National Health Insurance Deficit in Indonesia: Identification of Causes and Solutions for Resolution

Abstract

INTRODUCTION: Since it was implemented in 2014, National Health Insurance Program (JKN) in Indonesia experienced a financial deficit. JKN recorded a deficit of 9.7 trillion, 9.75 trillion and 10.98 trillion rupiah from 2016-2018, respectively. The deficit is estimated to still continue in the upcoming years. Systemic solutions are needed to bring JKN improvement in the future. 
 
 METHODS: Data was collected from June to December 2019 by in-depth interviews with selected informants and literature review, which later was analyzed by content and with data triangulation. 
 
 RESULT: The results of in-depth interviews and a review of some of the literature shows that there are four main factors that causes JKN deficit, which are capitation payment system to provider, the alleged fraud, lag of backed-referral system, and catastrophic disease. 
 
 CONCLUSION: This study provides a solution to the handling of JKN deficits in the short and long term in accordance with problems in terms of funding and JKN expenditure. The solution can be an alternative policy that can be implemented by the Government of Indonesia to deal with the JKN deficit.

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