scholarly journals The role of occupational health services in the universal health coverage era in Indonesia

2019 ◽  
Vol 38 (1) ◽  
pp. 1
Author(s):  
Muchtaruddin Mansyur
Keyword(s):  
Social Security ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
Pension Benefit ◽  
Occupational Health Services ◽  
Health Coverage ◽  
The Social ◽  
National Organizations ◽  
The Government ◽  
Universal Health

<p>In accordance to Act No 24 Year 2011 on The Social Security Administrating Body, the Indonesian National Social Security program is managed by  two national organizations, namely: Social Security Administering Body for Health (<em>Badan Penyelenggara Jaminan Sosial Kesehatan = BPJS Kesehatan</em>) and Social Security Administering Body for Labor (<em>Badan Penyelenggara Jaminan Sosial Ketenagakerjaan = BPJS Ketenagakerjaan</em>). The former is responsible for providing health coverage for all Indonesians through the National Social Health Insurance Scheme known as the Jaminan Kesehatan Nasional/JKN. The latter is  responsible for  providing the worker's social security consisting of Provident Fund Benefit, Accident Benefit, Pension Benefit, and Death Benefit.<sup>1</sup></p>The Indonesian government has been continuously improving the health service program towards better national universal health coverage and has set the 2019 functional achievement target of 95% of the population enrolled in the program. To ensure that this target of  the program will be achieved,  the government pays the premium of <em>BPJS Kesehatan</em> of the poor and near poor.<sup>2</sup>

scholarly journals Moving Towards Universal Health Coverage

2018 ◽  
pp. 19-45
Author(s):  
Ching Yuen Luk
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Coverage ◽  
Health Insurance System ◽  
Insurance System ◽  
Social Health Insurance System ◽  
The Government ◽  
Universal Health

This study uses a refined version of historical institutionalism to critically examine the complex interplay of forces that shape the health insurance reform trajectory in China since the mid-1980s and identifies problems that impede the government from achieving universal health coverage (UHC). It shows that China's multi-layered social health insurance system has covered more than 95 percent of its population, but failed to provide insured people with access to a range of essential services and make health care affordable. To achieve UHC, the government has to overcome significant hurdles, which include the inherently discriminatory design of the social health insurance system, disorder in the drug distribution system, deficits in the funding of health insurance, and insufficient medical protection for the old people.

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

scholarly journals Unique health identifiers for universal health coverage

2019 ◽  
Vol 38 (S1) ◽  
Author(s):  
Samuel Mills ◽  
Jane Kim Lee ◽  
Bahie Mary Rassekh ◽  
Martina Zorko Kodelja ◽  
Green Bae ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Identity Management ◽  
Health Coverage ◽  
Vital Event ◽  
Identification Number ◽  
Civil Registration ◽  
Advantages And Disadvantages ◽  
Number Systems ◽  
The Government ◽  
Universal Health

Abstract Identifying everyone residing in a country, especially the poor, is an indispensable part of pursuing universal health coverage (UHC). Having information on an individuals’ financial protection is also imperative for measuring the progress of UHC. This paper examines different ways of instituting a system of unique health identifiers that can lead toward achieving UHC, particularly in relation to utilizing universal civil registration and national unique identification number systems. Civil registration is a fundamental function of the government that establishes a legal identity for individuals and enables them to access essential public services. National unique identification numbers assigned at birth registration can further link their vital event information with data collected in different sectors, including in finance and health. Some countries use the national unique identification number as the unique health identifier, such as is done in South Korea and Thailand. In other countries, a unique health identifier is created in addition to the national unique identification number, but the two numbers are linked; Slovenia offers an example of this arrangement. The advantages and disadvantages of the system types are discussed in the paper. In either approach, linking the health system with the civil registration and national identity management systems contributed to advancing effective and efficient UHC programs in those countries.

