Mengukur Kemampuan Mengiur untuk Jaminan Kesehatan Nasional (JKN) tahun 2021 di Indonesia

Abstract

The purpose of this study is to conduct measurements of the of Indonesians in the National Health Insurance (JKN) in 2020-2021. Indonesia, as of now, implements a national health insurance service since 2014. It is expected that JKN will expand its coverage to achieve universal health coverage (UHC) in Indonesia. BPJS Kesehatan (BPJS-K) was appointed as the administrator of JKN and had experienced deficit until 2019. One of the weaknesses of JKN in revenue collection is the absence of cross subsidy and pegged contribution in certain level of income that makes the contribution very low for the rich and vice versa for the poor. this, the current study is to increase public awareness that JKN is a cross-subsidy between the rich and the poor in order to produce a more sustainable JKN, better healthcare coverage, and better quality. The methods used in the study are quantitative and qualitative analyses using expenditure data from SUSENAS (National Socio-Economic Survey) data in March 2021 and income analysis from SAKERNAS (National Labor Survey) data in March 2021 to measure the ability to contribute to JKN proportional to their spending and income. In this study several simulations were used to calculate potential contributions based on the percentile distribution of accumulated income levels and expenditure levels of the poorest (0%) and richest (100%). The result of this study shows that 75% of the population had the ability to contribute JKN above the class 3 (informal workers) percapita per month premium (Rp. 42,000,-), 40% of the population has the ability to contribute more than Rp. 100,000, - percapita per month (class 2 informal workers contribution), and the richest 10% of the population has the ability to contribute above Rp. 215,000, - percapita per month. The results of this study demonstrate that some people have the ability to contribute more to JKN, thus making JKN to have a better sustainable financial capacity. Keywords: ability-to-contribute; JKN; income level; spending; increasing rate Abstrak: Tujuan kajian ini adalah menghitung kemampuan mengiur (ability-to-contribute) penduduk Indonesia untuk Jaminan Kesehatan Nasional (JKN) pada tahun 2020-2021. Indonesia mengimplementasikan sistem jaminan sosial sejak 2014 yang diharapkan ke depannya JKN tersebut akan lebih luas cakupannya untuk mencapai cakupan kesehatan semesta (Universal Health Coverage/UHC). Namun BPJS Kesehatan (BPJS-K) yang ditunjuk sebagai penyelenggara JKN masih mengalami defisit hingga pada tahun 2019. Salah satu kelemahan JKN dalam pengumpulan iuran adalah masih kurangnya subsidi silang dan kontribusi dipatok pada pendapatan tertentu membuat kontribusi sangat rendah bagi si kaya dan sebaliknya bagi si miskin. Maka kajian ini untuk meningkatkan kesadaran penduduk untuk meningkatkan kontribusinya ke JKN dengan subsisi silang antara si kaya dan si miskin agar dapat menciptakan JKN yang lebih berkesinambungan, cakupan kepesertaan yang lebih luas, dan perbaikan mutu layanan. Metode yang digunakan dalam kajian ini adalah metode kuantitatif dan kualitatif dengan analisis pengeluaran menggunakan data SUSENAS (Survei Sosial-Ekonomi Nasional) Maret 2021 dan analisis pendapatan menggunakan data SAKERNAS (Survei Tenaga Kerja Nasional) Maret 2021 untuk mengukur kemampuan individu dalam membayar iuran JKN sebagai proporsi dari pengeluaran pendapatan mereka. Dalam kajian ini beberapa simulasi digunakan untuk menghitung kontribusi potensial berdasarkan persentil distribusi akumulasi tingkat pendapatan dan tingkat pengeluaran penduduk dari termiskin (0%) dan terkaya (100%). Hasil dari kajian ini adalah sebanyak 75% penduduk mempunyai lebih besar dari iuran peserta bukan penerima upah (PBPU) kelas 3 per orang per bulan (Rp. 42.000,-), 40% penduduk mempunyai kemampuan mengiur lebih besar dari Rp. 100.000,- per orang per bulan (setara iuran PBPU kelas 2 per orang per bulan), dan 10% penduduk terkaya mempunyai kemampuan mengiur lebih besar dari Rp. 215.000,- per orang per bulan. Dari hasil kajian ini ditemukan bahwa sebagian orang mempunyai kemampuan mengiur untuk berkontribusi lebih untuk JKN, sehingga JKN dapat mempunyai kapasitas keuangan berkelanjutan yang lebih baik. Kata kunci: kemampuan mengiur; iuran JKN; tingkat pendapatan; pengeluaran; kenaikan iuran

The Effect of Pandemic in Willingness to Pay (Wtp) for National Health Insurance Monthly Fee as Independent Participants: A Survey in Semarang

“…This phenomenon is because most respondents choose the JKN membership class based on the benefits of the services provided and the number of contributions that must be paid every month. This result aligns with similar research conducted in Bekasi in 2022 (Maulana et al, 2022), which shows that some people have the ability to contribute more to JKN, thus making JKN have a better sustainable financial capacity; however they do not want to pay more because most of the PBPU (Pekerja Bukan Penerima Upah) of the informal sector workers have uncertain wages.…”

“…The higher the increase, the fewer they agreed (Table IV), which is similar to the results of previous research conducted in Bulukerto District (Budiono et al, 2021), which shows that 23 of 28 respondents had an objection to the increase of the JKN membership fee. This result needs to be watched out for because objections to contribution rates will affect compliance with the payment of contributions (Kamila & Rochmah, 2023;Mekarisce et al, 2022), which will then result in a deficit in BPJS Health (Maulana et al, 2022).…”

Incidence of catastrophic health spending in Indonesia: insights from a Household Panel Study 2018–2019

“…Moreover, data published by the Statistics Indonesia (Badan Pusat Statistik - BPS) revealed that between 2014 and 2021, the average monthly household expenditure of urban households increased from IDR 979,000 in 2014 to IDR 1,487,000 in 2021, or by 70%. However, the average monthly household expenditure in rural areas increased by only 52%, from IDR 573,000 in 2014 to IDR 971,000 in 2021 [ 37 ]. With the same level of health care costs, the incidence of CHS would be lower for households in urban areas due to the higher average income.…”

Construction of BPJS National Health Insurance Membership Regulations in Indonesia

“…There are several terms used to describe the meaning of social security, such as social security [36], social insurance, or commonly social welfare [37]. In the Merriam-America Dictionary, it is defined as the principle or practice or program of public provision (as through social insurance or assistance) for the economic security and social welfare of The first dimension is the guaranteed population.…”