Implementation of National Health Insurance in Serang and Manado

Cicilya Candi, Adang Bachtiar


Faculty of Public Health, Universitas Indonesia



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.can­ Mobile: 085281428636.


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