Perluasan Kepesertaan Jaminan Kesehatan bagi Pekerja Sektor Informal (Studi Evaluasi Pra dan Pasca Jaminan Kesehatan Nasional)

https://doi.org/10.22146/jkki.50990

Haerawati Idris(1*), Laksono Trisnantoro(2), Elan Satriawan(3)

(1) Fakultas Kesehatan Masyarakat Universitas Sriwijaya Palembang
(2) Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
(3) Fakultas Ekonomi dan Bisnis Universitas Gadjah Mada Yogyakarta
(*) Corresponding Author

Abstract


ABSTRACT

Background: Informal sector workers still dominate the workforce in Indonesia. BPS data per August 2012 stated that 60.14% of workers in Indonesia’s status as workers in the informal sector. The informal workers is potential members of national health insurance. In achieving Universal Health Coverage, the health BPJS extend its scope beginning in January 2014 to include these workers. Method: This study aimed to evaluate the participation of the informal sector in health insurance scheme pre- and post the national health insurance. The study was conducted with quantitative and qualitative methods. Quantitative studies using secondary data, participation of workers in the informal sector BPJS 2014 program and qualitative study was obtained through a review of several studies related to worker’s health insurance and literature studies related health insurance policy. Result: The result shows that pre JKN the coverage is still low. This is motivated because the workers are not fully be covered in the social security program and they have not been covered by the Law No. 3 1992. Jamkesmas Program only able to cover poor informal sector workers. However, with the enactment of the National Health Insurance program organized by the health BPJS there is an increase in membership. The first 4 months of  monitoring the implementation of national health insurance showed a sizeable increase in registration. In addition, an increasing number of utilization is dominated by those who are sick. This indicates the occurrence of adverse selection. Based on the policy aspects, their participation has been stated in Presidential Decree No. 111 in 2013, but the rules do not explicitly describe the efforts that must be made in extending coverage and maintaining the continuity of these workers to remain a participant of JKN. This study implies that the policy makers need to create a scheme as effort to ensure the sustainability of the expansion of the membership and participation of the informal sector in health BPJS 

ABSTRAK

Latar belakang: Pekerja sektor informal atau dikenal dengan istilah pekerja bukan penerima upah masih mendominasi angkatan kerja di Indonesia. Data BPS per Agustus 2012 menyebutkan bahwa 60,14% pekerja di Indonesia berstatus sebagai pekerja di sektor informal. Jumlah pekerja informal yang cukup besar merupakan potensi kepesertaan jaminan kesehatan nasional. Dalam upaya pencapaian Universal Health Coverage (UHC), pihak BPJS kesehatan memperluas cakupannya mulai Januari 2014 termasuk pada pekerja ini. Kajian ini bertujuan untuk mengevaluasi kepesertaan pekerja sektor informal dalam skema jaminan kesehatan pra dan pasca JKN. Metode: Kajian ini dilakukan dengan metode kuantitatif dan kualitatif. Studi Kuantitatif menggunakan data sekunder berupa data kepesertaan pekerja sektor informal pada program BPJS tahun 2014 dan studi kualitatif diperoleh melalui review beberapa hasil penelitian terkait jaminan kesehatan pekerja ini dan studi literatur terkait kebijakan jaminan kesehatan. Hasil: Cakupan kepesertaan pra JKN masih rendah. Hal ini dimotivasi karena pekerja ini belum sepenuhnya ter-cover dalam program jamsostek & keberadaan mereka belum dicakup dalamUU No. 3/1992. Program jamkesmas hanya mampu mengcover pekerja sektor informal miskin. Namun, dengan berlakunya program Jaminan kesehatan Nasional yang diselenggarakan oleh BPJS kesehatan menunjukkan peningkatan kepesertaan. Monitoring 4 bulan pertama pelaksanaan jaminan kesehatannasional menunjukkan adanya kenaikan registrasi yang cukup besar. Selain itu, peningkatan jumlah utilisasi pekerja ini didominasi oleh mereka yang sakit. Hal ini menunjukkan terjadinya adverse selection. Berdasarkan aspek kebijakan,kepesertaan mereka telah tercantum dalam Perpres No. 111 tahun 2013 namun kebijakan ini belum secara eksplisitmenerangkan upaya yang harus dilakukan dalam memperluas kepesertaan dan menjaga kesinambungan pekerja ini untuk tetap menjadi peserta BPJS. Studi ini memberikan implikasi agar pihak pengambil kebijakan jaminan kesehatan nasional perlu membuat skema dalam upaya perluasan kepesertaan dan menjamin keberlangsungan kepesertaan pekerja sektor informal dalam BPJS kesehatan. 

