The development of Indonesia’s National Health Insurance (Jaminan Kesehatan Nasional – JKN) policy reflects a serious effort to achieve Universal Health Coverage (UHC) in a country with a large and diverse population. However, significant challenges remain on this journey.

“The health situation in Indonesia reflects the complexity of issues that need to be addressed. Changing health and demographic trends have influenced life expectancy, infant mortality, infectious diseases like malaria, and the shifting patterns of non-communicable diseases such as diabetes and heart disease,” said Ye Eun Ha.

Ye Eun Ha, a DPhil student in Social Policy at the University of Oxford, shared these insights during the Visiting Scholar event organized by the Faculty of Administrative Sciences, Universitas Indonesia (FIA UI). The event, held in a hybrid format on Wednesday, November 1, 2023, took place at the EDISI 2020 Auditorium in FIA UI Depok, attracting approximately 100 participants both in person and online.

Over the past decades, Indonesia has seen improvements in life expectancy, infant and child mortality rates, and a decline in infectious diseases like malaria. However, new challenges have emerged, including child malnutrition and diseases linked to social progress.

“The development of social protection and healthcare policies in Indonesia has spanned several decades. After gaining independence in 1945, the primary focus was on post-war recovery amidst poor health conditions. Health reforms began under President Soekarno, paving the way for informal social protection and the first initiatives toward establishing a national health system,” she explained.

During President Soeharto’s leadership, social security and health insurance programs expanded significantly, with notable improvements in health indicators during the 1970s and 1980s.

“Democratic reforms and constitutional changes laid the legal foundation for the right to social security. Social safety net programs and health insurance for the poor were developed as part of efforts to achieve Universal Health Coverage (UHC),” she added.

The National Social Security System Law (SJSN) was passed in 2004 to ensure social protection for all citizens. However, Ye Eun Ha highlighted that achieving UHC continues to face ongoing challenges, including issues related to healthcare quality, workforce, infrastructure, financing, and out-of-pocket expenses.

“Significant regional disparities, low participation from the informal sector, and deficits in the National Health Insurance (NHI) structure are critical problems to address. Additionally, issues such as corruption, dual practice among doctors, and the increasing role of the private sector pose further challenges,” she said.

Ye Eun Ha emphasized that the development of Indonesia’s national health insurance policy represents a remarkable effort toward achieving UHC. However, addressing sustained challenges in healthcare quality and coverage, financial management, and social and regional inequalities remains a daunting task for the government and policymakers moving forward.