The Study on the Conflicts of the Construction of the National Health Insurance Act Article 53 Paragraph 1 - Focused on the Principle of Social Security

2017 ◽  
Vol 10 (3) ◽  
pp. 609-640
Author(s):  
Choon Goo Lee ◽  
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
National Health Insurance ◽  
National Health

scholarly journals Revealing the Legal Protection of Patients Social Security Administration Agency of Health in Sanglah and Balimed Hospitals Denpasar

2020 ◽  
Vol 7 (2) ◽  
pp. 102-110
Author(s):  
RA Tuty Kuswardhani ◽  
I Nyoman Budiana
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
National Health Insurance ◽  
National Health ◽  
Legal Protection ◽  
The Elderly ◽  
National Formulary ◽  
Social Security Administration ◽  
Curative Therapy ◽  
The Social

Social Security Administration Agency of Health has a National National Health Insurance formulary, but in reality patients do not get drugs according to the National Health Insurance National Formulary. Therefore, the aims of this study are to determine the legal protection of patients of the Social Security Administration Agency of Health for the elderly in curative therapy in hospitals according to the national formulary of National Health Insurance at Sanglah Hospital and Balimed Hospital, and to know the responsibilities undertaken by the Social Security Administration Agency of Health in fulfilling its obligations for patients the Agency for the Implementation of the Social Health Insurance of the elderly in curative therapy in accordance with the national formulary of the National Health Insurance. This study uses a participatory observational (empirical-observational) empirical legal research method. Sampling with purposive sampling and data collection techniques using triangulation techniques. In principle, legal protection must refer to legal certainty, fairness and benefits for the population participating in the Social Security Administration Agency of Health for the elderly so that it is not impressed that Balimed Hospital and Sanglah General Hospital and the Social Security Administration Agency of Health make a service to consumers who are not good. The legal responsibility that should be obtained by the participants of the Social Security Administration Agency of Health for the elderly in Balimed Hospital and Sanglah Hospital Denpasar which is currently not maximally received by patients participating in the Social Security Administration Agency of Health for the elderly at Balimed Hospital and Sanglah Hospital.

scholarly journals BACK-REFERRAL PROGRAM IN THE ERA OF NATIONAL HEALTH INSURANCE AT BALUNG DISTRICT GENERAL HOSPITAL OF JEMBER IN 2017

2019 ◽  
Vol 7 (1) ◽  
pp. 33
Author(s):  
Christyana Sandra
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
General Hospital ◽  
National Health Insurance ◽  
National Health ◽  
Access To Health Care ◽  
Neurological Diseases ◽  
District General Hospital ◽  
Stable Conditions ◽  
Number Of Patients

Background: In 2014, National Health Insurance Program (BPJS Kesehatan) implemented Back-Referral Program (BRP) to facilitate access to health care for patients with chronic diseases in stable conditions. However, the program did not run well at District General Hospital of Balung which had the lowest back-referral program (6 participants) in 2015-2016.Aim: The study aims to examine the BRP at Balung District General Hospital of Jember in 2017.Methods: This study is designed as qualitative case study. The informants consisted of head of treasury verification, secretary of JKN service controlling, officers of local government’s free care scheme, coordinator of internal and neurological disease, specialists in internal and neurological diseases, officers of Social Security Agency for Health, officers of patient eligibility verification, and participants of Back-Referral Program. The study was conducted from October to December 2017.Results: Results show that the attendance of BPJS Kesehatan officers has no contribution to the services of BPJS Kesehatan in the hospital. Participants also find it difficult to follow the steps of BRP due to unavailability of drugs at primary healthcare centers. Moreover, neurologists have not written any referral recommendation since 2016, so there was no patient admittance.Conclusions: The BRP at Balung District General Hospital did not achieve its target (<5 cases/week). In the contrary, the average number of patients referred to the hospital was 86 patients per week. Balung District General Hospital should implement Standard Operating Procedure for letters signed by responsible physician for patients and evaluate the BRP. Keywords: National Health Insurance, Back-referral program, Hospital, Social security.

scholarly journals International Constructions of Social Security and Public Health: Policy Intersections 1920–1970

Gesnerus ◽  
2017 ◽  
Vol 74 (2) ◽  
pp. 205-215
Author(s):  
James A. Gillespie
Keyword(s):  
Health Policy ◽  
Health Insurance ◽  
Social Security ◽  
National Health Insurance ◽  
National Health ◽  
Social Insurance ◽  
Early Years ◽  
Health Security ◽  
Global Health Policy ◽  
The Social

