-pocket' system work in Indonesia?

In the 'out-of-pocket' system, individuals seek healthcare services and pay directly to healthcare providers (such as doctors or hospitals) for the services they receive. The more services provided, the higher the income for healthcare providers.

What is the second healthcare financing system discussed in the presentation?

The second system is the 'health insurance' system, where payment is made by a third party, such as an insurance company, after the individual receives healthcare services.

What are the two types of payment systems under health insurance in Indonesia?

The two types of health insurance payment systems in Indonesia are 'capitation' and 'diagnosis-related groups (DRG)'.

What is the capitation payment system?

The capitation system is a method of healthcare payment where healthcare providers receive a fixed amount of money per patient for a specific period, regardless of the number of services provided.

What does the Constitution of Indonesia say about the right to health?

The Constitution of Indonesia, specifically Article 28H, guarantees every citizen the right to live in a healthy environment and to receive healthcare services.

What is the role of the state in ensuring the right to health in Indonesia?

The state has a responsibility to ensure the fulfillment of the right to health for its citizens, as stipulated in the Constitution and laws such as the Health Law No. 36 of 2009.

How is the right to health protected by Indonesian law?

The right to health is protected through various legal frameworks, including the Indonesian Constitution, the Health Law No. 36 of 2009, and the Social Security System Law (SJSN) No. 40 of 2004.

What is the Jaminan Kesehatan Nasional (JKN) program?

Jaminan Kesehatan Nasional (JKN) is Indonesia's national health insurance program, aimed at ensuring universal health coverage for all citizens, which started in 2014 and is progressively moving towards universal health coverage.

What are the main objectives of the JKN program?

The main objectives of the JKN program are to make healthcare services more accessible and to ensure high-quality healthcare for the population.