 

Keywords


Evaluation; Health insurance; Informal sector workers; Evaluasi; Jaminan kesehatan; Pekerja sector informal

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References

Hidayat B, Thabrany H, Dong H. Sauborn R. (2004), The Effect of Mandatory Health Insurance on Equity in Access to outpatient care in Indonesia. Health Policy Plan, 19 (5):322-335

Krigia JM, Preker A, Carrin G, Mwikisa C. Diarra-Narna AJ. (2006), An Overview of Health Financing Pattern and The Way Forward In TheWHO African Region. East Afr Med, 83 (8):S1-S27

Mathaeur I, Schmidt JO, Wenyaa M. (2008), Extending Social Health Insurance to The Informal Sektor in Kenya. An Assessment of Factors Affecting Demand. In J Health Plan Manage, 23:51-68

Quayyum Z, Nadjib M, Ensor T,Sucahya PK. (2010), Expenditure on Obstetric Care andProtective Effect on Insurance on The Poor: Lesson from Two Indonesia districts. Health Policy Plan, 25 (3):237-247

World Health Organization. (2007), Paying Health Service. In Social Health protection.Geneva, Switzerland: WHO Health Organization Media Centre

Ole D, Carrin G, Evans D. (2010), Thinking of Introducing Social Health Insurance? Ten Question. In World Health Report 2010. Background Paper No.26. Geneva, Switzerland: Department of health system financing, WHO

Carrin, G., & Chris, J. Social Health Insurance. (2005), Key Factors Affecting The Transition Towards Universal Coverage. International Social Security Review, 58(1).

WHO. Health System Financing: The Path to Universal Coverage 2010. World Health Organization.

Muiya, B.M. (2013), Universal Health Care in Kenya: Opportunities and Challenges for The Informal Workers. International Journal of Education and Research Vol.1 No.11.

Kimani D, Muthaka DI, Manda DK. (2004), Health Care Financing Through Health Insurance in Kenya. The Shift to A national Social Health Insurance. Nairobi, Kenya: Kenya Institute for Public Policy Research and Analysis;1-71.

Carrin G, James C, Adelhardt M, Doetinchem O, Eriki P, Hassan M, van den Honbergh H, Kirigia J, Koemm B, Korte R, Krech R, Lankers C, Lente Van J, Mana T, Malonza K, Marthauer I, Okeyo TM, Muchiri S, Mumani Z, Nganda B, Nyikal J, Onsongo J, Rakuom C, Schramm B, Scheil-adlung X, Stierle F, whitaker D, zipperer M. (2007). Health Financing Reform in Kenya-Assessing The Social Health Insurance Proposal. South afr med J, 97(2):130-135.

BPS. (2012). Keadaan Ketenaga KerjaanAgustus 2012. Berita resmi statistik. No.75/11/Th.XV,5Nopember 2012.http: ww.bps.go.id/brs_file/naker_05nov12.pdf

Badan Perencanaan Pembangunan Nasional.(2009). Peran Sektor Informal Sebagai Katup Pengaman Masalah Ketenagakerjaan. http://bappenas.go.id/files/3513/5027/3734/kajian-peran-sektor-informal2010090310304327490__20110518101103__3050__0.pdf

Nazara, Suahasil, (2010). Ekonomi Informal diIndonesia. Publikasi ILO: Jakarta. http://www.ilo.org/wcmsp5/groups/public/—asia/—ro-bangkok/—ilo-jakarta/documents/publication/wcms_145402.pdf

Bappenas (2013). Evaluasi Paruh waktu RPJM,2010-2014, http://www.bappenas.go.id/files/1613/7890/3140/buku-evaluasi-paruh-waktu-RPJMN_Bappenas.pdf

Kementerian Kesehatan Republik Indonesia. (2013), Buku Pegangan Sosialisasi Jaminan Kesehatan Nasional (JKN) dalam system Jaminan Sosial Nasional 2014. Jakarta.

Departemen Kesehatan (Depkes), (2008). Kajian Masalah Kesehatan Kerja pada Pada Pekerja Sektor Informal. Direktorat Kesehatan Kerja Depkes RI, Jakarta.

Direktorat Pengupahan dan Jaminan Sosial Tenaga Kerja. (2008). Identifikasi Potensi Kepesertaan Jamsos Tenaga Kerja Luar Hubungan Kerja. Jakarta. Jurnal Kebijakan Kesehatan Indonesia, Vol. 04, No. 4 Desember 2015  145 Jurnal Kebijakan Kesehatan Indonesia

BPJS Kesehatan Tagih Tunggakan Iur Premi. http://www.mediaindonesia.com/misore/read/1489/BPJS-Kesehatan-Tagih-Tunggakan-Iur-Premi-2014/2015/05/07%2000:00:00

Cahyono, B. (1983). Pengembangan Kesempatan Kerja. BPFE, Yogyakarta.

Mishra, (2010). Keterbatasan PembuatanKebijakan Ekonomi Informal di Indonesia

Pelajaran Dekade Ini. ILO:Jakarta http: http://www.ilo.org/wcmsp5/groups/public/—asia/—ro-bangkok/—ilo-jakarta/documents/publication/wcms_145401.pdf

Thabrany, Hasbullah (2015). Jaminan Kesehatan Nasional. Edisi kedua. PT. Raja Grafindo Persada. Jakarta.

Indrayathi, Nopiyani and Listyowati (2015). Informal Workers and Its Role in Jaminan Kesehatan Nasional in Denpasar City: Feasible Model for Collecting Revenue to The Achievement of Universal Health Coverage. 2nd Indonesian Health Economics Association Congress. Jakarta.

TNP2K. (2015). JKN: Perjalanan Menuju Jaminan Kesehatan Nasional. Kementerian Sekretariat Negara RI Sekretariat Wakil Presiden, http: www.tnp2k.go.id25. Van der Gaag, Jacques and Vid Stimac (2012). How Can We Increase Resources for Health Care in The Developing World? Is (Subsidized) Voluntary Health Insurance the Answer? Health Economics 21:55-61.



DOI: https://doi.org/10.22146/jkki.50990

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