Title: Formation of Universal Health Care System in Indonesia

Author: Jeon Je Seong, Kim Hyung Jun

Name of Journal: The Southeast Asian Review (동남아시아연구) 

Abstract 

The Indonesian democratization of 1998, which proceeded in the midst of a serious economic crisis, imprinted on the elites the need for a social security system including health insurance, which had been perceived as privileges and favors. Such awareness resulted in the enactment of the National Social Security Act in 2004. However, the law to establish Agency for Health Social Security (BPJS), an essential prerequisite for the institutionalization of the 2004 Act, could not be enacted until 2011. The delay was caused by the reluctance of the central government and the ruling parties which considered the Act premature. The deadlock could be broken by, among others, two factors. The preemptive health policies of some local governments in the 2000s which were in line with universal care demonstrated that universal health coverage was feasible under the existing circumstances. The impasse in the legislative process could be resolved by pressures from the alliance of civil movement groups centered on the labor unions. Indonesia’s journey towards universal health care is a reminder that welfare reform, including health care, is closely related to, but not an automatic consequence of democratization. It should be emphasized that Indonesia provides a good example demonstrating the positive impacts of decentralization, electoral democracy and social movements on the development of social welfare system.

Keywords: health insurance, welfare reform, social security, electoral democracy, democratization, decentralization, labor union, civil society