JAMKESMAS and District Health Care Insurance Schemes No.
3.
4.
Research Questions
To what extent has the existing targeting method employed by each individual JAMKESDA scheme been effective in targeting the main target of JAMKESDA i.e. poor and disadvantaged people?
What is the prospect of long-term sustainability of the schemes?
Hypothesis
A universal scheme is considered as the ideal way of targeting because it may minimize the risk of mistargeting since it includes the whole population in the respective region. However, specific targeting can also be effective in targeting thosewho are eligible for the scheme when the existing scheme is dealing with limited financial resources.
The prospect of sustainability of the JAMKESDA scheme can be assessed in two ways:
Data & Information needed
Data Collection Technique
Source of Information
Data Analysis
• Document Study
• Regional MediumTerm Development Plan (RPJMD)/ Long- Term Development Plan (RPJP)/ Strategic Plan of Health Agency
• Second, each scheme should be analyzed as to whether the scheme has covered those who are not covered by JAMKESMAS. The analysis is made by calculating the percentage of poor who are not covered by JAMKESMAS and covered by JAMKESDA
• The service provided in Regional Health Insurance (JAMKESDA) scheme
• Document Study
• Regional Regulation/Regional Head Regulation of Can Regional Health Insurance (JAMKESDA)
• Third is comparing benefits offered by different JAMKESDA schemeswith the benefits provided by JAMKESMAS. The analysis may consider some examples as follows:
• The numbers of JAMKESDA scheme participants
• Document Study
• Data on the poor provided by regional government.
• Secondary document study
• The rule for determining JAMKESDA participants.
• Document study
• Information on criteria used to determine target.
• Report [of JAMKESDA accomplishment in Health Agency/ regional BPJS Health Agency/regional BPJS
• Regional Regulation/ Regional Head Regulation of JAMKESDA • Regional Head Regulation/ technical guidelines to manage JAMKESDA participant determination
• Data statistics of JAMKESDA
• Document study
• Report of JAMKESDA accomplishment in Health Agency/ regional BPJS.
• Regulations in regions that manage JAMKESDA scheme
• Document study
• Regional Regulation/ Regional Head Regulation of JAMKESDA
• Institutional sustainability; and • Financial sustainability.
6
• More, if JAMKESDA gives the services such as support for transportation cost for health care received outside the region, or gives transportation cost for deliverymen, etc. • similarly, if the service provided by JAMKESMAS and JAMKESDA is the same. • Less, if service provided by JAMKESDA is more restricted thanJAMKESMAS, for example JAMKESDA only covers basic health care in Public Health Center (Puskesmas) • The analysis is conducted by comparing the mechanism used by the regions with the experiences of other countries that have conducted the same targeting method (based on the literature review).
1. To assess the continuity of the JAMKESDA scheme in institutional aspect is conducted by using qualitative analysis of JAMKESDA scheme institutional system. The first step is by analyzing policy documents which are relevant to JAMKESDA. In principle, if JAMKESDA scheme is legalized in the form of regional regulation, it will have greater policy legitimacy. It may also be