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Private insurers want limits to scope of public healthcare coverage
Analysts have urged finalizing the prolonged discussions over a Coordination of Benefits (COB) scheme, which they say will reduce public-private competition and ultimately help the government toward achieving its universal health coverage goal, alleviate risk for private insurers as well as ensure better health benefits for all.
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The lobby of the Jakarta office of the Indonesian Life Insurance Association (AAJI) is shown in this undated file photo. (Courtesy of AAJI)
A
s private insurers struggle to design policies to complement what has been deemed “sufficiently comprehensive” public healthcare, analysts have suggested that the government limit the “excessive” number of categories covered under the Healthcare and Social Security Agency (BPJS Kesehatan) to leave room for the private sector.
Competition between private insurance firms and the state-run BPJS Kesehatan has become an issue of concern for the Financial Services Authority (OJK), which has prioritized achieving public-private cooperation by 2025 in its 2023-2027 insurance industry road map, launched in October.
According to the OJK, the national health insurance program should focus primarily on essential benefits, leaving room for private companies to provide supplementary health plans.
“To ensure that the public receives maximum benefits, collaboration between BPJS Kesehatan and insurance companies is necessary to facilitate easy access to these additional benefits,” the OJK states in its road map.
Analysts have criticized the existing coverage of BPJS Kesehatan as “too wide” and “almost unlimited” and suggested that the government curb the extent of coverage for wealthy subscribers while making it compulsory for those subscribers to include additional benefits provided by private insurers.
According to insurance industry analyst Irvan Rahardjo, the idea of combining coverage from BPJS Kesehatan and private insurers under a Coordination of Benefits (COB) scheme has been championed since the inception of BPJS Kesehatan in 2014.
The proposed COB scheme had not gained much traction in recent years however, he said, as the existing lack of coordination meant that private insurers tended to view BPJS Kesehatan as a competitor. As a result, some people ended up paying premiums for dual coverage.
