261851 Birth of the Largest Single Payer System, the National Health Insurance, in Indonesia

Monday, October 29, 2012 : 3:10 PM - 3:30 PM

Hasbullah Thabrany, Prof Dr , Center for Health Economics and Policy Studies, Universitas Indonesia, since 1986, Depok, Indonesia
Currently, Indonesia administers the largest coverage Medicaid scheme (Jamkesmas) covering 76.4 million poorest Indonesia. In addition, there are 20 million workers and their family members covered by social health insurance schemes. After long battle between the Parliament and the Government under pressures from labor unions, non-government organizations, students and other civil societies, in October 2011, a law creating the National Health Insurance Corporation (NHIC), a single payer to administer the NHI of Indonesia (Ina-Medicare) was passed. The political processes, labors demonstration, women for the NHI, and threats for the national strike, finally the Government agreed to pass the law. The overall legal development took almost two years with full and intense political battle by stakeholders. Conflicts, legal, and political maneuvers often observed by various stakeholders who pro and contra the NHIC. The establishment of NHIC followed the same movement of a single payer system in Taiwan, the Philippine, and South Korea. The birth of the Ina-Medicare by NHIC of Indonesia, scheduled to fully operation in January 2014, poses management challenges to provide universal health coverage for 237 million people living in more than 5,000 islands of Indonesia. The Ina-Medicare would provide comprehensive health coverage in public and private providers using prospective payment systems. The payment levels may vary across regions. The contribution is expected to be about 5% of monthly salary. The progresses of massive growth of health insurance coverage and the political process to establish NHIC will be presented and discussed.

Learning Areas:
Administration, management, leadership
Occupational health and safety
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss the complex and intense political debates surrounding a single payer system. Demonstrate that even in a diverse population and very large country a political consensus to achieve the most efficient health care reform can be achieved

Keywords: Financing, Insurance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be abstract author and sole presenter because I work at the Center for Health Economics and Policy Studies, Universitas Indonesia, since 1986 and the presentation is on the economics of health care in Indonesia.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.