TRIANGLE ANALYSIS OF HEALTH INSURANCE PUBLIC POLICY: A CASE STUDY ON THE INFORMAL SECTOR IN INDONESIA

Abstract

Background: The proportion of informal sector dominates the labour force in Indonesia. Yet, their presence has not been fully covered in the national health insurance system. Health insurance policy in Indonesia continues to change. In the framework of efforts to achieve universal health coverage, there should be a review of the health insurance policy. This study aims to analyze the health insurance public policy on the informal sector.

Methods: We reviewed the health insurance policy document and empirical literature study related informal sectors. The policy was analyzed using triangle analysis.

Result: The result of triangle analysis showed that based on actor, National Health Insurance (JKN) existing regulations has involved the role of official policy actors while interest groups (union informal sector and informal sector associations) have not been included optimally. This policy was not able to finance the services that  requires large medical expenses such as rare diseases. Along the way, the birth of the existing policy through a top down process and was influenced by many factors such as economic, political and international issues.

Conclusion: Informal sector involvement in health insurance policy formulation was still minimal. This policy should be developed by taking into account the informal sector contexts and hopefully will be able to achieve universal health coverage.

Keywords: Triangle analysis, health policy, informal sector

DOI: 10.26553/jikm.2017.8.3.135-144