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January 17, 2025 | 11:04 am
TEMPO.CO, Jakarta - Minister of Health Budi Gunadi Sadikin admitted that the current service of the health social security agency (BPJS Kesehatan) is "imperfect,” as the insurance is unable to cover the expenses for all diseases.
“BPJS does not cover everything. There are separate categories for the costs of each treatment—for example, the category for heart diseases will cover the heart stent procedure,” Budi said on Thursday, January 16, 2025.
Budi attributed BPJS Kesehatan’s shortcomings to the low figure contribution of its users. Class 3 members of BPJS Kesehatan currently contribute Rp42,000 per month, with Rp35,000 paid by users and Rp7,000 subsidized by the government. Meanwhile, the contribution for class 2 members is Rp100,000 per month, and class 1 members Rp150,000 per month.
To resolve the issue, he explained, the government will facilitate the entry of more private insurers into hospitals. “The shortfall can be covered by private insurance, so those who are sick can avoid paying a large amount,” he said.
The director of planning and development of BPJS, Mahlil Ruby, said the program is facing risks of default by 2026 if the government fails to swiftly make improvements. BPJS, Ruby added, is also facing the risks of deficit.
According to Mahlil, this happened because the costs incurred by BPJS were greater than the income obtained from monthly premium payments by users. “Between costs (expenses) and premiums, the costs can be higher,” he said, adding that BPJS Kesehatan records over Rp20 trillion of shortfalls.
Ni Made Sukmasari contributed to the writing of this article.
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