Law No. 24/2011 on social security providers (BPJS) received strong criticism during a seminar on the national health insurance system held in Yogyakarta, specifically with regard to the implementation of the law, which is predicted to cause various problems.
Yogyakarta Development Planning Board (Bappeda) staff member Affrio Sunarno said that one of the problems with the law was centralization, which could create a long wait for people to get health insurance since everything is centered in Jakarta.
“This is the era of decentralization. Jamkesda [regional health insurance] and Jamkesmas [people’s health insurance] are managed by regional administrations. With BPJS, however, everything will be handled in Jakarta,” Affrio said.
He also questioned the performance of PT Asuransi Kesehatan (Askes/Health Insurance), which has been given the mandate to run as BPJS.
“We, civil servants, rarely make use of Askes because every time we go to buy expensive medicine we are told that the medicine is not available,” Affrio said.
Other criticism that emerged during the seminar included the fact that the central government, up till now, had not yet finished the Government Regulation or PP for implementing the law on BPJS, which is supposed to come into effect in January 2014.
Article 70 of the law stipulates that the government is to prepare for the implementation of the regulation a year after the law was enacted, which would of made the deadline for the implementation October 2012.
“We have reached the final stage but we cannot yet say when it will be finished,” Deputy Health Minister Ali Ghufron said. He said that the government failed to meet the deadline because the PP working group (Pokja) had to deal with so many stakeholders including workers group, employers group and the community.
Another issue that is yet to be settled is the premium amount shared between workers, employers and the government. “This is beyond the capability of the Pokja,’ Ali said.
Separately, head of the regional budget sub-directorate of the Home Ministry’s regional finance directorate, Moch Ardian, highlighted the need for a PP on the transition process of the Jamkesmas and Jamkesda to the BPJS. This will ensure the government’s continued responsibility to people’s health.
“Remember, when the BPJS Law is put into effect by January 2014, the Jamkesda and Jamkesmas will no longer be. Without this particular PP, there will be further problems,” said Ardian.
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