The First Three Years of JKN: an Analysis of its Impact on Health Expenditure and its Implication on Income-Related Inequity in Access to Health Care
When full coverage is achieved, Jaminan Kesehatan Nasional (JKN) will deliver the biggest social health insurance in the world, covering over 280 million individuals. Since its introduction in 2014, JKN’s coverage has reached 68% of the population in 2017, and it is progressing towards full coverage by 2019. In this seminar, we will present two analyses on the JKN’s impact on total health expenditure and its implication on income-related inequity in access to health care during its first three years. Our findings can be summarised as follows. We find that JKN has a positive impact on total health expenditure (including subsidy), especially for those with high health care needs at the top of the total health expenditure distribution. While this finding has not shown that JKN provides financial protection to households against high medical expenditure, it may suggest that JKN has provided health protection to households in need of health care. On access inequity, we find that inequity has reduced after the introduction of JKN, especially in accessing private doctors’ clinics and private hospital beds. The main reason for this reduction appears to be the weakening role of a household’s economic status towards health care purchase, which is consistent with the fundamental of JKN as a consumption-smoothing mechanism. Other results, however, point to issues that need to be improved, such as smaller inequity reduction in rural compared to urban areas and distribution of health infrastructure that remains disfavouring the poor.