Adrian Wail Akhlas, Jakarta – The government has defended its decision to raise Health Care and Social Security Agency (BPJS Kesehatan) premiums after concerns were raised that the move conflicted with a recent Supreme Court ruling and ignored the exacerbated financial struggles of low-income people during the pandemic.
Finance Ministry budget director general Askolani said on Thursday that the policy aimed to improve the national healthcare system, adding that raising premiums would help the agency improve its services and standards amid mounting debts.
"We respect the Supreme Court ruling, but we should understand that the policy will provide us with comprehensive health protection for the long-term," Askolani told reporters during a livestreamed media briefing. "The government is doing its best to provide a sustainable healthcare system."
The government first raised BPJS Kesehatan premiums last year by around 100 percent, but the Supreme Court annulled the move in a judicial review ruling in March as it contradicted a number of prevailing laws.
The judicial review petition was filed late last year by individuals grouped in the Hemodialysis Patients Community, joining activists and members of the public who also protested against the increase, which they argued was too high.
President Joko "Jokowi" Widodo then issued on May 5 a Presidential Regulation (Perpres) No. 64/2020 on health insurance that will again increase the premium for first-class services to Rp 150,000 (US$10.11) per month per person from Rp 80,000 starting in July, as well as almost double the cost for second-class services from Rp 51,000 to Rp 100,000.
The government will increase the third-class service premium from Rp 25,000 to Rp 42,000 but will also increase its subsidies. Third-class participants would only need to pay Rp 25,000 this year and Rp 35,000 next year as the government is earmarking Rp 3.1 trillion to subsidize the hike.
BPJS, which provides health coverage for over 223 million people, has been struggling with cash flow problems for years, regularly booking claims far exceeding the premiums it collects.
BPJS president director Fachmi Idris said on Thursday that the new premiums would help the company repay liabilities that are already in default to hospitals and balance its financial position this year.
The agency has carried over a total of Rp 15.5 trillion in missed payments from last year to this year, of which Rp 4.4 trillion remains unpaid, Fachmi said during the same briefing.
"The new policy will help us settle the missed payments of 2019 and hospitals' cashflow could improve," Fachmi added.
However, the government's decision to raise premiums has raised eyebrows among lawmakers.
"There is an ongoing crisis right now and many individuals have lost their jobs," said Gerindra Party politician Obon Tabroni as quoted by kompas.com. "The public's access to health care should not be made complicated with a hike. People are suffering."
Ruling Indonesian Democratic Party of Struggle (PDI-P) politician Ribka Tjiptaning added as quoted by Reuters: "This proves the government is insensitive. People are losing their jobs, yet they ask for higher BPJS premiums."