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Korea to give Indonesia tips to run health insurance program

Song Soo-youn  Published 2018.11.27  15:40  Updated 2018.11.28 13:13

공유
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Korea’s National Health Insurance Service (NHIS) said it would pass on its know-how to Indonesia on how to operate the national health insurance program.

To help Indonesia establish universal health coverage (UHC), NHIS will work with the Korea Development Institute and the Organization for Economic Cooperation and Development (OECD) to offer consultations for health insurance policy for eight months, the health insurance agency said.

Indonesia established BPJS Kesehatan, a national health insurance company, by integrating multiple insurers in 2014.

BPJS has 13 regional headquarters and 119 branches. As of April, 74 percent of Indonesians subscribed the national health insurance. About 59 percent of the subscribers are low-income earners who receive the government’s subsidies. Twenty-five percent of them are employee subscribers and 16 percent, local subscribers.

The insurance rate is 5 percent for employee subscribers, and those for local subscribers are divided into three levels. Depending on the income, local subscribers pay regular insurance premiums. A low-income earner pays 23,000-rupiah ($1.59) insurance premium a month.

In Indonesia, state medical institutions offer 44.7 percent of healthcare service, and private, 55.3 percent. Primary care is supported under the capitated payment. Secondary and tertiary care is under the diagnosis-related group payment system called “INA-CBG.” BPJS contracted 79 percent of primary medical institutions and 83 percent of second and tertiary institutions.

An Indonesian health insurance subscriber should select at least a primary medical institution and must register membership. There is no individual co-payment.

In 2016, Indonesia’s life expectancy was 69.2 years, with a birth rate of 19 per 1,000 people and an infant mortality rate of 22.2 per 1,000.

The Indonesian government set a goal to achieve UHC by 2019 but faces a variety of problems. They include a surge in medical costs due to the increase of subscribers, limitations of the government’s financial resources for the expansion of the health insurance for vulnerable groups, lack of experience in running the program, weak infrastructure for medical care, and limitations in purchasing insurance services as an insurer.

To tackle the issues, NHIS plans to hand down its experience of running the Korean health insurance program and know-how to Indonesia and offer customized policy consultations, NHIS said.

In particular, NHIS will form a consultation group with health insurance researchers and scholars to help Indonesia achieve sustainability in health insurance finance, enhance the insurer’s function as a strategic service purchaser, and improve the medical delivery system.

“Our experience to improve the health insurance system in Vietnam, Oman, the Philippines, Ghana, Colombia, and Peru will help us give good advice to Indonesia,” an official at NHIS said. “After that, we will expand our business to help Indonesia execute the health insurance system.”

soo331@docdocdoc.co.kr

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