Yurike Metriani, Jakarta – Social Security Forum (Jamsos) of labor and worker unions want the government to reconsider the single-tier inpatient care system in the national health insurance scheme BPJS Kesehatan.

The Jamsos Forum brings together labor unions and civil organizations that pay attention to how the national social security system runs. The new system, better known by its acronym KRIS, will get rid of the three-tier scheme in BPJS Kesehatan. Once implemented, all BPJS Kesehatan participants will have access to the same standard of care and facilities. This new policy will fully be in place by June 30.

"We oppose KRIS. Having a single-tier care system actually contradicts with the principle of fairness. We want President Prabowo Subianto to reconsider policies that are related to social security," Jamsos Forum's coordinator Jusuf Rizal said in Jakarta on Wednesday.

The system will likely cause BPJS Kesehatan's expenditure to swell if the government decides to proceed with the plan without increasing the agency's subsidies. Jusuf added: "The government should ensure that BPJS Kesehatan can cover all those spending [following KRIS]."

He also feared that the KRIS system could affect the Jaminan Kesehatan Sosial (JKN) or national health insurance participants, citing out-of-pocket expenses. In other words, JKN participants might have to make up the cost differences if they wish to get better services.

Consumer protection expert and initiator of the Indonesian Consumer Forum (FKI) Tulus Abadi also had some concerns over the KRIS system. Tulus said: "The third-class JKN participants will have to pay higher fees. Because they are forced to move to the second-class [care], meaning they have to pay more. This is burdensome, especially for those coming from low-income households."

BPJS Watch Advocacy Coordinator Timbul Siregar said he feared that Indonesia still lacked adequate inpatient facilities to support the single-tier system.

"We are worried that if there is only one inpatient class, with limited bed conditions in hospitals, JKN participants who are sick may not get space. We are afraid that they will be offered to become non-JKN general patients," Timbul said.

"If we have a three-tier system, we can move someone to [other facilities of] the class above theirs if their class is full. This way, their medical bills still get covered by BPJS Kesehatan."

Nunung Nuryantono, the chairperson of the National Social Security Council, said that the regulation was still under review.

"Every policy that the government makes should not cause an uproar. We should make sure to maintain the quality and the benefits delivered by the JKN system. We should also take the social guarantee funds into consideration," Nunung said.

Source: https://jakartaglobe.id/special-updates/govt-told-to-reconsider-singletier-inpatient-care-syste