JKN was created to integrate fragmentations of any existing insurance schemes managed by state-run agencies (JAMKESMAS, ASKES and ASABRI, JPK JAMSOSTEK) into a single national carrier of health insurance, BPJS Health.
The Indonesian government requires all residents to register with BPJS Health, regardless of the risks.
Patients are first required to visit either the community health facilities (PUSKESMAS) or a private clinic (that has been registered as a BPJS Health partner) as the first level of medical treatment, either of which are covered by JKN.
The WTP provides information regarding whether the current premium is affordable enough and whether they would like to join BPJS Health with the current premium system.
During the first step, we explained how JKN and BPJS Health work.
In contrast, the 2011 BPJS reform was a bottom-up initiative.
Although an open policy-making process and an incentive structure that is sensitive to social pressures exist in Indonesia, these cannot explain why the 2004 SJSN law could not be implemented while the 2011 BPJS law was able to be put into effect.
Indonesia's Social Policy Provisions Prior to the BPJS Reform
These challenges have been consistently present both for the 2004 SJSN law and the 2011 BPJS law.
However, progress in implementing comprehensive reform was slow until after the BPJS law was passed in 2011.
Similar to ASKES, the scheme will be merged with BPJS I in 2014.
As of January 2014, all health financing schemes (JAMKESMAS, JAMKESDA, JAMSOSTEK and ASKES) are administered by a newly established body, called BPJS Kesehatan.