Population Coverage to Reach Universal Health Coverage in Selected Nations: A Synthesis of Global Strategies

2020 ◽  
Author(s):  
Minoo ALIPOURI SAKHA ◽  
Najmeh BAHMANZIARI ◽  
Amirhossein TAKIAN
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Health Coverage ◽  
Political Commitment ◽  
Population Coverage ◽  
Definite Indicator ◽  
Expanding Population ◽  
Universal Health

Background: This study aimed to provide tailored transferrable lessons for expanding population coverage through a descriptive lens by reviewing the population coverage policies, reforms and strategies in selected nations. Methods: In this comparative short communication, 14 countries with different status of population coverage and political economy that had successful experiences with coverage expansion were selected and categorized in four groups to study their approaches to reach Universal Health Coverage (UHC). Results: Although each country needs to tailor its policies and reforms based on its own contextual factors, the legal right of citizens to social security and health protection are enshrined in most countries' Constitution. Some countries adapted political and economic reforms to evolve their Social Health Insurance schemes. National laws to push governments to adapt UHC as a national strategy for ensuring that every resident is enrolled in health insurance schemes are key policies to reach UHC. Conclusion: A series of reforms are required to provide total population coverage through various approaches. To create an effective insurance coverage, physical merger of all insurance funds is not necessarily required. Further, the share of GDP for health is not a definite indicator to reach UHC. Finally, strong political commitment and citizens’ participation are the key issues in reaching UHC, while considering the poorest, remote and neglected population really matters.  

scholarly journals Gambaran Out of Pocket pada Awal Era JKN di Indonesia

2018 ◽  
pp. 141-146
Author(s):  
Ingan Tarigan ◽  
Taty Suryati
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Financial Protection ◽  
Health Coverage ◽  
Medical Expenses ◽  
The Poor ◽  
The Government ◽  
Universal Health

Abstrak Pogram Jaminan Kesehatan Nasional (JKN) salah satunya bertujuan memberikan perlindungan finansial khususnya biaya katastropik terhadap semua peserta. Penerima manfaat JKN berhak mendapatkan berbagai layanan sebagai bagian dari paket manfaat dasar tanpa mengeluarkan biaya pelayanan, dan diharapkan Out of Pocket (OOP) akan lebih rendah dibandingkan dengan mereka yang tidak memiliki asuransi kesehatan. Tujuan penulisan akan membandingkan total pengeluaran untuk kesehatan dari peserta jaminan kesehatan dengan yang tidak memiliki jaminan kesehatan pada awal era JKN. Dalam analisis ini, pengukuran pengeluaran perawatan kesehatan hanya mencakup biaya pengobatan langsung, seperti biaya konsultasi, pemakaian kamar di rumah sakit dan obat-obatan. Analisis dengan menggunakan data Susenas 2014 terdiri dari 274.673 individu dan 71.051 rumah tangga di 33 provinsi di Indonesia. Hasil penelitian menunjukkan bahwa pada awal era JKN ada sedikit perbedaan OOP pada penduduk miskin dibandingkan dengan penduduk dimana proteksi finansial terhadap penduduk miskin untuk pengeluaran kesehatan masih rendah.Kepemilikan jaminan kesehatan memberikan proteksi finansial akibat pengeluaran biaya kesehatan, khususnya pengeluaran biaya katastropik dibandingkan dengan yang tidak memiliki jaminan kesehatan. Kepesertaan penduduk miskin ditargetkan tahun 2019 sudah terpenuhi sehingga target pemerintah tentang Universal Health Coverage (UHC) perlindungan finansial pada penduduk miskin dan hampir miskin semakin tinggi atau OOP semakin mendekati nol. Kata kunci: OOP, Pembiayaan, Asuransi Kesehatan Abstract One of the main objectives of the JKN program is to provide financial protection, especially catastrophic costs to all members. JKN beneficiaries are entitled to various services as part of the basic benefit package without incurring service costs, and it is expected that Out of Pocket (OOP) will be lower than those who do not have health insurance. The purpose of writing will be to compare the total health expenditures of health insurance participants or beneficiaries and those without health insurance. In this analysis, the measurement of health care expenditures only includes direct medical expenses, such as consultation fees, hospital room usage and medication. Using Susenas data 2014 consists of 274,673 individuals and 71,051 households in 33 provinces in Indonesia. At the beginning of the JKN implementation, there was little difference of out of pocket in the poorest population compared to the richest population. This shows that financial protection to the poor for health expenditures are still low. The ownership of health insurance tends to provide financial protection due to health expenditures, especially catastrophic expenses compared to those without health insurance. In the Year of 2019 where the government targeted to Universal Health Coverage (UHC) expected protection financial on the poor and near poor is getting higher or out of pocket or getting closer up to zero. Keywords: OOP, Financial Protection, Health Insurance

