Monday, 17 July 2023, the Faculty of Public Health (FPH), Universitas Indonesia (UI) held an open doctoral promotion session on behalf of Muh. Arief Rosyid Hasan. The session was chaired by Prof. dr. Mondastri Korib Sudaryo, M.S., D.Sc. with Promoter dr. Adang Bachtiar, M.P.H., D.Sc., and the co-promoter Prof. Dr. dr. Fachmi Idris, M. Kes. and Prof. dr. Hasbullah Thabrany, M.P.H., Dr.PH. Acting as a team of examiners Prof. dr. Anhari Achadi, S.K.M., Sc.D .; Prof. Ali Ghufron Mukti, M.Sc., Ph.D.; Prof. Dr. dr. Dumilah Ayuningtyas, MARS.; Dr. drg. Julita Hendrartini, M.Kes., AAK.; and Prastuti Soewondo, S.E., M.P.H., Ph.D. Arief successfully defended his dissertation entitled “Formulation of Additional Health Insurance Policy for Participants in the National Health Insurance Program in Strengthening the Role of a Welfare State” and graduated as Doctor of Public Health Sciences with cum laude predicate.
JKN is now a social health insurance scheme with the most participants in the world. The population who has become participants in the JKN program is 90.34 percent of the population or 248.77 million people. The JKN program is Indonesia’s best achievement as a welfare state. Arief’s dissertation departs from the problem of using the National Health Insurance (JKN) in Indonesia. However, the JKN program can still be developed and its quality improved. Currently, there are still 25 million Indonesians whose health is not guaranteed with JKN. In addition, there are also health services that are not guaranteed by JKN. This makes the Indonesian people still have to use Additional Health Insurance (AKT) with an average out of pocket (OOP) expenditure of up to 2.7 million Rupiah. The percentage of OOP in Indonesia still exceeds the WHO recommendation limit, which is not to exceed 20% of total health spending. “The number of JKN participants is important, but what needs to be considered is how active the participation is so that the principle of gotong-royong in Pancasila can be implemented properly,” said Muh. Arief.
Independent financing and the existence of services that are not guaranteed by the JKN program, raises demand for additional health insurance (AKT). Arief’s research proves that the demand for inpatient room upgrades is increasing with an average increase of 509 percent every year from 2019-2022. This increase in class of care is one of the benefits that is not guaranteed by the JKN program, which is an opportunity for AKT products.
“Additional Health Insurance for National Health Insurance participants shows how the controlled market mechanism synergizes with the role of the State in creating prosperity. When optimized, this synergy will emerge as the future of the political economy of health in Indonesia,” said the man who currently serves as Independent Commissioner of BSI.
Arief’s research aims to obtain AKT policy formulation for JKN program participants. This study using a mix of quantitative and qualitative methods found that respondents using AKT had the characteristics of highly educated, productive age, urban people, and expenditures other than food exceeding the average Provincial Minimum Wage (UMP). AKT is still the largest number of insurance underwriters used for outpatient and inpatient services. Meanwhile, the combination of JKN and AKT is still the insurance option with the fewest users.
Based on the results of his research, Arief advised policy makers to improve and strengthen the National Social Security Council (DJSN) and the Financial Services Authority (OJK) in the National Social Security System, encourage efforts to control quality and control costs of health services through the preparation of the National Guidelines for Medical Practice (PNPK), and ensure an ecosystem that is conducive to the implementation of the National Social Security System in Indonesia. Arief also suggested that a policy analysis and deeper study be carried out regarding the use of AKT and the reasons for the existence of out of pocket in Indonesian society.
On this occasion, the Visioning Speech by Prof. Dr. Ir. R. Nunung Nuryartono, M.Sc., as the Deputy for Social Welfare Improvement Coordination representing the Coordinating Minister for PMK RI Prof. Muhadjir Effendy who stressed that being healthy is the right of all countries. Therefore, the JKN program, which requires contributions, applies the principle of mutual cooperation in bearing the burden of social security costs. It was recorded that in June 2023, JKN membership had reached 93.47 percent of the entire Indonesian population. “Various improvements continue to be encouraged by the government and all stakeholders, including of course the research results of Doctor Arief Rosyid which are very useful. One of the keys to this research is that the formulation of Additional Health Insurance (AKT) policies for JKN participants needs to be carried out as part of improving JKN. AKT is the future of the political and economic categorization of health,” said Prof. Dr. Ir. R. Nunung Nuryartono, M.Si.
This open session presented a number of national figures from various backgrounds, starting from the Deputy Chairman of the Indonesian People’s Consultative Assembly, Ahmad Muzani; Indonesian Ambassador to Switzerland 2018-2022/Komut BSI, Muliaman Hadad; Minister of Trade 2020-2022, M. Lutfi; Menristekdikti 2014-2019, M. Nasir; Chairman of DPD RI 2009-2016, Irman Gusman; Political Economy Scholar, Fachry Ali; UIII Chancellor, Komaruddin Hidayat; Din Syamsuddin, cross-party figures, media figures, Directors and Commissioners of BUMN, to activists for NU, Muhammadiyah, HMI organizations, and so on.
Doctor drg. Muh. Arief Rosyid Hasan, M.KM. is the 18th graduate of the Doctor of Public Health Sciences program in 2023, the 293rd Doctor of Public Health Sciences program graduate, and the 377th FPH doctoral graduate. (WR)
