REPUBLIK INDONESIA
INDONESIA
Presented by : Miranti Putri Prihantika
at Strengthening Social Health Protection Toward UHC
JICA Tokyo, January 2019
DEMOGRAPHIC : INDONESIA POPULATION
2
POPULATION
3
Population Pyramid for Indonesia
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DEATH RATE
This entry gives the average annual number of deaths during a year per 1,000 population at midyear; also known as crude death rate. The
death rate, while only a rough indicator of the mortality situation in a country, accurately indicates the current mortality impact on population
growth. This indicator is significantly affected by age distribution, and most countries will eventually show a rise in the overall death rate, in
spite of continued decline in mortality at all ages, as declining fertility results in an aging population. 5
CAUSES OF DEATH
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ECONOMIC INDICATORS ; GDP
The Gross Domestic Product (GDP) in Indonesia was worth 1042.17 billion US dollars
in 2018 (reaching an all time high). The GDP value of Indonesia represents 1.68
percent of the world economy.
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GDP PER CAPITA
The GDP per capita is obtained by dividing the country’s gross domestic product, adjusted
by inflation, by the total population. 8
GDP GROWTH
Growth was supported by private consumption, fixed investment and exports. GDP Growth Rate in
Indonesia averaged 1.42 percent from 2005 until 2019, reaching an all time high of 4.21 percent in the
second quarter of 2018. 9
INDONESIA NATIONAL INCOME
GNI is the sum of value added by
all resident producers plus any
product taxes (less subsidies) not
included in the valuation of
output plus net receipts of
primary income (compensation of
employees and property income)
from abroad
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DISPARITY
• In March 2018, the level of inequality in expenditure by
the Indonesian population as measured by the Gini Ratio
was 0.389.
• This figure decreased by 0.002 points when compared to
the September 2017 Gini Ratio of 0.391. Meanwhile,
compared to the March 2017 Gini Ratio of 0.393, it fell
by 0.004 points.
• The Gini Ratio in urban areas in March 2018 was
recorded at 0.401, down compared to the September 2017
Gini Ratio of 0.404 and the March 2017 Gini Ratio of
0.407.
• Meanwhile, the Gini Ratio in rural areas in March 2018
was recorded at 0.324, an increase of 0.004 points when
compared to the March 2017 and September 2017 Gini
Ratio of 0.320.
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Due to rising economic activity many new jobs were created, hence pushing down the nation's
unemployment rate 12
INTRODUCTIO National Social Security System
N (NSSS)as known SJSN
NSSA Healthcare NSSA Employment
NSSC
1 Januari 2014 1 Juli 2015
(15 Member of
Council)
Secretariat DJSN
NHI 13
About SJSN National Social Security System
(SJSN)
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National Health Insurance (JKN)
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Definition
JKN is a benefit in a form of healthcare protection so
that participants receive benefits in healthcare and
protection of basic health needs which is given to
every individual who has paid a premium or have the
premium covered by the government.
(Presidential Regulation Number 12/2013)
NATIONAL HEALTH INSURANCE (JKN)
Regulator/Govt (MoH)
BPJS Kesehatan
Regulation on standard of health care
delivery
nt
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Con
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Pay
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Clai t
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Regulation on health human resource,
ntr
trac
men
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an
ms
Co
Regulator pharmaceutical, etc
nm
t
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mp
Regulation on standardization of tariff
Co
Delivery of service
Members Healthcare providers
utilize the services
Healthcare Benefits of JKN: Comprehensive—Medically
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Necessary, all in kind in contracted providers
• Inclusion • Exclusion
1. Health services outside
1. Primary healthcare providers network except
provided in public and for emergency;
private clinics 2. Self-inflicted health
injuries;
2. Specialty care by
specialists, inclusive 3. Costmetics and
rooms, labs, rads, supplements;
drugs, supplies 4. Healthcare services
covered under work
a. Inpatient injuries or road accidents
programs;
b. outpatient
5. Self-referral/on personal
If it is listed, it covers demand, infertilities,
> 2,000 services and overseas health care, etc.
goods/drugs
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Contribution
Employee contribution is 5% monthly wages, subject to wage ceiling of IDR
12 million per month (=US$900)
a. Employees of the private sector (1% from payroll and 4% from employer)
b. Civil Servants, Military, Police Personnel (1% from employee and 4% from
employer)
Self-Employed people & Non Employed rich, can choose three
hospitalization schemes
a. Class III: IDR 42,000 (=US$3)/month/person
b. Class II: IDR 110,000(=US$8)/month/person
c. Class I: IDR 160,000 (=US$11)/month/person
Poor and Near Poor Premium as Participants Receiving Contribution
Assistence/Subsidized Premium Recipient (PBI) is Paid by the
Government: IDR 42,000 (=US$3)/month/person
JKN is single health insurance scheme in Indonesia
toward achieving UHC
• A single pooling fund;
• Compulsory membership;
• Premium collected from contributory and non contributory membership;
• Standardize benefits packages, provided by public and private health care facilities;
• Several policies to ensure both quality and financial sustainability of the JKN program:
• Credentialing and contracting mechanism;
• Provider payment reform Capitation & INA-CBG;
• Institutionalize a utilization review management;
• National drug formulary;
• Health Technology Assessments;
• Clinical Advisory Board;
• Technical Tariff Team.
JKN
CONTRACTED
PROVIDERS
Primary HC Hospitals Pharmacies Optic Laboratory
facilities
21.385 2.244 2.342 1.007 379
Source: Annual Report of BPJS Kesehatan
MORE THAN 220 MILLION PEOPLE ARE
BENEFIT FROM THE PROGRAM TODAY
Since the
transformation of
Health Social Security
System 5 years ago,
Indonesia puts a great
effort to increase the
membership and
closing the gap
towards UHC
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INDONESIA IS COMING TOWARDS UHC
By the end of
Desember 2019,
Indonesia has achieved
around 83% of the population covered
by Jaminan Kesehatan Nasional (JKN) Program,
with 5 province nearly coming to UHC.
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NOW MORE PEOPLE ACCESS HEALTHCARE FACILITIES
Since the establishment of
JKN, more people accessing
the healthcare facilities.
There is around 640.822
services a day through JKN
System in average. Within 5
years, Yearly Healthcare
Access is increased for
around 268%
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JKN Challenges
Demand Supply Financing Deficit Control
•Increased coverage of • Adequacy of health •Adequacy of tariffs •Increased
membership to UHC 2019 facilities •Collectability of Revenue through:
especially the informal sector Increased
• distribution of health contributions mainly
•Integration of population
facilities from segments of Non- coverage &
information system
JAMKESDA integration into • Fulfillment of health Wage Member (PBPU) collectability of
JKN facilities and •Development of JKN dues
•Socialization JKN good infrastructure Tariff (either Kapitasi • Decrease
service system, membership Spending
Fulfillment of Health or INA-CBG)
to the community through: Fraud
•Community access to health • Human Resources •The high burden of
services especially in remote Standardization of health financing for Prevention
areas, very remote, islands competency of health catastrophic diseases Quality control &
and borders facilities and Health Cost
Human Resources
Conclusion
JKN is ensuring all population will be covered in single
National Health Insurance program and it brings
Indonesia to achieve Universal Health Coverage, we
hope it will be happen in 2020.
Everyone, as a member of society, has the right to social security..." 27
Universal Declaration of Human Right Art 22, Dec 1948
T
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Borobudur
Temple
(The world’s
biggest Buddhist
monument)
