SIMULASI PENGHITUNGAN TARIF PREMI SEBAGAI UPAYA ADVOKASI REALOKASI SUBSIDI PREMI PPK I JAMINAN KESEHATAN JEMBRANA

Abstract

Background: Program of Jembrana Health Insurance (JHI) is
intended to provide health insurance at first level (PPK I) for
inhabitants of Jembrana District. Up till now, financing of JHI
depends on subsidy in which it is growing up and has a trend
to be out of the target. Therefore, it needs to increase the
member participants by implementing the premium payment.
Aim of this research was to analyze premium of JHI
comprehensively to advocate the reallocation of premium
subsidy of JHI.
Methods: Type of this research was case study through
analyzing secondary data. Data on members, utilization,
operational cost and claim cost data was collected using form
at Bapel JKJ, Jembrana District Health Office and Negara
Hospital.
Results: The first Premium tariff scheme of JHI is free for 40 %
inhabitants who earn low income, Rp48.171,00 for 40%
inhabitants who earn medium income, and Rp96.341,00 for
20% inhabitants who earn high income. The second Premium
tariff scheme of JHI is free for 40% inhabitants who earn low
income, Rp89.595 for 40 % inhabitants who earn medium
income, and Rp96.341,00 for 20% inhabitants who earn high
income.
Conclusions: Local government could develop JHI
comprehensively by relocating premium subsidy of PPK I for
40% inhabitants who earn low income, besides that local
government should apply principles of managed care by
controlling cost and quality in terms of comprehensive health
insurance.
Keywords: health insurance, premium