Less Government In Preparation BPJS Harmonious Health5 March 2013
Jakarta – The government, especially the relevant ministries, considered less harmonious in preparing for the implementation of policies related to Social Security Agency (BPJS) Health on January 1, 2014. Regulation 101/2012 concerning Beneficiary Contribution (PBI) and Presidential Decree 12/2013 on National Health Insurance (JKN) is among one of the products disharmony.
Members of the House of Representatives Commission IX of PDI-P Dr. Karolin Margret Natasa said the Ministry of Finance (Kemkeu) has full authority to set budgets BPJS, including reducing the amount of contributions for the PBI. In fact, the technical ministries, such as Ministry of Health (MOH), Ministry of Social Affairs (Kemsos), Ministry of Manpower and Transmigration (Kemnaker), who joined the team BPJS implementation task force has determined the amount of fees, based on calculations that incorporate all components of the health service.
Even the Coordinating Minister for People’s Welfare (Menkokesra) Agung and the National Social Security Council (DJSN) has approved a number. Two regulation produced the PP PBI and regulation JKB is evidence antarkementerian disharmony, especially Kemkeu – which does not seem to appreciate the technical ministries.
“What is the use of technical ministries, if ever Kemkeu finally have the power to set a budget? If you do not believe ya dissolve ministries only. He (Kemkeu) counts with its own assumptions, actuarial calculations themselves, ultimately the result does not match, even much lower than the three formulations of the agreed fee pelaksanana BPJS task force team, “said Karolin in a roundtable discussion held in cooperation with, the United Labor Council of Indonesia ( MPBI), Elkape, BPJS Watch, Atma Jaya University, and the afternoon Daily Updates Sound, in Jakarta, Monday (4/2).
Related fees, according to Karolin, in the Commission IX with MOH recently, Deputy Minister of Health (Wamenkes) admits, to reach a consensus on the amount of contributions, not because of the calculations, but the agreements and commitments that are difficult politically. Still based Wamenkes statement, Karolin said dues calculation PBI Rp 15,500 per person per month by Kemkeu, for a number of reasons, such as counting the number was out of non PBI, Social Security and Askes reject operational funds of Rp 2 trillion, according to the mandate Social Security Act.
In addition, the agency argued that the form does not need too much capital, and health infrastructure does not require a large investment. Karolin regretted that the government reasons, because it holds investments in health requires a huge budget and can only be evaluated after decades.
During this time, he said, the budget allocation for health amounts to only 1-2% of the total state budget. In fact, health facilities are not only less than the amount, but also the distribution is not uniform in all corners. The need for a bed, for example, currently there are only about 500,000 of all health centers, government and private hospitals in Indonesia. While the standard of the World Health Organization (WHO) was 1% of the population, or should have 2 million beds. That is, Indonesia is still less about 1-1.5 million beds.
In addition to fees in PBI, Karolin also highlighted about the number of poor and can not afford that in the PBI, which is the fee paid by the government. He said that, until now the National Team to Accelerate Poverty Reduction (TNP2K) can not prove or account for the calculation of the number of poor people who get as much as 96.4 million people. Should the standard of the poor and can not afford is the population with incomes below the provincial minimum wage (UMP), then the fact that dikaver PBI estimated number of more than 120 million people.
“We assume TNP2K do not have a network up to the grass roots, and only process the data that already exists. I suspect this is BPJS Health Jamkesmas program just renamed, “says Karolin.
Karolin warned, do not let these reasons intentional to delay the implementation of the National Social Security System (Navigation). Aura looks to derail the debate dwell only on the size of contributions, while the remaining time for the implementation of BPJS less than one year.
According to him, there should be efforts to break these constraints, if not the first of the new security system in Indonesia has not carried out on time. In an internal meeting of Commission IX of the House of Representatives recently, the head commission IX are required to send a letter to the House leadership to immediately make a consultation meeting with Kemkeu.
In line with Karolin, Presidium of the Social Security Action Committee (KAJS) Timboel Siregar Kemkeu deplores the analogous problem for the sick and needs of people with political economy. Fiscal reasons or the ability of the state budget that is always thrown Kemkeu, just making it up.
In fact, if the government is smart, social aid large numbers in various schemes can be reduced and diverted to PBI. The problem is that social assistance has so far become a political tool to win elections konstetuen voice.
Number of PBI
KAJS and MPBI also highlights the problem of the amount of PBI. People can not afford according to the government, which set out in regulation JKN Article 1 paragraph 6, defined as those who have a source of income, salary or wages, which is only able to meet the basic needs of a decent, but can not afford the tuition for themselves and their families.
If related to the needs of decent living as stipulated in Law 13/2003 on Manpower, should the “can not afford” to be defined as having a source of livelihood with income equal to or less than the applicable minimum wage in the local area.
“The government wants to complicate the poor and people are not able to obtain the right health insurance without discrimination, by making such provisions,” said Timboel.
To note, the Minister of Finance to cut the amount of PBI’s first approved as 96.4 million decreased to 84.6 million. With fees in the first approved is $ 22,200 per person per month, reduced to Rp 15,500 per person per month.
For the amount of regulation that is trimmed, and MPBI KAJS representing the workers would ask the House, in particular the Commission IX to deny fees in and a predefined amount of government regulation and greater scaling up. If any amount of regulation is still used on 1 January 2014, they insist that there is no mechanism for reporting or registration as a participant BPJS society. Because, according to him, the amount of regulation imposed by government have not touched the abandoned children, children without parents, who live on the streets or under bridges.
In addition to tuition and the amount of PBI, MPBI and KAJS also protested the government’s authority to regulate the rest of the budget or slipa in paying dues for PBI. He warned that the Social Security Act and the Act mandates BPJS BPJS to organize this system based on the principle of a trust fund, the contributions and investment results is a surrogate of participant funds to be used for the greater interest of the participants.
“Therefore, the government should not regulate the balance of the budget used to pay Iran for PBI. Budgets for direct regulation of the President to BPJS, and that determines PBI is DJSN, instead of MOH or Kemkeu, “he said.
In response to all of that, Jesus Rachmatawarta of the Fiscal Policy Office Ministry of Finance said that, in calculating the dues this regulation, it has to give space to the ministries or institutions BPJS to have its own count. Rp 22,200 figure is also entered as one Kemkeu scenario, even a scenario Rp 80,000 per person per month.
However, he made sure that the rate of Rp 15,500 is based on the calculation of the appropriate technical actuary, such as calculating utilization rates, capitation fees and the cost per unit of advanced care, medical cost inflation, shifting patterns of disease, to the aging population.
In addition, considering the economic and fiscal considerations, such as competition with other social security, economic competitiveness, flexibility state budget and macroeconomic pressures. He denied cutting the amount of dues and the amount of PBI as an attempt to cancel the execution BPJS.
“Premiums will not continue to be studied, not absolute force in January and for all. While the number of PBI, what we want is all the components contribute to this system. BPJS not show performance with mengkaver more people to the government, “he said.