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Healthcare agency projects historic deficit this year
Despite BPJS Kesehatan playing down the risk by pointing to substantial assets, analysts suggest the agency start planning a mitigation strategy.
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An employee of the Healthcare and Social Security Agency (BPJS Kesehatan) serves a customer at the agency’s branch office in Jakarta on July 1, 2020. (JP/Dhoni Setiawan)
T
he Healthcare and Social Security Agency (BPJS Kesehatan) has projected a record deficit for the National Health Insurance (JKN) program this year.
A projected gap of Rp 18.9 trillion (US$1.21 billion) between its fees revenue and benefit payouts would mark the largest shortfall the agency has experienced since its inception in 2014.
While BPJS Kesehatan has pointed to substantial assets that could cover the deficit for a while, analysts suggest the agency start working on a mitigation strategy, which could involve raising fees, requesting cash injections from the government or reducing benefits for members.
At the end of last year, BPJS Kesehatan had 267.3 million registered users, 95.75 percent of the country's population. However, around 53 million of them did not consistently contribute financially, according to Abdul Kadir, the chairman of BPJS Kesehatan's supervisory board.
Abdul noted that the expenses to cover claims from health facilities still surpassed the revenue the agency could collect from members in a single year.
"We predict a deficit of around Rp 18.9 trillion this year. That means BPJS Kesehatan's assets will be eroded, [which] may result in a failure to pay [for treatment in the future]. All stakeholders need to think about this [problem and determine] how to ensure the resiliency of BPJS Kesehatan," Abdul said during an event commemorating the program's 10th anniversary on Jan. 11.
Last year, BPJS Kesehatan recorded Rp 151.4 trillion in membership revenue, marking a 5 percent increase over the previous year. At the same time, however, the public healthcare provider’s expenses in covering claims surged by more than 40 percent to Rp 158.8 trillion.
