2016 Deficit Widens. BPJS Health Needs Goverment\’s Intervention

Bisnis Indonesia 14 September 2015
Irfan Humadi, a speaker of BPJS Health said without government’s intervention  BPJS Health is predicted to be in deficit of Rp  11 trillion in 2016 . This amount is widened because in the beginning of the implementation in 2014 the deficit already of Rp .3 trillion, while during the year 2015 is expected to be Rp 6 trillion. \” This amount is accumulated, because the large number of participants who are now still being hospitalized and treated earlier and new participants are also increasing \” Irfan said in Jakarta last week.
 In addition to the high number of claims, BPJS also experiences problems in receivables from local governments, other than that there are also independent participants who are less obedient to pay contributions. Especially the first period registrant who does not set up bank autopay  account. In total, together with independent participants who are in installment for one month or two months, the receivables can reach 30% of the participants. Irfan explained, according to the rules, BPJS will not stop the services for participants who are in arrears of up to six months.
It is necessary to manage that participants to pay on time and start cover when they are in good health. Currently, he also proposes that the grace period before the termination of service shortened \”he said. Although it estimates a deficit balance, but he believes the state will intervene for the sustainability of the program. He pointed to the deficit in 2015 the government has provided the state capital participation (PMN) for operational and the technical reserves with a total of Rp. 5 trillion.The fund of ex Jamsostek can be used as a bailout. The entire investment profits in 2014 have also been submitted to the social security funds.
Riduan, financial director BPJS Health said, on the indicative ceiling in the Draft State Budget 2016, Minister of Health proposes that the number of beneficiaries (PBI) rise from 86 million to 92 million people. In addition to the increase in the amount of participants, the government proposed an increase fees from Rp. 19,500 into Rp. 23,000.
With the increasing government participants and dependents, it is predicted that there will be an additional premium of RP. 6 tirillun.
The hospitals asks Indonesian fare Case Base Groups (Ina CBGs) to be immediately evaluated. Ichsan Hanafi, secretary general of The Association of Indonesia Private Hospital said that adjustments can be made in parralel with BPJS premium rates that are subject to be reviewed every two years.
Ina CBGs is standard medical services and tariffs set by the government. This standard is a reference for the BPJS Health in claim payment as well as medical procedures in hospitals.

Ichsan said the adjustment rate of CBGs Ina is expected to bring in more private hospitals and doctors to join BPJS Kesehatan. Because, at this time hospitals or a doctors are not happy with the tariff.