Implementation of National Health Insurance in Serang and Manado

Cicilya Candi, Adang Bachtiar

Faculty of Public Health, Universitas Indonesia

ABSTRACT

Background: In 2018, financial condition of the Social Security Administering Agency (BPJS) had deficit of up to 9 trillion rupiah. BPJS established national health insurance (JKN) cadre program to overcome the problem. This study aimed to examine the implementation of JKN in Serang and Manado.

Subjects and Method: This was a qualitative study carried out in Serang (Banten) and Manado (North Sulawesi). A total of 12 cadres was selected for this study. The theme of this study was implementtation of national health insurance in Serang and Manado. The data on JKN cadre was obtained from BPJ office in Serang, Banten, and Manado. The data were collected by focus group discussion (FGD) and in-depth interview with community leaders, adminitrators of BPJS health local office, BPJS deputy heads of regions, local goverments, headman, the head of sub-district, community health center, region health office, and BPJS main office. The data were analyzed using the adaptation of the Malcolm Baldrige framework and policy implementation of Van Meter and Van Horn theory. Secondary data was processed to see the performance of cadres assessed from collectability contributions.

Results: Secondary data analysis showed that performance of JKN cadres was far below from target. JKN cadres were focused on collecting dues. JKN cadres were not optimized because the dominant duty of cadres was only focused on 1 of 4 of cadre duties. This was related to the renumeration system that only focuses on achieving dues collection. Communication between BPJS and related sectors had been established but had not been optimal. Each sector did not yet know its duties and roles in supporting JKN cadre programs.

Conclusion. The implementation of JKN is not yet optimal. Dues collection by cadres is ineffective to increase BPJS income.

Keywords: JKN cadre, cadre renumeration, BPJS

Correspondence: Cicilya Candi. Faculty of Public Health, Universitas Indonesia, Depok, West Java. Email: cicilya.candia@alumni.ui.ac.id. Mobile: 085281428636.

DOI: https://doi.org/10.26911/theicph.2019.04.60

￩￫ x