The need for high health costs cannot be adjusted to improving health services and low purchasing power. Facing this problem is needed so that the government provides health services that can be accessed by all segments of society, as one of the citizens’ rights. Based on law number 40 of 2004 concerning the National Social Security System (SJSN), the Government is responsible for guaranteeing health protection for the people of Indonesia BPJS is a social organizing body to provide social expression to the people of Indonesia.
Definition Health insurance is insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over a large number of persons. By estimating the overall risk of health care and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement.
Advantages The advantages of BPJS are:
1. Premiums are quite cheap compared to other health insurance, and there are 3 groups available for participants to choose from.
2. Participants who are protected from many diseases, outpatient and hospitalization and surgery.
3. Does not matter the participants have had the disease before
Deficiency The shortcomings of BPJS are:
1. A long procedure compared to other health insurance. Participants must go through a tiered referral mechanism.
2. It cannot be used for medical treatment abroad, because this is national health insurance.
3. The zoning of referral of health facilities based on place of residence is applied, reducing the right of patients to choose medical facilities.