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Jakarta Post

Healthcare preparation in chaos

Mariel Grazella
Jakarta   ●   Mon, September 23, 2013

The government'€™s universal healthcare coverage program is only three months away from its effective implementation scheduled for Jan. 1, 2014, the same year the country will hold its general election.

However, the government has yet to finalize key parts of the far-reaching program, which will also impact companies and their businesses.

Okky Asokawati, a member of the House of Representatives'€™ Commission IX overseeing health, said the government had to pass at least eight decrees on the implementation of the 2011 Social Security Providers (BPJS) Law, which mandates two forms of social coverage.

The first, universal health coverage, aims to provide basic healthcare to all citizens, and the second, labor coverage, seeks to provide insurance for work-related accidents, old-age, pensions and death.

'€œThe government has only passed two decrees on health coverage, one of them was related to government aid recipients,'€ the United Development Party (PPP) lawmaker said recently, adding that all employers from both the public and private sectors must comply with the universal healthcare coverage program once it was launched.

The healthcare program will cover all citizens, including around 63 percent of 240 million Indonesians who, according to Health Ministry data, already receive aid from various social protection programs.

While universal health coverage will go live in 2014, labor coverage will be implemented on July 1, 2015.

'€œWe cannot afford any extensions,'€ Social Affairs Ministry secretary-general Kasali Situmorang told The Jakarta Post. '€œNot passing all decrees before Jan. 1, 2014, would cause PT Jamsostek and PT Askes to lose their legal status.'€

State-owned enterprises Jamsostek, an insurance provider for non-civil servants, and Askes, which provides coverage to civil servants, will be molded into one to carry out the BPJS program.

Kasali added that the government had also prepared other necessary decrees.

For example, the decree on the universal healthcare premium amount had been submitted to the Law and Human Rights Ministry for review, he said. Another decree in progress would regulate the investment of premiums considered assets, as well the ledger system of these assets.

In regard to the decree on premiums, the government has proposed that it deduct 4.5 percent of a worker'€™s monthly income as payment. '€œOut of this amount, employers will be responsible for covering 4 percent and workers are liable for the remaining 0.5 percent,'€ Kasali noted, adding that this amount and its formula would be applicable only between Jan. 1, 2014, and the end of June 2015, when labor coverages comes into effect.

The self-employed, meanwhile, would pay fixed premiums, based on the class of healthcare services they wanted, instead of having their wages or salaries deducted, he said.

However, the lack of fixed guidelines nearing the deadline worries businesses.

Indonesian Employer'€™s Association (APINDO) chairman Sofjan Wanandi said businesses needed to know the '€œrules of the game'€ to review the BPJS'€™s impact on businesses, including extra costs they would incur to cover each of their employees.

PT Asuransi Jiwa Manulife Indonesia vice president director and head of employee benefits Nelly Husnayati said that those in the private sector '€œneed clarity on the shape of BPJS'€ benefits from the program by offering add-on benefits to those covered by the universal health coverage, as it did not insure certain services such as orthodontics.

World Bank Indonesia senior social protection specialist Mitchell Wiener reminded that the program, while protecting workers, '€œshould allow Indonesian companies to be competitive and not impede labor market growth'€.