scholarly journals Government plans in the 2016 and 2021 Peruvian presidential elections: A natural language processing analysis of the health chapters

2021 ◽  
Vol 6 ◽  
pp. 177
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Manuel Castillo-Cara ◽  
Jesús Lovón-Melgarejo
Keyword(s):  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Universal Health Coverage ◽  
Presidential Elections ◽  
Clinical Medicine ◽  
Health Coverage ◽  
Keywords And Phrases ◽  
The Government ◽  
Universal Health

Background: While clinical medicine has exploded, electronic health records for Natural Language Processing (NLP) analyses, public health, and health policy research have not yet adopted these algorithms. We aimed to dissect the health chapters of the government plans of the 2016 and 2021 Peruvian presidential elections, and to compare different NLP algorithms. Methods: From the government plans (18 in 2016; 19 in 2021) we extracted each sentence from the health chapters. We used five NLP algorithms to extract keywords and phrases from each plan: Term Frequency–Inverse Document Frequency (TF-IDF), Latent Dirichlet Allocation (LDA), TextRank, Keywords Bidirectional Encoder Representations from Transformers (KeyBERT), and Rapid Automatic Keywords Extraction (Rake). Results: In 2016 we analysed 630 sentences, whereas in 2021 there were 1,685 sentences. The TF-IDF algorithm showed that in 2016, 22 terms appeared with a frequency of 0.05 or greater, while in 2021 27 terms met this criterion. The LDA algorithm defined two groups. The first included terms related to things the population would receive (e.g., ’insurance’), while the second included terms about the health system (e.g., ’capacity’). In 2021, most of the government plans belonged to the second group. The TextRank analysis provided keywords showing that ’universal health coverage’ appeared frequently in 2016, while in 2021 keywords about the COVID-19 pandemic were often found. The KeyBERT algorithm provided keywords based on the context of the text. These keywords identified some underlying characteristics of the political party (e.g., political spectrum such as left-wing). The Rake algorithm delivered phrases, in which we found ’universal health coverage’ in 2016 and 2021. Conclusion: The NLP analysis could be used to inform on the underlying priorities in each government plan. NLP analysis could also be included in research of health policies and politics during general elections and provide informative summaries for the general population.

Universal health coverage and user charges

2013 ◽  
Vol 8 (4) ◽  
pp. 529-535 ◽  
Author(s):  
Peter C. Smith
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
Social Health ◽  
World Health ◽  
World Health Report ◽  
Health Coverage ◽  
User Charges ◽  
Universal Health

AbstractThere has been an explosion of interest in the concept of ‘universal health coverage’, fuelled by publication of the World Health Report 2010. This paper argues that the system of user charges for health services is a fundamental determinant of levels of coverage. A charge can lead to a loss of utility in two ways. Citizens who are deterred from using services by the charge will suffer an adverse health impact. And citizens who use the service will suffer a loss of wealth. The role of social health insurance is threefold: to reduce households’ financial risk associated with sickness; to promote enhanced access to needed health services; and to contribute to societal equity objectives, through an implicit financial transfer from rich to poor and healthy to sick. In principle, an optimal user charge policy can ensure that the social health insurance funds are used to best effect in pursuit of these objectives. This paper calls for a fundamental rethink of attitudes and policy towards user charges.

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