MILLIONS THOUGHT NOT COVERED BY NATIONAL INSURANCE PLAN

By Andi Abdussalam

Jakarta, Jan 4 (Antara) - The government launched the National Health Insurance (JKN)  program this month to provide citizens with health services, though it is believed that over 10 million poor people have not yet been covered by the program.          The government has only registered 86.4 million poor people it includes on its list of health insurance assistance recipients (PBI). Yet based on data from the Social Safety Net Program Data Collection (PPLS), in 2011 there were 96.7 million poor people in the country.          The National Team for the Acceleration of Poverty Alleviation (TNP2K) also registered 96.7 million poor people in the country.          Thus, some 10.3 million poor people have not yet been included on the PBI list to receive health insurance services. Therefore, according to the Social Security Action Committee (KAJS), about 10.3 million poor people are not yet covered by the National Health Insurance (JKN) program.          "Data received from the National Team for the Acceleration of Poverty Alleviation shows that the number of poor people in the country is recorded at 96.7 million, while the number of poor people registered on the insurance assistance recipient (PBI) list is only 86.4 million," remarked KAJS Secretary General Said Iqbal on Friday.            Iqbal pointed out that based on the Ministry of Health's statement, the recorded 10.3 million poor were not part of the PBI list, as they were already included in the Regional Health Insurance Scheme (Jamkesda).          "That is untrue, because the JKN is not the same as Jamkesda. The JKN allows recipients to avail medical services across Indonesia, while Jamkesda recipients can only receive medical services in specific areas," Iqbal emphasized.          Therefore, Iqbal, who is also the president of the Indonesian Workers Unions Confederation (KSPI), will, through the KSPI, ask the House of Representatives (DPR) to use its rights of investigation and inquiry to probe the Social Security Management Agency (BPJS), which has not yet included all poor people in the country in its health service program.           "We will also file a judicial review with the Supreme Court (MA) on the Presidential Regulation (Perpres) and the Government Regulation (PP), which are not in line with the Law on National Social Security System (SJSN)  and Law on BPJS.  The judicial review will be filed, owing to the fact that millions of the underprivileged have not yet been included in the National Insurance Program," stated Iqbal.         Iqbal said the government was still half-hearted in the implementation of the JKN because there were still 10.3 million poor people who faced difficulties in gaining access to health services at hospitals.          The fact contradicted the statement of President Susilo Bambang Yudhoyono that there would be no more poor people being rejected at hospitals, Iqbal pointed out. The President made the statement when he launched the BPJS operations on January 1, 2014.          Further, he called the step taken by the health minister to include the 10.3 million poor in the Regional Health Insurance (Jamkesda) scheme a trick and constituted a public lie.          This, however, was caused by differences in Jamkesda and JKN. Jamkesda is funded through regional budgets, while JKN is paid for using the state budget. Thus, participants of Jamkesda do not receive medical services anywhere in the country, but only in specific areas.           Even in Jakarta, he claimed, not all of the poor have the Jakarta Health Cards (KJS), which are integrated with the National Health Insurance (JKN).  Jakarta Governor Joko Widodo reported that although 4.7 million people are eligible KJS recipients, only 3.5 million KJS cards had been issued.          "Another 1.2 million poor actually do not hold the KJS cards in Jakarta. Thus, they will automatically not be covered by the National Health Insurance or the JKN. This means that about 1.2 million poor in Jakarta will be rejected at hospitals because they are not JKN members.          After all, workers will not pay premiums for the Jamkesda program in 2014 because Law No.3/1992 on Jamsostek (worker social insurance) is still effective until 2015. The insurance premiums of workers for this program are paid by their employers. So, the Perpres No.101/2013 which regulates the payments of premiums by workers and employers has not yet been accepted by workers.          In the meantime, apart from the issue of the 10.3 million poor, an expert from the minister of social affairs said that the Social Security Management Agency (BPJS) should also give priority to 1.8 million people with community and social problems (PMKS).          "These are the neglected people, such as street children, the elderly, disabled persons and loiterers, who have to be given priority as they still stay in houses for street children," stated Sapto Waluyu, from the Ministry of Social Affairs for public relations and governance.          He noted that Social Affairs Minister Salim Segaf Al Jufri had signed a Social Affairs Minister's Decree No. 146 and No. 147/HUK/2013 per December 23 on the criteria of the poor and on the recipients of health insurance assistance (PBI).           The number of underprivileged registered with the PBI list stood at 86.4 million, with a budget of Rp19.3 trillion.           That is why the implementation of the BPJS has also sparked protest because, based on the Social Safety Net Program Data Collection (PPLS), in 2011 there were 96.7 million poor people.      This means there will be 10.3 million poor people who will not benefit from these services.           Social affairs observer Dr Bagus Aryo noted that the accuracy of the data will decide on the success of the BPJS. "Thus, the people who are not yet included in the PBI list could be covered with the regional social insurance (Jamkesda) scheme based on their respective domiciles. Then, they should gradually be integrated into the BPJS system," Bagus Aryo explained.          He added that the ministry of social affairs should ensure that the integration of data takes place as soon as possible so that there will not be poor people who do not have access to health security services, wherever they live.          Beginning January 1, 2014, the government launched the JKN system under the Social Security Management Agency (BPJS).          There are four categories of people who are eligible to receive JKN services: previous participants of the health insurance (Askes) scheme; the poor, very poor, and high-risk individuals who were previously covered under the state-owned insurance firm, PT Jamsostek; military personnel; and police.          Those who are economically stable can participate in the JKN scheme by paying monthly premiums at affordable prices based on the class of coverage they plan to enroll in, such as class III with a premium of Rp25,500, class II with Rp42,500 and class I with Rp59,500.          President Yudhoyono, when chairing a limited cabinet meeting on the final preparations of the health insurance scheme on Monday, urged all parties, including government officials, hospital operators and paramedics, to fully support the program.          More than 35 million civil servants, police personnel and employees of state-owned companies have joined the health insurance program. In total, 121.6 million Indonesians are now part of the program, and 125 million others are expected to follow soon.          As of Thursday, a total of 9,217 public health care centers across the country have teamed with the BPJS to carry out the health insurance program, or about 96 percent of the target.***3*** (T.A014/INE/H-YH) (EDITED BY INE) (T.A014/A/BESSR/A/Yosep) 04-01-2014 16: