Urban Health Protection Services and Workers’ Resistance in Greater Jakarta

Urban Health Protection Services and Workers’ Resistance in Greater Jakarta: Problems and Potentials of Expanding Coverage of National Health Insurance Through Taxation

Research Time Range : November 2014 – June 2015

Abstract :

Since the 1990s, social protection policies in developing countris suffered a setback along with the increasing role of the state. Thus, Inkrispena conducted research with Asia Monitor Resource Centre (AMRC) in 2014-2015 with total cost spend for the research was 12.000 HKD. This qualitative research aims to identify the demands of marginalized groups on social protection based on the found issues of health care, analyzes the limitations of National Health Insurance (Jaminan Kesehatan Nasional –JKN) as part of the National Social Security System (Sistem Jaminan Sosial Negara – SJSN) in Indonesia as well as documenting the ways workers get their social protection rights. The research findings indicate that the provision of health care through JKN program is under the market logic, in line with the declining of the state’s role. Instead of being financed through taxes, SJSN appear more as a social insurance with the largest share of financing borne by participants’ premium fees.

By its nature that resembles social insurance, the health care received by the participants tend to be discriminatory. This discrimination is due to the health facilities in Indonesia being dominated by the private parties. Through prospective system application, the rates for health services are pushed as low as possible, so the private parties tend to discriminate against insurance participants, as if this discrimination manipulates informations; such as information on hospital inpatient room availability, manipulating the drug prices, to refusing to serve insurance participants.

Another interesting finding was the fact that Indonesia’s Social Security Agency (Badan Penyelenggara Jaminan Sosial – BPJS) as the JKN administrator also operates as financial services institution. This can be seen from the inclusion of the Financial Services Authority, the agency plays the regulatory and supervisory role to the financial services sector, as the supervising institution of BPJS. BPJS function as a financial services institution is allowed to invest assets to various investments instruments that are potentially laden with human rights violations such as the mining sector.

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