Increasing participant fees, BPJS Health must be ready to open up

bpjsAfter being flooded with public protests, the government finally decided to postpone the increase BPJS Health class III contributions for the independent participant category. However, this decision does not apply to contributions with class I and II service benefits. Starting April 1 2016, BPJS Health Class II contributions increased to IDR 51,000 per person per month, from previously only IDR 42,500. Meanwhile, for class I, the monthly fee per person skyrockets from IDR 59,500 to IDR 80,000.

PATTIRO believes that it is not unlawful for BPJS Health to increase participant fees. However, it must be remembered, as a public body, the Indonesian public health insurance institution must be willing to be transparent, especially regarding information regarding the calculation of participant premium unit costs. “So, BPJS Health must open the calculations of premium unit costs so that the public knows where the nominal amounts of IDR 51,000 and IDR 80,000 come from,” said PATTIRO Researcher Didik Purwondanu.

By disclosing this information, explained Didik, the public can monitor whether the fees they have been paying every month are sufficient or not. From there, the public can assess whether the increase in BPJS Health contributions is actually reasonable or not. “This needs to be done so that people do not feel cheated, especially when the services provided by BPJS Health partner hospitals are still not optimal,” he explained.

Apart from making transparent information regarding premium unit costs, it is also legally obligatory for BPJS Health, as a public body, to disclose information regarding the size of the budget they have been managing.

“BPJS Health is a public body, in accordance with the Information Openness Law, they must disclose various public information that they have, including the amount of funds they receive from the government and the public funds they manage. “They must also disclose information on how many Indonesians are registered as members of BPJS Health,” added Didik.

Furthermore, apart from the importance of transparency in budget management, BPJS Health must also disclose information regarding the reasons they suffer losses. “The public needs to be informed whether losses occur because there are too many sick people in Indonesia, or because of the large hospital operational costs, or because there is something wrong in the claims system resulting in cost overruns. This is necessary so that there are no wild assumptions in society. “The public needs to know, because what BPJS Health manages is public money,” concluded Didik.

It is not only the issue of budget transparency and the reasons for increasing fees that the institution needs to think about. PATTIRO Public Service Specialist Rokhmad Munawir explained that the increase in monthly BPJS Health contributions has the potential to cause new problems.

“Because of the increase in fees, it is feared that independent class I and II participants will actually flock to move to class III. As a result, the rooms for class 3 will be full. Moreover, hospital behavior is sometimes bad, rejecting patients on the grounds that the rooms are full. “If this happens, it’s possible that hospitals will even more often refuse BPJS Health patients,” said Rokhmad.

If these concerns are true, Rokhmad emphasized that BPJS Health must open up and be willing to collaborate with civil society who are members of the National Health Insurance Users Association (JKN) to carry out supervision of hospitals. “This is also important to do so that hospitals do not increasingly reject JKN participating patients,” he added.

Rokmad also emphasized that in the next three months, the government must evaluate its policy of increasing BPJS Health contributions. “Because the government continues to insist on increasing BPJS Health contributions, over the next three months, this policy must be evaluated. If the impact on society is not good, they must reduce the fees again. “Don’t forget, also make the evaluation results transparent,” stressed Rokhmad.

This article was published in Rakyat Merdeka Online with the title Naikkan Iuran Peserta, BPJS Kesehatan Tidak Transparan.

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