Laila's Struggle to Survive with Non-Functional Kidneys
For hundreds of times, haemodialysis needles have pierced Laila Ayu Karlina’s arm. Since being diagnosed with chronic kidney failure in 2022, the woman has had to undergo regular dialysis therapy to replace her damaged kidney functions. This routine, performed twice a week, is not merely a treatment; for the 35-year-old, it is an effort to survive rather than to be cured.
Laila revealed that the costs for this therapy are substantial. A single haemodialysis session costs approximately Rp 2 million, meaning it requires Rp 16 million per month to maintain the twice-weekly schedule, excluding laboratory tests, preparation, surgery, and medication. Such costs would be nearly impossible for her to bear independently. Fortunately, her medical expenses have been covered by the Kartu Indonesia Sehat (KIS), a health card she had possessed for years but had never previously used.
She stated that she has long been a recipient of the Health Insurance Contribution Assistance (PBI JK) status. However, complications arose in February 2026 when her PBI JK status was deactivated because she was deemed to fall into decile 6 of the national socio-economic data (DTSEN). This caused her to miss a vital dialysis session. Through advocacy, her status was restored in early March 2026, though the restoration only applied to her, not to her father and two siblings living with her in Bekasi, West Java.
Her family members are currently registered as Class 3 independent participants of BPJS Kesehatan, paying monthly premiums. Laila views this system as a form of mutual cooperation (gotong royong) within the National Health Insurance (JKN) programme, where healthy participants effectively subsidise those in need. She noted that this spirit is crucial for those with chronic illnesses, as finding stable employment is difficult when managing such conditions.
The President Director of BPJS Kesehatan, Mayjen TNI (Ret.) Prihati Pujowaskito, reaffirmed the organisation’s commitment to the sustainability of the JKN programme. He emphasised that the programme relies on the spirit of mutual cooperation through premium collection. Currently, out of over 280 million registered participants in Indonesia, approximately 79 per cent are active participants who pay monthly premiums. BPJS Kesehatan aims to increase active coverage to 100 per cent to ensure that no citizen falls into poverty due to healthcare costs.