Assessing the national health insurance system: a study of the implementation of health insurance policy in Indonesia

This study aims to analyse the implementation of Indonesia’s Health Insurance policy, which has been in effect since 2014. This research uses a qualitative approach to analyse data that was gathered through observations, interviews, focus group discussions (FGD) and the review of documents. The respondents in this study consist of three groups: citizens as insurance recipients, hospital management, and Indonesian national health insurance management institutions. The study analysed the data using interpretive methods. The results of the study indicate that the National Health Insurance – Healthy Indonesia Card (JKN-KIS) system is a useful policy, especially in meeting basic needs within the public health sector. However, there are several problems regarding aspects such as participation, inappropriate fees, a benefit package system that actually creates fragmentation in health services, as well as ineffective risk management. The budget deficit within the Social Security Agency of Health (BPJS Kesehatan) as the policy implementer has placed significant limitations upon hospitals in providing services as a result of claims that hospital payments are not being paid by BPJS Kesehatan.