When its full coverage is achieved, the National Health Insurance (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 toward full coverage by 2019. In this seminar, we will present two analyses of JKN’s impact on total health expenditure and its implication on income-related inequity in access to health care during its first three years. 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 for households against high medical expenditure, it may suggest that JKN has provided health protection for households in need of health care. On access inequity, we find that inequity, especially in the access to private doctors/clinics and private hospital beds, has reduced after the introduction of JKN. The main reason for this reduction appears to be the weakening role of a household’s economic status in health care purchase, which is consistent with the fundamentals 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 disfavoring the poor.   

Speaker: Prastuti Soewondo (TNP2K)