JKN Premiums Again Hiked Amid Hard Times

KOMPAS/HENDRA A SETYAWAN

Attendants serve customers on 4 Nov. 2019 at the office of the Health Care and Social Security Agency (BPJS Kesehatan) in Pancoran, Jakarta. The premiums for all BPJS Kesehatan policies will be increased in January 2020 under the amendment to Government Regulation No. 82/2018 as stipulated in Presidential Regulation No. 75/2019.

Less than two months after the Supreme Court overruled the government’s plan to increase the premiums of the National Health Insurance (JKN), the government has again decided to increase the JKN premiums.

We all know that these are hard times. The Covid-19 epidemic has had a tremendous impact on the economy. Nearly two months of the large-scale social restrictions (PSBB) has caused the economy to stagnate.

Companies are cutting employee salaries, furloughing employees or even terminating jobs. Meanwhile, self-employed people are finding it extremely to conduct any business transactions. It is likely that they are among the 115 million of the aspiring middle class who are now affected, according to the World Bank.

Also read : BPJS Kesehatan Premium Revenue Estimated to Drop Rp 5 Trillion in 2020

With 18 regions implementing the PSBB, this has hampered seasonal economic growth during Ramadan that depends on household consumption. As a matter of fact, it is almost certain that the Idul Fitri “boom” will not occur because of the government’s ban on mudik (exodus). Like it or not, this is what we must endure together to break the chain of Covid-19 transmission.

However, amidst these circumstances, the government has again raised the JKN premiums. On the one hand, it must be admitted that the JKN has helped many Indonesians bear the high costs of health care over the seven years of its existence. By 2019, more than 224 million people were JKN members. The government covers the premiums of 60 percent of JKN members who are also recipients of the government’s social assistance programs, whether through the state budget or the regional budget.

Read also: Cancellation of JKN Fee Increase Needs to be Reviewed

Kompas/Wawan H Prabowo

People wait their turn to have their files processed at a Healthcare and Social Security Agency (BPJS) counter at the Pasar Rebo regional general hospital, Jakarta, on Saturday.

On the other hand, the JKN continues to be embattled by a deficit. The biggest budget is for combating noncommunicable diseases. According to the 2018 Financial Report of the Health Care and Social Security Agency (BPJS Kesehatan), the health costs of heart disease was Rp 10.5 trillion, cancer Rp 3.4 trillion, stroke Rp 2.6 trillion, and kidney failure Rp 2.4 trillion, followed by thalassemia, hemophilia, cirrhosis and leukemia.

The JKN’s financial imbalance has continued to swell its deficit. Health Minister Nila Moeloek (2019) said that the deficit rose from Rp 1.9 trillion (2014) to Rp 9.4 trillion (2015), Rp 6.7 trillion (2016), Rp 13.8 trillion (2017) and Rp 19.4 trillion (2018).

Also read : BPJS Kesehatan Needs Better Management

We understand that health insurance works by calculating the risk of disease and illness into costs so it can guarantee health coverage without burden individuals. The premium is calculated based on the benefits offered and the JKN member’s health condition. The wider the range of benefits and health problems, the greater the cost will be.

Therefore, instead of burdening the public with a hike in JKN premiums during these difficult times, the government needs to consider many issues. The JKN’s efficiency and effectiveness, for example, is unattended housework. In fact, the government can review its intervention options starting with this very point, from reducing the categories that are covered to increasing bailout funds, to delaying the hike until the economy returns to normal.