T

he Corruption Eradication Commission’s (KPK) recent is investigation into alleged misappropriation of health funds has shown that corruption has become a threat to the government’s commitment to provide Indonesians with quality health care.

Jombang Regent Nyono Suharli Wihandoko, who was arrested on Saturday, is accused of receiving bribes from Jombang Health Agency acting head Inna Sillestyowati in December 2017 in return for his promise to promote the latter as an agency head.

Inna reportedly bribed the regent using capitation funds of 34 community health centers (Puskesmas) across Jombang that amounted to Rp 200 million (US$14,000).

Capitation funds are an amount of money provided by the government for primary health care facilities through the Health Care and Social Security Agency (BPJS Kesehatan), a state body that manages the national health insurance program (JKN).

Both Nyono and Inna have been named suspects in the case.

BPJS Watch secretary general Timboel Siregar said the illicit practice would hinder Jombang residents from getting quality health care services as Puskesmas in the regency would not be able to use the capitation funds to provide quality treatment.

He added that the funds came from premiums paid by BPJS Kesehatan card holders that were later distributed by the agency to around 18,000 primary health care facilities, such as clinics and Puskesmas, across Indonesia.

According to BPJS Kesehatan data, capitation funds collected as of November 2017 amounted to almost Rp 14 trillion. The funds, which are used to provide treatment and upgrade facilities at each healthcare center, are paid every month by the agency.

“With a decline in quality of their healthcare services caused by the capitation fund misappropriation, patients will no longer be able to get treatment at the primary care facilities.

“As a result, they will be referred to hospitals, for which the government will have to reimburse treatment costs of patients seeking medication at the higher-level health centers. This can lead to a fund deficit,” said Timboel.

Started four years ago, the JKN has covered 190 million people, more than 70 percent of Indonesia’s population.

It is predicted that BPJS Kesehatan will suffer from a Rp 9 trillion deficit in 2017, the lower than Rp 9.7 trillion in the previous year.

Center for Healthcare Policy and Reform Studies chairman Luthfi Mardiansyah said claims that were much higher than premiums paid for by JKN participants were among factors that led to the deficit.

“Sometimes there are unnecessary transfers of patients from Puskesmas to hospitals.”

The Jombang case is not the first one where healthcare funds were allegedly misappropriated.

Budi Santoso, the then-Subang Health Agency head in West Java, was indicted for embezzling money earmarked for BPJS Kesehatan in 2014.

Budi was eventually found guilty in a case that reportedly cost the state Rp 2.6 billion.

A KPK study in 2015 showed that BPJS funds were prone to corruption due to poor supervision. The commission also saw a lack of regulation regarding the use of the funds that could lead to corruption.

According to Presidential Regulation No. 32/2014 on capitation funds management, the distribution of the funds are supervised by each region’s health agency. Meanwhile, their usage is supervised by regional inspectorate offices. Timboel urged the government to revise the presidential regulation regarding the management of capitation funds. “It [the funds] should be managed independently without any intervention from regional heads and officials.” (srs)