The Nuts & Bolts of Jamkesmas, Indonesia’s Government-Financed Health Coverage Program for the Poor and Near-Poor

This case study describes and assesses Jamkesmas, Indonesia's government-financed health coverage program for the poor and near-poor. It provides a detailed description of the scope, depth, and breadth of coverage provided under Jamkesmas, and highlights ways in which the program interacts with the rest of Indonesia's health system. It also summarizes and discusses evidence on whether Jamkesmas is attaining its stated objectives of removing financial barriers and improving access to health care by the poor and near-poor, what could be improved, and what lessons can be learned from the experience of Jamkesmas that could help inform Indonesia's quest for universal coverage. The primary theme underlying the study is that supply-side constraints and supply-side subsidies have not been leveraged to increase the effectiveness of the Jamkesmas program. There are significant geographic deficiencies in the availability and quality of the basic benefits package, especially for those living in relatively remote and rural locations of the country, and this limits the effective availability of benefits for many Jamkesmas beneficiaries. The remainder of the case study is organized as follows. Section two provides general background and information on health system outcomes in Indonesia. Section three is an overview of health care financing and delivery. Section four describes the institutional architecture of Jamkesmas. Section five highlights the process of targeting, identification, and enrolment of beneficiaries under the program. Section six focuses on the role of public financing. Section seven outlines the basic benefits package. Section eight provides an overview of the information environment of Jamkesmas. Section nine discusses the special theme of supply-side constraints and supply-side subsidies that dilute the effectiveness of the Jamkesmas program. Section ten discusses the pending agenda around some of the architectural and operational features of Jamkesmas in the context of universal coverage.

Bibliographic Details

Main Authors:	Harimurti, Pandu, Pambudi, Eko, Pigazzini, Anna, Tandon, Ajay
Format:	Working Paper biblioteca
Language:	en_US
Published:	World Bank, Washington DC 2013-01
Subjects:	access to health care, access to health services, access to services, accountability mechanisms, administrative costs, Adult mortality, Adult mortality rate, adverse selection, aged, alternative medicine, ambulatory care, ambulatory services, basic health services, Beds, cancer, capital investments, capitation, capitation payment, catastrophic expenditure, catastrophic health spending, Center for Health, certification, child mortality, child mortality rates, clinical guidelines, Communicable diseases, complications, contraception, Contraceptive prevalence, Contract Monitoring, cost of care, cost of provision, cost sharing, delivery mechanisms, delivery of health services, dental prosthesis, Dependency ratio, developing countries, Development Planning, doctors, economic growth, economic status, emergency care, emergency obstetric services, employment, essential drugs, expenditures, families, family members, fee schedules, fee-for-service, fertility, fertility rate, financial barriers, Financial Management, Financial Protection, financial risks, Financing Health Care, fixed costs, Gross domestic product, health care, Health Care Delivery, health care financing, health care providers, health care services, health centers, Health Coverage, Health Expenditure, health facilities, Health Financing, Health Indicators, Health Insurance, health insurance program, health insurance scheme, health insurance schemes, Health Organization, health outcomes, health plan, health providers, Health Research, health sector, Health service, Health Service Delivery, Health service utilization, health services, Health Spending, health spending share, Health System, Health System Financing, health systems, health workers, healthcare services, hearing aids, hospital, hospital beds, Hospital expenditure, hospitals, household size, Human Resources, ill health, immunization, incentives for doctors, income, income countries, income groups, inequities, infant, infant mortality, infant mortality rate, informal sector, information systems, inpatient care, Institutional Capacity, integration, International Cooperation, Life expectancy, Life expectancy at birth, live births, local governments, marketing, Maternal Mortality, Maternal mortality rate, Maternal mortality ratio, media attention, Media coverage, medical doctor, medical equipment, medical ethics, medical facilities, Medicines, mental hospitals, midwives, military personnel, Millennium Development Goal, Ministry of Health, morbidity, Mortality, National Development, national government, National Security, Neonatal mortality, nurses, Nutrition, outpatient care, patient, patients, physician, Physicians, population groups, potential abuse, pregnant women, prenatal care, primary care, primary health care, print media, private care, private doctors, private hospitals, private sector, Private spending, progress, provider payment, provision of care, provision of health care, provision of health services, provision of services, public awareness, Public Expenditure, public health, Public health expenditure, public health providers, public hospitals, public providers, public sector, public services, Public spending, quality of care, quality of health, quality of services, radiology, referral services, Reimbursement rates, Research Policy, respect, rural areas, Safety Net, sanitation, sanitation facilities, Skilled birth attendance, Social Health Insurance, social health insurance schemes, Social Insurance, social marketing, social programs, Social security, socialization, specific incentives, Spouse, surgery, television, Tuberculosis, under-five mortality, universal access, Universal Health Insurance Coverage, urban areas, urban development, vaccines, woman, workers, World Health Organization,
Online Access:	http://hdl.handle.net/10986/13305
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