The Challenges of Universal Health Insurance in Developing Countries: Experimental Evidence from Indonesia’s National Health Insurance (original) (raw)
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In 2014, Indonesia implemented a new, nationwide, subsidised universalcoverage health insurance program, under which poor Indonesians do not pay to become members and others pay a relatively low fee. This program has created a national debate about the effectiveness of the ownership of health insurance in increasing the use of health services-particularly among the poor-given the limitations in their quantity and quality. Using membership data on different health insurance programs from the 2007 rounds of Susenas and Riskesdas, this article researches the impact of having health insurance on health service utilisation, by controlling the levels of quality and quantity of health services in the area. We argue that having health insurance increases health service utilisation by approximately eight percentage points when people feel sick (or by approximately five percentage points if we include those who do not feel sick).
International Journal of Health Planning and Management, 1992
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BMC Public Health, 2023
Background Indonesia has made significant progress in expanding universal health coverage (UHC) through its National Health Insurance (NHI) mechanism. However, in the context of NHI implementation in Indonesia, socioeconomic disparities caused its subpopulations to have different literacy of NHI concepts and procedures, increasing the risk of healthcare access inequities. Hence, the study aimed to analyse the predictors of NHI membership among the poor with different education levels in Indonesia.
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Institutional delivery has an impact on the decline in maternal mortality rate. In Indonesia, institutional delivery increases every year, but there are still 30%-37% mothers who deliver at home. Unfortunately, the increase is not in line with maternal mortality reduction, so that Indonesia does not achieve the fifth MDGs goal. To achieve Universal Health Coverage, Indonesia implements National Health Insurance (NHI). NHI integrates four types of health insurance, namely Askes/ASABRI, Jamsostek, Jamkesmas and Jamkesda. One of its benefits is maternal health services. Health insurance can address financial barriers on delivery in health facility. By using secondary data of National Basic Health Research 2013 and Village Potential 2011 data, this study aimed to analyze effect of health insurance on institutional delivery in Indonesia. Samples were 39,942 women aged 15-49 years old who gave birth to their last child during 2010-2013. The study used econometric approach by applying prob...
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The implementation of national health insurance in Indonesia since 2014 has brought out the missing middle problem in which the non-poor informal sectors have remained uncovered from the health care due to self-enrollment. Therefore, achieving UHC in Indonesia will take a long process, especially when the proportion of non-poor informal sector in total population is large enough. This study aims at examining three main issues that may have become obstacles for informal sectors to join the program: (1) observing supply side readiness, (2) examining affordable premium and willingness to pay of informal sectors, and (3) exploring why informal workers have been reluctant to join the national health insurance. This study reports that around 53.7% of Sub National Government (SNG) faced a shortage of health facilities of 59,387 beds, though in some regions had surplus of beds (per 1000 people). This study also finds that a single premium for all over Indonesia is unfair and unaffordable fo...
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