National Health Insurance Program financing during the COVID-19 pandemic: financial viability and

This paper examines the state of National Health Insurance Program (NHIP) financing during the COVID-19 pandemic in the Philippines, an event which coincides with the implementation of the Universal Health Care (UHC) mandates on restructuring the NHIP premium schedule, providing immediate eligibility to NHIP benefits, and expanding member benefits. Using the ratio of total expenditures to total revenues as the measure of financial viability, it shows that the NHIP remains financially viable during the COVID-19 pandemic year of 2020. Projections for 2021 however show that NHIP financial viability may be adversely affected by the significantly higher number of COVID-19 cases with the negative effect mitigated only if COVID-19 benefit claim patterns remain as weak as observed for 2020. On the revenue side, the potential for a lower premium is observed to be offset by the higher rates in the UHC mandated premium schedule. On the expenditure side, potential increases associated with the implementation of immediate eligibility and the introduction of COVID-19 benefits are mitigated by lower NHIP benefit utilization due to reduced mobility and access to health facilities. Secondary analysis on who has to bear the burden of paying for NHIP benefits, however, shows that the implementation of UHC financing initiatives may heighten adverse incentives on members’ willingness to pay premiums. Using the benefit expenditure-premium contribution ratio as the measure for the burden of paying for NHIP benefits, it is shown that the Formal Economy sector shoulders the burden of funding the NHIP benefits of the Informal Economy and Sponsored sectors.

Policy Analysis of the National Health Insurance Program in Budget Deficit Problems and Its Implication to guarantee patient Covid-19

The purpose of this study is to analyze and describe the National Health Insurance program in terms of the budget deficit problem and its implications for health insurance for Covid-19 patients. This study uses a qualitative method oriented to library research (library research) using secondary data sources and William N. Dunn's analytical approach. The results of this study indicate that the National Health Insurance (JKN) program has not found a bright spot in dealing with the budget deficit after the JKN rate increase through Presidential Decree Number 75 of 2019 was canceled by the Supreme Court because it was considered to have violated the provisions of the 1945 Law article 28 H paragraph 1. The handling of covid-19 patients as the health insurance is instructed to be borne by the BPJS also has legal regulatory constraints, which is contrary to Presidential Decree Number 82 of 2018 article 52 paragraph 1 letter O. Even though the efforts to service covid-19 patients, the budget comes from injecting APBN and APBD funds as effort prevention of a larger deficit, but operationally violates applicable legal provisions. For this reason, it is necessary to make new rules and revise related regulations in order to accelerate the handling of policies in accordance with applicable legal provisions.

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

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.

Indonesia Universal Health Coverage Implementation on University Students

This research aimed to investigate the percentage of university students at the University of Bengkulu, Indonesia, who participated in the national health insurance program, and why the students did or did not participate in the national health insurance program. This research was performed with the inductive approach and sampled 366 university undergraduate students from eight faculties at the University of Bengkulu, Indonesia. The data collection was conducted by survey technique using a questionnaire. The results show that only 58.2% of university students who participated in the national health insurance program and their parents played an important role in determining whether they participated in the program. Pseudo universal health coverage would probably happen in Indonesia since some students participated in the national health insurance program. However, their premium payments were overdue, so that their insurance coverage became inactive. The unique finding of this research is that 1.96 percent of students mentioned that they did not participate in the national health insurance program because they perceived this program categorized as usury, which is forbidden in Islam. Penelitian ini bertujuan untuk mengetahui persentase mahasiswa Universitas Bengkulu yang mengikuti program jaminan kesehatan nasional, dan mengapa mahasiswa mengikuti atau tidak mengikuti program jaminan kesehatan nasional. Penelitian ini dilakukan dengan pendekatan induktif dan mengambil sampel 366 mahasiswa sarjana dari delapan fakultas di Universitas Bengkulu, Indonesia. Pengumpulan data dilakukan dengan teknik survei menggunakan kuesioner. Hasil penelitian menunjukkan bahwa hanya 58,2% mahasiswa yang mengikuti program jaminan kesehatan nasional dan orang tuanya yang berperan penting dalam menentukan keikutsertaan mereka dalam program tersebut. Pertanggungan kesehatan universal semu mungkin akan terjadi di Indonesia karena beberapa pelajar berpartisipasi dalam program jaminan kesehatan nasional. Namun, pembayaran premi mereka terlambat, sehingga pertanggungan asuransinya menjadi tidak aktif. Temuan unik dari penelitian ini adalah 1,96 persen mahasiswa menyatakan tidak mengikuti program jaminan kesehatan nasional karena menganggap program ini termasuk riba yang dilarang dalam Islam.

Pelatihan Pemerataan Kepersertaan Jaminan Kesehatan Nasional Secara Online Di Wonolelo Pleret Bantul

Citizens of the Cegokan Wonolelo Pleret Bantul sub-village still do not understand the National Health Insurance (NHI) program managed by the BPJS. Public knowledge is still very minimal and the desire to register to become NHI participants is still low due to several factors such as the economy and information that is still minimal. The objective is the public can register to become a National Health Insurance participant online. Method by Counseling and training.Knowledge and ability of community participants about the ways and flow of registration to become participants in the National Health Insurance program increased after counseling and training from 40% to 95%. Community can practice registering for NHI online. Community knowledge and abilities are good about registering as participants in the National Health Insurance program after counseling and training.