Policy Implementation Model of National Health Insurance Through Social Health Insurance Institution (BPJS) in Indonesia

Abstract

Purpose: Health development is fundamentally aimed at increasing awareness, willingness, and the ability to lead a healthy life for everyone to achieve optimal health, as mandated by the opening of the 1945 Constitution of the Republic of Indonesia. It is the right of the community to receive healthcare services from the state. However, efforts through implementing the National Health Insurance Policy entrusted to the Social Health Insurance Institution (BPJS) Health, until now, are far from the meaning of justice. The implementation of BPJS Health still faces various issues, including problems with BPJS Health that occurred since the card activation process. Second, the referral of healthcare institutions designated by BPJS Health must be expanded and more flexible. Third, the complexity of BPJS Health service flow due to implementing a tiered service flow.   Theoretical Framework: SJSN stands for the National Social Security System, a social security system in Indonesia under Law Number 40 of 2004. This social security is one of the forms of social protection organized by the Republic of Indonesia to ensure its citizens can meet basic living needs and create an independent, advanced, just, and prosperous Indonesian society.   Methods: This research uses a qualitative approach that finds, understands, explains, and obtains an overview of social and public phenomena related to policies and programs implemented by the government in the context of implementing the national health insurance system. Data is analysed descriptively, referring to the Data Analysis Technique Model by Matthew B. Miles et al. (2014).   Findings: Through this research, recommendations are made for policy implementation improvements, including developing and empowering policy implementers with a humanistic and participatory approach through periodic provision and training of medical and hospital support staff. Thus, the implementation model can be emphasized in improving regulations, participation, finances, healthcare services, benefits, premiums, institutions, and organizations.