Proceedings of the 13th Meeting of the
COMCEC Poverty Alleviation Working Group
13
Mr. ZUFRI began his presentation on the history of National Health Insurance in Indonesia, named
Jaminan Kesehatan Nasional (JKN). In 1968, Indonesia implemented a similar program, called
Askes and Asabri, that insured only segmented population, i.e. civil servants, police and military
officers. This program was expanded in 1990s to include formal workers and poor people under
different program. This health system was then integrated into a single universal health coverage
under JKN in January 2014 ten years later after the law of the National Security System passed.
Under JKN, the coverage was scaled up to target 95 percent of population in Indonesia in 2019.
After its 5 years of implementation, JKN has successfully increased the number of people covered.
It could be proved by comparing its first year of implementation with the current number of
registered members. In its first-year of implementation, JKN recorded the number of people
covered reached 133.42 million people. This number almost doubled by early March 2019, when
this number reached 218.13 million people. A similar growth is observed by the ‘supply-side’, i.e.
number of affiliated healthcare facilities. In 2014, there are only 18,437 healthcare affiliated within
JKN system. This number rose to 27,211 facilities by March 2019.
Mr. ZUFRI continued his presentation on the distribution of insurance schemes by categories. From
the chart presented, Mr. ZUFRI pointed out that most of people insured has been subsidized. 96.1
million people out of 218.13 million people who covered by JKN in March 2019 are categorized as
subsidized recipients from the national budget (PBI – APBN) and 35.31 million people were
subsidized recipients from local budget (PBI – APBD). In other words, more than 60 percent of
people covered in the system has been subsidized.
Afterwards, Mr. ZUFRI presented several studies that examine the impact of the implementation of
JKN on access to health by the poor. He pointed out the impact of JKN in three perspectives. First,
JKN has successfully reduced the inequality between the poor and non – poor in accessing to
healthcare (Agustina ., 2019; Dartanto ., 2015). As a result of this system, there has been an
improvement on healthcare utilization of the poor people considerably (Johar, et. al., 2018). Second,
JKN has reduced the household expenditure on healthcare. This argument was observed by
Agustina . (2019) who shows a decrease in out-of-pocket money for health expenditures after
conducting a household survey.
Finally, Mr. ZUFRI emphasized that the implementation of JKN has contributed to reaching ‘1-digit
poverty rate’ target set by Government of Indonesia. Since the health expenditure is one of fourteen
indicators for measuring poverty in Indonesia, reducing the expenditure of poor people through
JKN directly affects downward poverty rate in Indonesia.
6.2. Malaysia
Dr. Mohd Safiee b. ISMAIL, Principal Assistant Director for the Ministry of Health of Malaysia
presented on Malaysia country profile, the health case system, some achievements, various efforts
to achieve universal health coverage, issues and challenges and the way forward.