Celebrating Human Rights Day: Universal Health Coverage in Indonesia

Indonesia is a country with amazing diversity – and it means a whole unique set of problems within. This level of diversity also leads to many problems, such as the implementation of Universal Health Coverage in Indonesia, well known as the National Health Insurance System (NHIS) that was managed by the Social Security Agency for Health (SSAH). Since implementation started in 2014, NHIS coverage reached about 70% of the population in 2018. The prospective capitation payment in primary healthcare and referral systems led to improved efficiency and effectiveness in access to health service and service delivery across all groups of people in Indonesia. However, challenges remain and new problems emerge – insufficient quantity and quality of primary healthcare facilities, inadequate medical supplies and certain drugs, miscalculation of low and middle-income groups, and poor health information systems. Moreover, financial sustainability as the most frequently addressed problem hasn’t met a great solution yet. One of the biggest hurdles in NHIS is the people themselves: lack of knowledge about NHIS. Responding to that, SCORP CIMSA Faculty of Medicine Sebelas Maret University celebrates Human Rights Day with Universal Health Coverage as the theme. The celebration was held in two days: Grand Lecture on Friday, 20^th December 2019 and ground campaign on Sunday, 22^nd December 2019. 

The grand lecture was given to medical students of Sebelas Maret University by astonishing speakers. While giving a lecture about SSAH, Mrs. Fajarati talked about how the NHIS program has been going on so far. NHIS is founded on the basis of humanity, beneficiary, and social justice. NHIS has two general types of participants: the subsidized group and the nonsubsidized group. The system applied is cross-subsidizing, where healthy people share the financial burden of the sick. She also addressed the problems faced by SSAH, such as population coverage that hasn’t achieved 100% by now, health facilities that aren’t covered yet, and raised insurance fees that’s recently being discussed a lot by citizens. She explained in her lecture that the financial burden that SSAH has to manage is very heavy. For one patient with a certain severe disease, the treatment cost needed has to be covered by about 5000 other healthy people that paid for NHIS. The raised fee is very much needed – population coverage can be widened and all health facilities can be covered by the added income. The other lecture, which was given by Gregorius Yoga Panji Asmara, MD, gave the audience valuable insight from the medical doctor’s side. He brought issues about doctors’ salaries and health services discrimination into the light. He also spoke about the roles of medical students regarding the NHIS program. 

The ground campaign that was held on Car Free Day at Slamet Riyadi Street, Surakarta, Central Java started around 7 o’clock in the morning. CIMSA students were divided into three groups, where a group consisted of around 4-5 people. Every group had to educate the citizens they met about the NHIS program – the facilities, how to access the services, and other ongoing issues such as the recently raised fee. Through the ground campaign intervention, it showed us that people don’t really know much about NHIS – about the importance and benefits within. A citizen gave us the advice to do the campaign around rural sides, where the coverage percentage is low. 

With this event being held, we hope that medical students and people, in general, can understand more and show full support for the NHIS program. It starts with us because health is a #UniversalCall.

Author:

Gabrielle Adani 

CIMSA Indonesia

Universitas Indonesia

Firyal Eqwa Yanayir

CIMSA Indonesia

Universitas Sebelas Maret