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

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