The problems of national health insurance played a prominent, but shifting role in the formation of global health policy. This paper uses the work of Geneva based organizations from the end of the First World War to the 1970s to explore the crossing points between health policy and social security. From its formation the League of Nations Health Organisation had an uneasy dialogue with the social insurance and security approaches adopted by the International Labour Organization and the International Social Security Association. When the social insurance concerns of the interwar year broadened into ‘social security’, largely led by the ILO, this debate spilled over into conflicts over the leadership of global social policy and carried over into the early years of WHO. Conflicts centred on the difficult relationship between national health insurance and the other elements of what became the welfare state. The paper identifies the difficulties of constructing a global policy space for action on health security.

Revenue and financing of patients with national health insurance by the social security organizing agency to improve health services

2020 ◽  
Vol 30 ◽  
pp. 276-279
Author(s):  
Syarifuddin Yusuf ◽  
Nuzul Achmar ◽  
Haniarti ◽  
Hasdiana ◽  
Mahkrajani Madjid ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
National Health Insurance ◽  
National Health ◽  
The Social ◽  
Improve Health

scholarly journals Disposition factors in the implementation of the National Health Insurance Program-Healthy Indonesia Card in Makassar City

2021 ◽  
Vol 2 (1) ◽  
pp. 45-54
Author(s):  
Askariani Sahur ◽  
Muh. Akmal Ibrahim ◽  
Thahir Haning ◽  
Hamsinah Hamsinah
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
National Health Insurance ◽  
National Health ◽  
Work Experience ◽  
Supervisory Board ◽  
Social Security Administration ◽  
National Health Insurance Program ◽  
Insurance Program ◽  
Health Insurance Program

This study aims to analyze the disposition factors in the implementation of the National Health Insurance Program-Healthy Indonesia Card in Makassar City. This research uses qualitative methods. This research focuses on disposition factors in the implementation of health insurance service delivery policies at the Guarantee Administration with a phenomenological approach. Sources of data were collected through direct observation and in-depth interviews. The results showed that the disposition in the implementation of the National Health Insurance Program-Healthy Indonesia Card at the Makassar City Social Security Administration is through the appointment of employees in the Social Security Administering Bodies (BPJS) organizational structure at the level. Specific requirements (minimum S1, minimum 5 years work experience as supervisor for the Supervisory Board and directors for the Board of Directors) are considered qualified to hold the position. The selection of branch leaders is imposed by an internal selection system of BPJS Kesehatan. Incentives received by the leadership and employees for determining the amount of salary based on the provisions of the central level and adjusted to the region. The amount of salary / incentive for Makassar City BPJS Health employees is determined according to the lowest Makassar City Minimum Wage, the rest is based on position level. It can be understood that the performance of the Makassar City Healthcare BPJS has not provided the satisfaction of JKK KIS users because there are still complaints from prospective participants who are still taking care of membership, even though it is admittedly the process of validating data originating from the kelurahan, people still consider it slow.

scholarly journals ANALISIS KEPUASAN JAMINAN KESEHATAN NASIONAL PADA PENGGUNA BPJS KESEHATAN DI KOTA SEMARANG

2017 ◽  
Vol 6 (1) ◽  
pp. 53
Author(s):  
Ita Listiyana ◽  
Eunike Raffy Rustiana
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
National Health Insurance ◽  
National Health ◽  
Sampling Technique ◽  
Health Care Insurance ◽  
Cross Sectional ◽  
Significant Difference ◽  
Form Of Government ◽  
The Government

National health insurance (NHI) as a part of national social security system (NSIS) is a form of government commitment to the implementation of health insurance among people in Indonesia entirely. State-owned enterprises (SOEs) assigned specifically by the government to provide health care insurance was the BPJS for Health (social security provider for health). The aim of this study was to analyze the satisfaction of national health insurance among BPJS for Health participants in Semarang City based on education, tuition classes, and place of service. This study was analytical survey with cross sectional approach. Sample of Non PBI (Contribution Assistance Recipients) BPJS for Health were 269 respondents, with purposive proportional sampling technique. There was a significant difference regarding the satisfaction of health insurance based on education level (basic, secondary, and high) and place of service (public hospital and private hospital). There was no significant difference on satisfaction of health insurance based on tuition classes (class I, II, and III). BPJS for Health participants who did not satisfied with the national health insurance were 64.7%. The most important complaint was the process of obtaining an inpatient room.

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