Indonesia has seen a sharp rise in the daily numbers of confirmed COVID-19 infections.
As of Thursday (21 May), the country reached a daily high of 973, bringing the total number of confirmed COVID-19 cases to 20,162.
The government spokesperson for COVID-19 mitigation task force, Ahmad Yurianto, in a virtual press conference on Wednesday (20 May) said that the sharp spike in the numbers of COVID-19 daily cases is due to a lack of awareness in complying with large-scale social restriction (PSBB) measures, given that people were seen gathering in crowds ahead of the Eid-al-Fitr holiday.
Another concern is on whether the healthcare facilities have enough hospital beds to accommodate the patients.
According to OECD Data of available hospital beds per 1,000 inhabitants, Indonesia ranked 41 of the listed 42 countries with one bed available for every 1000 inhabitants in 2017.
However, there are eight provinces in 2018 that have not met the WHO standard — not a single person out of the 1000 people in the provinces were able to receive hospital care.
According to CEOWORLD Heath Care Index 2019, Indonesia ranked 52nd among 89 countries listed for its quality of the health care system based on criteria such as infrastructure, professionals, cost, availability of quality medicine, and government readiness.
Indonesia ranked 55th among 93 countries listed in the Numbeo Healthcare Index 2020. Singapore ranked 25th.
Indonesia has a universal healthcare coverage called the National Health Insurance (JKN), run by the BPJS Kesehatan (Healthcare and Social Security Agency).
Through this scheme, the Indonesian government wants to ensure that all Indonesians can access affordable, comprehensive healthcare service.
According to data from BPJS Kesehatan, as of 27 December last year, 224.1 million Indonesians are registered under the JKN-KIS (Healthy Indonesia Card) scheme.
The Indonesian government’s decision to raise the BPJS premium starting July this year has triggered nationwide criticism, saying that raising the health insurance premium during the COVID-19 pandemic is like rubbing salt into the wounds of many contributors who are currently struggling financially.
Previously, the Supreme Court verdict had annulled the rise in the BPJS premium, thanks to the class action submitted by the Indonesian Hemodialysis Patient Community (KPCDI).
Deputy Finance Minister Mardiasmo said that the decision to hike the BPJS premium is due to the agency’s deficit.
Member of the National Social Security Council (DJSN), Iene Muliati, echoed the statement, claiming that 11 million out of 22 millions of independent subscribers do not actively pay their monthly premium.
The Indonesian Corruption Watch (ICW) observed, however, that the main cause of the BPJS deficit is the fraud committed by designated first-level health facilities (FKTP) and advanced health facilities (FKTL), not the premium’s late payment.
For example, FKTP must typically issue a reference for a patient to seek medical treatment in FKTL or hospitals. However, FKTP may also refer patients to health community centres.
Plans to do away with classification of service in national health insurance ongoing
Indonesia’s federal government is also planning to eliminate the three classes of the BPJS to provide an equal service for all Indonesians, regardless of the amount of the premium paid.
There are three classes of BPJS. The first class has a monthly premium worth Rp 80,000. The second class monthly premium is set at Rp 51,000 while the third class is set at Rp 25,500.
However, the DJSN has yet to explain more detail about the policy to eradicate classes in the national insurance scheme. Plans to do so are expected to be completed at the end of this year.
BPJS Kesehatan Director Fahmi Idris told Detik last year that the BPJS monthly premium is still low compared to other countries’ national insurance premiums such as Vietnam.
The BPJS’ current premium for the lowest class is Rp 25,500 (S$2.44), while Vietnam’s lowest premium for the insurance is US$2.70 (S$3.83).
Numerous illnesses are covered by BPJS, such as stroke, hypertension, cancer, and diabetes.
However, there are some health conditions not covered by the BPJS, such as treatment for drug addiction, alternative health medications such as acupuncture, and so on.
The BPJS Kesehatan covers medical expenses for COVID-19 patients, whether they are registered as the BPJS Kesehatan members.
The same procedure applies to expatriates who are COVID-19 patients in Indonesia.