JKN Fee Increase Deemed Necessary to Prevent Deficit, but Transparency is Key

The Chairman of the Indonesian Health Economists Association, Hasbullah Thabrany, explained that contributions in an insurance-based system should be adjusted at least every two years. Currently, the Jaminan Kesehatan Nasional (JKN) contributions managed by BPJS Kesehatan have remained unchanged since 2020, for over five years. “Ideally, contributions should be increased every two years, especially for PBI (Prosperous Indonesia Health) and PBPU (Non-Employee Health Insurance) contributions. In reality, the cost of treating chronic diseases remains high, so an increase is necessary; it’s already too late,” said Hasbullah when contacted on Thursday (February 26th). With the increase in contributions, it is hoped that there will be no more deficits in BPJS Kesehatan. The increase in contributions also needs to be calculated based on the economic conditions of the people and the adequacy of BPJS to pay all claims and prevent further deficits. Hasbullah also stated that the government’s contribution of Rp42,000 since 2020 for PBI should have increased to Rp70,000 now. The lack of increase means that the government is not setting an example. “If the government is not willing to increase contributions to a more appropriate level, how can the people be expected to pay more appropriate contributions? So, it must increase,” he said. If calculated, the increase in contributions based on actuarial analysis should average Rp70,000 per person. Meanwhile, for the third decile, if their ability is Rp42,000, the rest can be assisted by the government. Therefore, in general, an increase in contributions is necessary, but it must be managed transparently, and a subsidy scheme should be prepared for non-PBI participants. “If the economic condition of the less affluent people is considered, they can be given a 10% or 50% discount, or whatever is appropriate, so that it does not burden them,” he said. “But the people must also understand that there are rights and obligations; if they want to receive good service, there are contributions and a higher price,” he added. Contacted separately, the Head of the Bureau of Communication and Public Information of the Ministry of Health, Aji Muhawarman, said that the government is still developing a plan to save BPJS Kesehatan from deficit. The plan is being discussed by the Ministry of Finance, the National Social Security Council, and related stakeholders. “Sorry, for this (the plan to save BPJS Kesehatan from deficit), it is still under discussion with the National Social Security Council, the Ministry of Finance, and others,” said Aji briefly. Aji also could not disclose in detail when the plan would be completed. He said that the budget issue is under the control of the Ministry of Finance. “Because if it’s a matter of budget, it’s definitely with the Ministry of Finance. And for the target, there is no deadline yet,” he concluded. (Iam/P-3) The amount of contributions for participants in the National Health Insurance (JKN) program is considered necessary to be evaluated in order to maintain the sustainability of funding for health services in the face of increasing medical costs. At the regional level, local governments are encouraged to prepare an emergency scheme through the APBD (Regional Budget) to temporarily cover the costs of affected residents who are in the process of re-activating their insurance. Member of Commission IX of the DPR RI, Edy Wuryanto, emphasized that the sustainability of BPJS Kesehatan is important. However, increasing BPJS Kesehatan contributions does not solve the deficit problem. The Indonesian Consumer Foundation emphasized that the increase in JKN contributions must take into account the public’s ability to pay and encourage the elimination of penalties. The Coordinator of Advocacy for BPJS Watch, Timboel Siregar, said that the increase in BPJS Kesehatan contributions should not be applied to independent participants in classes 1, 2, and 3, or the middle class.