TEMPO.CO, Jakarta - The huge arrears currently piling up at the Health Care and Social Security Agency (BPJS Kesehatan) budget is only the tip of the iceberg. These structural faults need addressing on a fundamental level. Makeshift solutions will not cure the chronic sickness in the cash flow of the agency managing the National Healthcare Guarantee (JKN) program.
With the aim of guaranteeing the right of all citizens to obtain health care, the JKN was established based on a realistic concept. At a time of financial constraints, the state asked the people to come together to bear the costs.
Problems began when the government was inconsistent in the way it ran the insurance scheme that the program required. The implementing agency, BJPS Kesehatan, was not supported with the risk management instruments that should be a part of an insurance business.
The premiums are still lower than actuarial calculations. As of the end of last year, the average monthly contribution per investor was Rp5,625 less than the claims paid out to them. This is the main reason why the BJPS Kesehatan cashflow has been negative since the JKN program started in 2014.