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JKN members may opt out of state health insurance

National health insurance (JKN) holders are torn between leaving or switching to more affordable services after the government decided to increase premiums for the state insurance

Arya Dipa (The Jakarta Post)
Bandung
Wed, November 13, 2019

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JKN members may opt out of state health insurance

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span>National health insurance (JKN) holders are torn between leaving or switching to more affordable services after the government decided to increase premiums for the state insurance.

Zaky Yamani said suffering from clinical depression had forced him to join the insurance scheme as doing so had helped him a great deal in covering his medical expenses.

He said if he did not get the insurance, which is managed by the Health Care and Social Security Agency (BPJS Kesehatan), he would have to spend up to Rp 2 million (US$142.31) a month. Thanks to being a JKN holder he just has to pay Rp 400,000 for the medicines that BPJS Kesehatan does not cover.

This, he said, meant that the 100 percent increase in the premium was still lower than the medical expenses he had to cover monthly.

“The case could be different for those who are not sick,” said the father of one who works as a freelance writer.

He added that even his wife also asked him to quit BPJS Kesehatan due to the planned increase in the premium.

“We are still discussing it. Anther possibility is switching to a lower class,” said Zaky, who is a member of the first class JKN.

The government recently issued a presidential decree that mandates the premium increases, the second time during the five years since the insurance was introduced.

The JKN premiums for the first-class service are increasing from Rp 80,000 to Rp 160,000 per month, second-class premiums are more than doubling to Rp 110,000, and the premiums for third-class, which includes coverage for the fully subsidized poor citizens in the country, is increasing from Rp 25,500 to Rp 42,000. The new premiums will be effective in January.  

The increase has received public resistance over concerns that it will burden people, especially the poor who are covered by the government to receive third-class service.

Lawmakers have protested the increase for the lowest class of service, demanding the government to increase subsidy to cover the poor families.

Another JKN member, Iqbal, also said he would transfer from previously second class to third class next year, saying that the strategy was quite rational for him and his family to remain getting protection from the state’s health insurance.

“The increase [in JKN premium] is too high for us to cover,” Iqbal said.

West Java Health Agency head Berli Hamdani Gelung Sakti said that class switch was a reasonable reaction to the increase in JKN premium. “Moreover, membership is obligatory for all family members.”

Responding to the possibility of a decrease in the people’s interests to join BPJS Kesehatan, Berli said such a phenomenon was possible and could weaken the insurer’s fiscal strength.

“If that is the case, it could decrease the people’s access to health services that in turn will also influence its quality,” Berli said.

To anticipate this he suggested efficient and effective use of the budget. One way of doing so, he said, was by offering only the human resources and medical appliances that were most wanted by the public.

He also said his side would increase the coverage of health services in the province especially in the southern parts.

The West Java administration currently manages six hospitals offering a total of 800 beds, most of which are for class III patients. “We are currently waiting for the infrastructure for an additional 300 beds for class III patients,” he said.

He also said the West Java administration had allocated up to Rp 800 billion for the 2020 provincial budget to cover 40
percent of the total BPJS Kesehatan premium to cover the subsidized poor people.

Acting provincial administration secretary Daud Ahmad said the total number of people covered by the subsidy was 4,048. Previously the administration allocated Rp 600 billion for the subsidy.

“[With the new premium]The additional subsidy fund is estimated to reach between Rp 230 billion and Rp 250 billion, or some Rp 800 billion in total,” said Daud.

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