By: Aura Nabila*
The Joko Widodo era government has tried to overcome the BPJS Health financial deficit through various policies that can support health services for the people of Indonesia. This was implemented by establishing a Presidential Regulation and internal policy at BPJS Kesehatan to obtain funds of up to Rp. 9.23 trillion. Discipline the local government through PMK Number 183/2017 which regulates the mechanism for resolving the regional health insurance contributions arrears is one of the step government to applied, through deduction of revenue-sharing funds to each local government that defaults on paying participant contributions to the community as registered through the Regional Health Insurance program. Based on BPJS Health data, some local governments are late paying contributions and tend to register residents who have high risk diseases, which impact on the BPJS Health financial deficit.
Not only that, another method pursued by the Jokowi government to patch deficits is through PMK 222/2017 concerning the use, monitoring and evaluation of excise revenue sharing for tobacco products. Funds worth Rp1.48 trillion from excise on tobacco products are expected to help support health facilities. The Ministry of Finance will also cut cigarette tax from all regions by 10 percent, which is taken from the total cigarette excise revenue, as stated in Presidential Regulation 82/2018. Deputy Finance Minister Mardiasmo said in the Presidential Regulation, there was a rule that ordered the finance minister to be able to cut according to PMK in the form of 75 percent of 50 percent of regional cigarette tax receipts, which are used for JKN (National Health Insurance). This policy is expected to be sufficient to patch BPJS Kesehatan cash of Rp 5.51 trillion which has been leaked and can even save operational funds of Rp 200 billion.
On the other hand, President Joko Widodo has also ordered the BPKP (Financial and Development Supervisory Agency) to audit this deficit problem in accordance with procedures and accountability. And, instructed the Director of BPJS Kesehatan Fachmi Idris along with the directors to improve the system, both verification and the financial system. Because BPJS does not only serve the center but reaches up to the Regency, City, Province and throughout the country. Of course this is not an easy thing to control and even monitor claims from the hospital.
Another strategy is improving management of health facility claims in the form of fraud mitigation, so that it can save a budget of Rp. 750 billion and align BPJS Health with other social guarantees such as BPJS Employment, Taspen, Asabri, and Jasa Raharja. In addition, Managing Director of BPJS Health Fachmi Idris also designed other efforts to improve the referral system and refer back through the online system, which is expected to save up to Rp. 500 billion and make it easier for the public not to get old BPJS services in each sick.
Joko Widodo explained that there are four types of diseases that suck huge BPJS health budget expenditures, namely the heart with an expenditure of Rp 9.5 trillion, cancer of Rp 3 trillion, kidney Rp 2.2 trillion and cataracts reaching Rp 2.6 trillion. Thus, the President said there was a need for a solution in creating a healthy city / district so that expenditure by the Health BPJS could be reduced through a PHBS (Clean and Healthy Behavior) program to create a healthy society.
To realize this PHBS program, the President invited all parties to carry out development which began with healthy infrastructure, as well as clean and healthy sanitation so that there was no outbreak of disease. Then industries that still dispose of waste into sewers, must begin to be organized and emphasized so that they no longer pollute the environment carelessly.
Various efforts to improve BPJS in the era of President Joko Widodo have been rolled out, this is solely for the sake of the Indonesian people to be able to get the best health care from the government and show the real performance of the current Indonesian government.
*) Islamic Economics Student, Islamic University of Indonesia