T

he government has decided to increase the number of beneficiaries for the community health protection scheme (Jamkesmas) to 86.4 million in 2013, up from last year’s 76.4 million.

The Health Ministry’s director general for health management programs, Supriyantoro, said over the weekend that the government would increase coverage to more poor people this year.

“We have approximately 10 million new Jamkesmas holders. The number of poor people has gone down but more are now living right on the margin. Once they are in a crisis caused by natural disaster or economic disruption, they can easily fall into the category of poor,” he said.

Expanding the Jamkesmas program is part of the government’s effort to introduce universal health coverage in early 2014.

All government health coverage schemes under the programs provided by the Jamkesmas, local administration-funded Jamkesda, PT Jamsostek and PT Askes, will be administered by the Social Security Provider (BPJS).

It is projected that 96.4 million people will be covered by the BPJS in 2014.

The whole population of Indonesia is expected to have health coverage by 2019.

Fahmi Idris, the director of PT ASKES, a state-owned health security provider which will be the implementing agency of the BPJS said, “the Jamkesmas expansion is part of our effort to run a new health system. I’m grateful to the Health Ministry, with the support of the TNP2K, for registering those eligible.” The TNP2K is the government-sanctioned National Team for Accelerating Poverty Reduction.

To prepare for the transition, the ministry will pilot universal health coverage in three model areas: Aceh, Gorontalo and West Java from July this year.

For the expanded Jamkesmas program, the government has earmarked Rp 8.29 trillion (US$860.85 million) in 2013, up from Rp 7.38 trillion in 2012. Of the total Jamkesmas fund, Rp 1.59 trillion will be allocated for the Jampersal childbirth scheme.

“The Jamkesmas program will involve over 1,000 hospitals across the country, almost half of which will be private,” said Usman Sumantri, the Health Ministry’s director for community healthcare financing.

Economic growth in recent years has helped Indonesia reduce its poverty rate to just under 12 percent in 2012 from 12.5 percent the year before, data from the Central Statistics Agency (BPS) statistics shows.

Yet, many remain susceptible to falling below the poverty line.

“Health has a unique characteristic. People are at greater risk of poverty if they get sick. So it is crucial for the government to cover not only poor but also those who live near the poverty line, depending on its financial capability,” said Prastuti Soewondo from Health Assistance Working Group at the TNP2K.

Prastuti said that the data for participants in the health insurance program would be compiled from the Integrated Database on Poor and Almost Poor prepared by the TNP2K.

“They cover the 40 percent of Indonesians whose economic status is the lowest,” she said.

While he World Bank defines extreme poverty as living on less than $38 per day, or roughly Rp 366,000, anyone with a monthly income of less than Rp 233,000, the TNP2K categorizes as ‘poor’.

Each province however has its own criteria.

In Jakarta, for example, the benchmark for ‘poor’ is set at just over Rp 350,000 per person or around Rp 1.4 million per household, assuming that each family has four members.

An individual is “almost poor” if they earn approximately Rp 400,000 per month or Rp 1.6 million per family.