Cost Caps and Coverage for All: How to Make Health Care Universally Affordable

Kendall, David; Horwitz, Gabe; Kessler, Jim

doi:10.2139/ssrn.3356722

Cited by 1 publication

(1 citation statement)

References 11 publications

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“…According to Jigjidsuren (2016), the improvement of health insurance for the poor needs political power and multi sectoral movements, while in Indonesia Jung (2016) argued those aspects were necessary but needed more people power for the case in Indonesia. Technical aspects for making cost cap (Kendall et al, 2019), or improving hospital competitiveness (Sepehri, 2014), could bring health insurance effectiveness came true. Nevertheless, developing countries' implementation needs to learn more from other developing countries rather than developed countries to gain more objective outcomes (Camacho & Conover, 2013).…”

Section: Resultsmentioning

confidence: 99%

Subsidized health insurance impact among the poor: Evidence on out-of-pocket health expenditures in Indonesia

Sosodoro,

Ramadhan,

Susamto

2023

JESP

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Universal Health Care (UHC) in Indonesia, named the National Health Insurance (Jaminan Kesehatan Nasional - JKN), has been running since 2014. JKN was predicted to be the most extensive UHC program in the world. Under JKN, the poor get free health services through the cashless method through a sub-program called Contribution Assistance Recipients (Penerima Bantuan Iuran - PBI). Unfortunately, JKN faced several failures to cover the program's expenditures within years. Within the current dynamics, was PBI, as part of JKN still effectively helping the poor? We examined the effectiveness of the PBI program by measuring differences in out-of-pocket health expenditures for the poor with similar socio-economic characteristics who used PBI and those who did not. We incorporated secondary data from National Socio-economic Survey (SUSENAS). The dataset was executed by using Propensity Score Matching (PSM) methodology. We used health expenditures and socio-economic parameters such as income, education, and gender from the 2017 and 2018 SUSENAS data. We found that in 2017, the total health expenditures of the PBI beneficiaries were lower than the non-beneficiaries. Nevertheless, by merging all two years' data, similar to 2018, we found general pattern that PBI participants' total health out-of-pocket payments were bigger than the non-participants. Health expenditures such as medicine, traditional practitioners, and others, were expenditure classifications in which PBI beneficiaries had lower expenses than non-beneficiaries in 2017. Therefore, Therefore, the UHC subsidy program for the poor in Indonesia has not only been ineffective through the years of implementation but also has not been effectively implemented for all variations of health expenditure types.

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