F

aced with a money hemorrhage caused by soaring hospital bills in the national health insurance (JKN) program, the government will take the drastic measure of activating JKN cards one month after program registration.

The implementation of the new policy was instructed by Coordinating Economic Minister Sofyan Djalil, who believes that it will prevent people from registering for the JKN program only after they fall ill.

'€œCards will be activated one month after registration,'€ he told reporters after a meeting with the Healthcare and Social Security Agency [BPJS Kesehatan] in Jakarta over the weekend. '€œDiscipline [to pay premiums] could not exist if you wait until you'€™re sick before paying for insurance. We cannot forget that this is an insurance program that happens to be managed by [a government agency].'€

The JKN program started showing signs of financial troubles when the BPJS released a report on its claim ratio, which has increased on a monthly basis.

The claim ratio is the ratio between the hospitals'€™ bills for health services and the premiums collected by the agency, both from tax funds, to finance the poor under the scheme, as well as those paid by employees and those who are individually registered for the insurance.

In November 2014, the claim ratio had reached 99.6 percent, a significant rise from a ratio of 91.8 percent a few months prior.

Then in December 2014, the claim ratio had exceeded 100 percent, meaning that the money collected by BPJS Kesehatan from premiums was less than the total service bills.

'€œBut don'€™t think the ratio claim exceeding 100 percent shows that we have failed because since the very beginning, we predicted that it would exceed 100 percent,'€ BPJS Kesehatan director Fahmi Idris said. '€œWe predicted that many people would wait until they were sick to register.'€

He said people were used to having a financial barrier that prevented them from accessing health services. Therefore, the JKN program opened the gate for floods of sick people who previously had to rely on private insurance or their own money.

'€œThis problem will continue in 2015 if we don'€™t manage it,'€ Fahmi said.

The BPJS Kesehatan is asking the government for financial aid in 2015.

'€œThe financial aid from the state budget [APBN] is being deliberated by the Finance Ministry and the House of Representatives. At least Rp 6 trillion [is expected to be disbursed],'€ said Fahmi.

Sofyan said there was no other alternative to solving the financial problems, with no possibility of premium-rate increases this year.

'€œThe one-month activation period is rather lenient. Canada has a three-month activation period [for its universal healthcare program],'€ he said.

Sofyan also said there was still a possibility that the government would revise the new policy in the future.

'€œWe will keep improving the system because this is a new system,'€ he said.

While Sofyan had instructed the BPJS Kesehatan to implement the new policy, it would be a while before the new regulation was officially imposed, Fahmi said.

'€œWe will keep informing the public so that they are not shocked [when the new policy starts],'€ he said.

Therefore, the new regulation will not come into effect until a few months from now, according to Fahmi.

'€œWe will discuss the matter with the Health Ministry on the legal standing of the policy,'€ he said. '€œWe could put it in a presidential decree or in a BPJS Kesehatan regulation.'€