Unproportional Health Services in Hospitals for Third Class BPJS Kesehatan Participant

Abstract

BPJS is a legal entity formed to carry out social security programs by Law Number 24 of 2011 regarding Social Security Administrator. BPJS Kesehatan services divided by class according to the non-medical benefits of participation in Presidential Regulation Number 82 of 2018 regarding Health Insurance. The 3rd class membership services constitute the majority and require hospital preparedness. The reality is that the majority of Indonesian people are registered as BPJS Kesehatan 3rd class participants, but contradictively the Minister of Health Regulation Number 56 of 2014 regarding Classification And Licensing of Hospital only allocates at least 30% hospital beds for 3 rd class BPJS Kesehatan participant, so that many 3rd class BPJS Kesehatan participants are not accommodated according to their service class. Even though The Regulation of the Minister of Health of The Republic of Indonesia Number 85 of 2015 Concerning National Hospital Rates Scheme, 3 rd class BPJS Kesehatan participant hospital rates are set under the break-even point. This paper identifies socio-legal problems and analyzes problems using a conceptual approach related to the implementation of the law. There is a gap between the facts and the regulations made by the ministry of health-related to hospital services for patients in 3 rd class BPJS Kesehatan participants. 3 rd class, BPJS Kesehatan participants is difficult in obtaining facilities due to the limited allocation of hospital beds. The losses because the hospital rate guidelines for 3rd class BPJS Kesehatan participants are set below the break event point even though the majority of hospital customers are 3 rd class BPJS Kesehatan participants. Patients as 3rd class BPJS Kesehatan participants receive unproportional health services in hospitals due to gaps in the Ministry of Health regulation. Ministry of Health must improve regulations related to hospital services for 3rd class BPJS Kesehatan participants by increasing the minimum allocation of the number of hospital beds and hospital service rates for 3rd class BPJS Kesehatan participant.

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