8/11/2019 Axis Capital Bermuda a History of Healthcare in Indonesia

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Axis Capital, Bermuda: A history of healthcare in Indonesia

Local governments initially started carrying health insurance back in 2003 when MegawatiSoekarnoputris government presented the Health Service Insurance for Poor Families program,or JPK-Gakin. The notion was for district managements to apply their personal communityhealth insurance schemes in line with local requirements. Nevertheless, limited programs everactually got off the ground before Susilo Bambang Yudhoyonos new government presented abill that laid the foundation for a nation-wide program and made JPK-Gakin redundant, Law no.40/2004 on a National Social Security System (SJSN). Simultaneously, Yudhoyonos governmentannounced a program to run free, however basic, healthcare to the poor - Askeskin (heathinsurance for the poor), which was substituted in 2008 by Jamkesmas (community healthinsurance).

Certain regional administrations put up a round. In 2005, East Javas government led a test atthe Constitutional Court demanding that SJSN gave the central government a monopoly onsocial service provision and broke the constitution and Law no. 32/2004 on RegionalGovernance. The court approved that SJSN did not stop local governments from emerging theirown social security programs, as well as for healthcare. Ever since, the quantity of local healthinsurance programs has increased year on year.

One of the groundbreaking systems was Jaminan Kesehatan Jembrana (JKJ) presented in 2003by Gede Winasa, the head of Jembrana district in Bali. According to this scheme, all members ofJKJ, may they be poor or non-poor get free primary care from public and private providers.Residents branded as poor acquire secondary and tertiary care too. Money comes chiefly fromthe district budget, with about central and provincial government subsidies. Winasa hadpreceding experience in the health sector, equally as a dentist and as a health bureaucrat, and

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8/11/2019 Axis Capital Bermuda a History of Healthcare in Indonesia

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he was extensively acclaimed for his idea and actual leadership by the media. It appears thatseveral politicians round the country saw at the good promotional he received, and his famewith voters, and free healthcare schemes arose to spread.

Many Jamkesda programs bid simple care at community health centres (puskesmas), andtypically just for the poor who arent covered by other programs, resembling the nationalscheme Jamkesmas. And reviews propose that because of the above reasons, scams and fraudssprout. But in resource-rich regions such as Aceh, healthcare programs are far moreopenhanded. In 2009 Acehs then Governor, Irwandi Yusuf, presented the Jaminan Keseh atanAceh program. Similar to the scheme in Jembrana, JKA bids universal coverage for all residentsof Aceh, and it began a dramatic point in the acceptance of health services with theconsequence that some local hospitals have writhed to manage ever since.

JKA likewise covers almost all illnesses and patients with complex illnesses can be flown tohospitals in Jakarta to have treatment. Prices are so far about Rp. 400 billion (US$41 million)per year. Officials on the border of Aceh report that people go over from North Sumatra to getAceh identity cards that will let them have free healthcare. The money for JKA comes fromspecial autonomy funds compensated by the central government as a consequence of the2005 peace deal that ended the separatist insurgency in Aceh.

At the same time in the poorer regions of Indonesia, local administrations sense bound to bidsome kind of free or heavily subsidized health service. The government introduced an insuranceprogram that offered free basic care at public hospitals to residents not covered by alternativeschemes, like Jamkesmasinn Kupang, the capital city of one of Indonesias poorest provinces,East Nusa Tenggara. While in Central Lombok, instead of providing basic healthcare coverage,the district head assured a much contracted program that covered free maternal healthservices to pregnant women.