Moving forward to achieve universal health coverage in Indonesia

All countries in the united nations, including Indonesia, have committed to achieving universal health coverage (UHC) as part of the sustainable development goals by 2030. UHC exists in a country when all citizens have access to quality healthcare services they need without suffering financial hardship. At the beginning of 2014, Indonesia launched new national health insurance, Jaminan Kesehatan Nasional-Kartu Indonesia Sehat (JKN-KIS), and officially announced it’s plan to achieve UHC by 2020. This thesis aims to evaluate the progress of the JKN-KIS towards UHC. Three key challenges were identified, i.e., medicines management, the health financing system, and the demographic trend. Regarding medicine management, the government of Indonesia introduced several new medicine policies to support JKN-KIS. However, these policies have not been fully utilized because of a lack of harmonization and a lacking an evidence-base. Regarding the health financing system, it appeared that the target for reducing out-of-pocket-payment schemes below 20% may be reached by 2024. In the meantime, the target for achieving 4% of GDP spend on healthcare through government schemes still remains challenging. As for the demographic trend, it is clear that an aging population implies an increase in non-communicable diseases, especially cardiovascular disease. The latter represents the largest financial burden on the JKN-KIS program. Smoking has been identified as the key risk factor amenable to government intervention. To conclude we found that JKN-KIS is the cornerstone for Indonesia to achieve UHC. However, improving efficiency and raising financial resources for health are the necessity to address these key challenges.

Dissertation: http://hdl.handle.net/11370/19bf24fa-e4ee-490a-847e-f9e5e5912750