High Level Forum on Expanding Coverage to the Informal Sector
Oct 2013 – Indonesia hosts a High Level Forum on Expanding Coverage to the Informal Sector on 29 September – 2 October 2013, in Yogjakarta, Indonesia
While the implementation of the National Roadmap has been moving forward in 2013, one crucial question has remained unsolved: How will BPJS Health cover the non-poor informal sector?
Following up on several discussion rounds and workshops concerned with the informal sector the High Level Forum was organized to bring in international experiences and exchange on lessons learned from other countries such as Korea, Thailand, Viet Mam and the Philippines. The policy discussion was continued with Indonesian representatives from MoH, BAPPENAS, DJSN, MoF, Local Government, PT Askes and PT Jamsostek. The main trade off in opinions still lies in the question of contribution financing vs. subsidies which the MoF would have to agree on.
Moreover, a Policy Brief by BAPPENAS, summing up the results of a study conducted to analyze the main challenges and recommendations for expansion of social health protection to informal workers in Indonesia was presented. Characteristics of informal workers, challenges of contribution collection and/or contribution assistance to the non-poor informal workers were discussed.
The Forum was supported by GIZ, AusAID, and the JLN, with contributions from WHO and the World Bank.
Consensus Building and Launch of the National Health Roadmap
Nov 2012 – In 2011 Indonesia’s government promised to provide Universal Health Coverage to all its citizens from 2014 on. For this purpose, building up on the Law 40/2004 concerning the National Social Security System (SJSN), the law 24/2011 on the establishment of the National Carrier for Health (BPJS Health) by January 1, 2014 was enacted.
The law foresees the transformation of Persero Asuransi Kesehatan Indonesia (Askes), currently being the health insurance scheme for civil servants, into a single payer for the whole population of Indonesia.
The National Social Security Council (DJSN) and other relevant key stakeholders such as the MoH, have developed the National Health Roadmap which describes the reform process to be undertaken for the establishment of BPJS Health. The development of the document, also known as the Roadmap for Universal Health Coverage, faced continued challenges in coordination and synchronization among the stakeholders from various sectors. However, due to intense process of consensus building, the Roadmap was endorsed as a standalone national document.
The Roadmap was launched on November 29, 2012 at a meeting attended by over 1100 key national and regional stakeholders. The Coordinating Minister for People’s Welfare, Minister of Health and Minister of National Development Planning attended as well as Governors and Heads of District from the 33 Provinces, as well as representatives of international agencies.
The Roadmap is supposed to be the key guiding document for implementation of reform in the next years. The development partners of the Partners for Universal Coverage group (PUC) need to coordinate their support accordingly in order to increase efficiency and promote a shared UHC vision.
Oct 2012 – The IT-Workshop was conducted in Jakarta to bring together DJSN with other relevant stakholders and discuss the future IT activities, priorities and roles for the implementation of Nationale Health Roadmap.
The workshop is one example for successful cross-sectoral collaboration of diverse national agencies such as the Ministry of Home Affairs, the Ministry of Health, PT Askes und PT Jamsostek, TNP2K, BAPPENAS as well as hospital administration and provider representatives and development partners.
Key topics of the workshop were how to foster the cooperation of the agencies to establish a unified data base of BPJS members and agree on universal standards for data sets.
Forming a ‘Partnership for Universal Health Coverage’
Jan 2012 – Though Indonesia has made significant progress towards UHC/SHP in the last few years, a number of strategic choices still need to be made with regard to the enrolment of the informal sector, the harmonisation of various insurance benefit packages, improving efficiency through provider payment mechanisms, and the harmonisation of various insurance carriers. In this context, the prospect of joint harmonised support of development partners has been welcomed by various national agencies, such as the National Social Security Council (DJSN), the National Development Planning Agency (BAPPENAS) and the Ministry of Health.
Several P4H network partners are already, or intend to become, more active with regard to UC and SHP in Indonesia. Promoting open and inclusive networking at country level, WHO Indonesia launched a ‘Partnership for Universal Health Coverage’ in Jan 2012 comprising WHO, the World Bank, ILO, GIZ, AusAID, JICA, USAID and the JLN.
Engaging with P4H
Dec 2011 – Since its transition to democracy in 1999, Indonesia has made significant progress in introducing democratic institutions and practices and in moving towards a market economy. As part of this process, the government has begun the substantial reform of the National Social Security System (SJSN), notably with the passage of new legislation in 2004 (law No. 40/2004) which is intended to ensure protection and social welfare for all Indonesians. While the Indonesian Government has made progress in improving social protection over the past few decades by introducing pro-poor programmes such as health insurance for the poor, rice for the poor and conditional cash transfers, major challenges remain, including increasing coverage for informal workers, reducing systemic fragmentation, and increasing systemic performance.
In December, P4H network partner, GIZ, invited the P4H Coordination Desk to participate in an appraisal mission to discuss ways to integrate future GIZ support with the work of other development partners under the P4H umbrella. The mission helped to clarify current support requirements and to facilitate the creation of a country network (Partnership for Universal Health Coverage) thus laying the foundation for the scale-up of joint, harmonised support for Indonesia on its path towards universal health coverage.
- Report from coordination desk (pdf, 408kb)