Implications of Social Inequality for Soldiers in Health Services of the Indonesian National Armed Forces Managed by the Social Security Agency

Abstract

This scientific journal research analyzes Law No. 24 of 2011 on health services for the Indonesian National Armed Forces (TNI) sector along with their families included in the national health insurance managed by the Healthcare and Social Security Agency (BPJS) and its implementation regulated in the Presidential Regulation and Health Minister Regulation. However, the implementation of the BPJS health insurance at the TNI institutions does not show effective results, and it tends to decline. Therefore, it is necessary to interpret various factual factors affecting the success of the implementation process of health service delivery policies, which will be useful for finding synergies in the implementation of health services in the TNI. This research on the implementation of policies in the TNI health services was a scientific activity prepared using certain types and strategies and at the same time viewed from certain aspects which had several types and strategies. Therefore, this research used the descriptive qualitative method. Six factors should be interpreted to know the implementation of the TNI health service policy under Law No. 24 of 2011, namely; 1) policy standards and objectives, 2) resources, 3) characteristics of the implementing organization, 4) attitudes of the implementers, 5) communication among organizations related to implementation activities, 6) social, economic and political environments. All these factors synergize with each other and affect health services to TNI, which are administered by BPJS.

Kualitas Pelayanan Kesehatan di Rumah Sakit Militer

“…Adanya ketidakpuasan pasien pada pelayanan rumah sakit militer di bagian pendaftaran, layanan pemeriksaan penunjang, hingga obat-obatan yang didapat merupakan beberapa keluhan yang dialami oleh pasien yang melakukan pengobatan ke rumah sakit militer. [6][7][8] Penelitian ini selanjutnya berusaha meneliti pelayanan kesehatan di rumah sakit militer dengan menggunakan lima dimensi kualitas mutu milik Parasuraman, Zeithaml, dan Berry. 9 Lewat analisis lima dimensi tersebut, pelayanan kesehatan yang diberikan oleh Rumah Sakit Angkatan Udara dr. Esnawan Antariksa diharapkan dapat diidentifikasi sehingga dapat memberikan gambaran bagaimana mutu kualitas pelayanan kesehatan yang ada di rumah sakit militer.…”

Social Exclusion in Indonesia Military Hospital

“…This is caused by the complexity of the registration process, sub-optimal supporting examinations, and the allocation of different drugs. Likewise, Purwalaksana et al (2021) research explained that implementing BPJS Kesehatan in military institutions did not show effective results and tended to decline. This was explained in Purwalaksana's research, which focused on analyzing Law Number 24 of 2011 concerning Health services for the Indonesian National Armed Forces and their families used in a qualitative descriptive method.…”

“…In accordance with the Regulation of the President of the Republic of Indonesia Number 12, 2013, Government hospitals that refuse to cooperate with BPJS Kesehatan in healthcare for BPJS Kesehatan participants are violating the obligations specified in the Presidential Regulation of Health Insurance and will be sanctioned. Studies on Health Insurance related to the BPJS Kesehatan Program have been done widely (see: Arpey, Gaglioti, and Rosenbaum, 2017;Garza, 2019;Putri and Murdi, 2019;Boro, 2020;Purwalaksana et al, 2021). The present study aimed to discuss the phenomenon from the sociological perspective focusing on healthcare in military hospitals managed by the Ministry of Defense.…”

“…Military patients, civil servants from the Ministry of Defense, and their families were more satisfied with healthcare before the existence of BPJS Kesehatan (Ernawati, 2016). In addition, other studies explained that members of the Indonesian national armed forces, civil servants of the Ministry of Defense, and their families who wished to seek treatment could not go directly to their selected hospital (Purwalaksana et al, 2021). They had to go through the First-Level Health Facilities, known as FKTP, to get the treatment.…”

“…They had to go through the First-Level Health Facilities, known as FKTP, to get the treatment. Before the implementation of BPJS Kesehatan, Indonesian national armed forces, civil servants of the Ministry of Defense, and their families could seek treatment directly at their selected hospital using health insurance from the military institution (Purwalaksana et al, 2021).…”