The materialization of the new health insurance scheme in Indonesia is a long way coming. Since the 80s, the government has done everything it could to provide cheaper yet high quality medical assistance to its less fortunate citizens. Indeed, this project has undergone a lot of trial and error before finally paving its way on its introduction last year. A staggering 130 million Indonesians are now enjoying its benefits. However, it is not without challenges. In previous reviews by Westhill Health Insurance Consulting in Jakarta, one of the longest running online insurance consulting agency in the world, geographical location, corruption and the overall population of the archipelago are some of the major hindrance to the total success of the insurance scheme. Evidence from many studies in other countries shows that when people are insured, the demand for health care increases. As a result health care providers are often not able to cope with the increase in demand. Both trends have been very apparent in the first year of the new insurance scheme in Indonesia. Increased demand can have an adverse effect on quality of existing care, so with increased access comes a need to ensure quality. The distribution of health care facilities across such a large and scattered country makes this a particular problem in Indonesia. Most are currently concentrated in large cities like its capital in Jakarta, Sumatra and Bali (all of which are centered because of the income these cities contribute to the country), and there needs to be further decentralization to smaller cities and villages, as well as an improvement in quality. Only on its first year, many optimists still believe that these challenges would be overcome in the next few years. The goal is to enroll all of Indonesia’s population – which is more or less 200 million and is considered the 4th largest in the world – in this scheme in 2019. With the help of computers and modern technology, the process will now finally make more efficient management possible for the first time. There is also an expectation that the higher demand for health care will in no time lead to an improvement in facilities and quality of health care for the people of Indonesia. One of the biggest challenges will be changing the behavior of patients, whereas before people went straight to specialists, if they could afford to, now they have to get a referral from a primary health facility. This new system has earned a lot of complaints from individuals and it would take a lot of time for them to get used to it. In order for this work, the government will need to improve people’s trust in and experiences of the primary health care structure.
