Harmoko, MD#, Edward, MD #Institut Kesehatan Helvetia Health Policy Analysis Analysis of National Health Insurance in Indonesia: It’s Sustainability from Macro-economic Aspects Harmoko, MD#, Edward, MD #Institut Kesehatan Helvetia

BACKGROUND Following the theme of universal health coverage Major pro and contra that needs more study Potential area exist for reformation

INTRODUCTION Indonesia is in the midst of major health system reformation National Health Insurance (NHI) is one of the healthcare products that aimed for a comprehensive, affordable, and high quality manner Slow improvement due to low education, difficult geographical access, cultural barriers, low income and low health expenditures

INTRODUCTION Financial crisis, Indonesia is still struggling to finance healthcare, especially for the poor A strong relationship between health status of a population and healthcare financing, especially healthcare expenditures Nominal amount and percentage of gross domestic product, are lower in developing countries rather than those in developed countries, that in which contribute negatively on the improvement of health status in Indonesia

INTRODUCTION Healthcare financing is the most important element in achieving healthcare improvement. The weight of healthcare expenditures affect the availability of human resources, medical supplies, distribution of healthcare facilities, quality of services, and other important process of healthcare delivery (WHO 2000)

OBJECTIVE Healthcare financing through NHI schemes will be reviewed to identify problems and potentials for reformation Give evidence-based information and analyze the NHI program in Indonesia: it’s sustainability from macro-economic aspects

Universal Health Coverage a. the percentage of the population covered b. The comprehensiveness of the health services included c) the percentage of health-care costs still borne by the population

METHOD OF RESEARCH This research is done with qualitative approaches. The research strategy is exploring towards process, activity, and event The primary data were directly collected by researchers by in-depth interview, focus group discussion (management, hospital administrative, and primary health services) and case-study interpretative approaches. the secondary data were collected from several documentations and publications

RESULT Membership Encourage from private sector Law enforcement with administrative sanctions Contribution Low contribution fee require for increasing Cross subsidy or mutual sharing Healthcare provider Readiness of public health center Distribution, facilities, and comprehensiveness of providers

RESULT Financial Price regulation Fund management option for liquidity and solvability Pharmaceutical Efficiency of pharmaceutical expenditure Fiscal GDP consider as the third lowest (2.7%) Low fiscal income

CONCLUSION Strategy for sustainability: supporting effective, efficient, and equitable Expanding membership Creating fiscal capacity for revenue Increasing GDP in healthcare expenditure Efficiency, distribution and amelioration of healthcare providers Developed rewards system to encourage public health center