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Understanding of the health insurance program in the perspective of human rights in Indonesia

Authors:
  • Universitas Krisnadwipayana, Indonesia

Abstract

This paper discusses the public's understanding of the health insurance program from the perspective of human rights in Indonesia. The author believes that the public needs to understand the health insurance program from the point of view of law and human rights as citizens living in Indonesia and democracy. A series of data searches on some insurance and health literature databases were reviewed from a legal perspective. The data that has been collected is then analyzed under a phenomenological approach, a study model that seeks to understand a phenomenon that exists in a context to be described and studied for re-understanding. The data search was carried out by keyword on the Google Scholar search engine in many publications published from 2010 to 2022. Based on the data and research results, we believe that all of these have met the requirements for validity and accuracy of the data to answer the problem. The results, among others, are that based on regulatory law number 24 of 2011, every citizen has the right to get assistance in health and social insurance like life insurance from the state.
How to Cite:
Manullang, S. O. (2022). Understanding of the health insurance program in the
perspective of human rights in Indonesia. International Journal of Health Sciences, 6(S1),
1646-1660. https://doi.org/10.53730/ijhs.v6nS1.4921
International Journal of Health Sciences ISSN 2550-6978 E-ISSN 2550-696X © 2022.
Corresponding author: Manullang, S.O.; Email: somanullang@unkris.ac.id
Manuscript submitted: 27 Nov 2021, Manuscript revised: 09 Feb 2022, Accepted for publication: 18 March 2022
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Understanding of the Health Insurance Program
in the Perspective of Human Rights in
Indonesia
Sardjana Orba Manullang
Universitas Krisnadwipayana, Indonesia
Abstract---This paper discusses the public's understanding of the
health insurance program from the perspective of human rights in
Indonesia. The author believes that the public needs to understand
the health insurance program from the point of view of law and
human rights as citizens living in Indonesia and democracy. A series
of data searches on some insurance and health literature databases
were reviewed from a legal perspective. The data that has been
collected is then analyzed under a phenomenological approach, a
study model that seeks to understand a phenomenon that exists in a
context to be described and studied for re-understanding. The data
search was carried out by keyword on the Google Scholar search
engine in many publications published from 2010 to 2022. Based on
the data and research results, we believe that all of these have met the
requirements for validity and accuracy of the data to answer the
problem. The results, among others, are that based on regulatory law
number 24 of 2011, every citizen has the right to get assistance in
health and social insurance like life insurance from the state.
Keywords---understanding, health insurance, legal perspective,
human rights.
Introduction
Regulation Number 24 of 2011 stipulates that state employee pension assistance
is directed by the Social Jamina Organizing Agency or BPJS, which consists of
health insurance whose implementation began on January 1, 2014, the National
Health Insurance (JKN) as a health care guarantee framework for all Indonesian
residents is carried out through welfare administration specialists ranging from
emergency clinics to health focuses that focus on all levels of society
(Sulistyaningsih & Hartiwiningsih, 2021; Irdawati, et al. 2020; Manullang, S. O.
2021). BPJS Health capacities to coordinate a medical coverage program. They
held broadly founded on social protection and the rule of value to guarantee that
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members get medical care advantages and security in gathering essential
wellbeing needs (Fitriati et al., 2012). The advantages that are the freedoms of
members are individual wellbeing administrations that incorporate promotive,
preventive, remedial, and rehabilitative administrations, including drugs, clinical
gadgets, and clinical consumables as indicated by clinical requirements. The
presence of the National Health Insurance program by BPJS Health can assume a
part in the government assistance area in the locales. The above is very
interesting for BPJS Health officials to spread information on the National Health
Insurance. Everybody Must Have BPJS Health. Jakarta, CNBC Indonesia-
Coordinating Minister for Human Development and Culture Muhadjir Effendy
opened his voice regarding the Government's choice to make BPJS Health
cooperation a necessity to get to a few public offices and administrations (Negara,
S. D., & Ramayandi, A. 2020).
With this study, we want to get in-depth information in the form of study results
and scientific evidence that can achieve the goal of a deep understanding of the
importance of citizens' rights to health protection in the form of health insurance.
This is important because residents' low level of medical treatment ability will
affect public understanding of the importance of the JKN and BPJS Health
programs. The review observes that BPJS Health task is more straightforward in
understanding the oppressed, specifically by working on administration and free
public legal rights. As shown by the Tanya (2017) study results, there is an effect
of a chance of occurrence on the community's utilization of the National Health
Insurance Program (NHIP). According to Anjani & NurulAulia (2018), their study
hypothesis states that adjusting the disposition depends on the improvement
(improvement) that talks with the community as residents who seek health
services.
This implies that the nature of the source of correspondence will determine the
outcome of changes in individual perspectives and behavior, community-level
meetings (Apriani & Rumana, 2018). For example, the Work Accident Insurance
in BPJS Employment protects the risks of accidents in an employment
relationship, including accidents that occur from home to work or vice versa, to
business trips. Alternatively, the rules stipulate that BJPS participants can enjoy
their rights when they retire. The Employment Social Security Administering
Agency or BP Jamsostek said participants could still withdraw part of their old-
age security or JHT balance of 30 percent with a minimum membership
requirement of 10 years (Erniaty & Harun, 2020; Manullang, S. O. 2021).
According to Sitompul et al. (2016), the task of BPJS Health is considered to be
more straightforward in understanding the oppressed, especially by working on
various accessible public administrations. As shown by the impact of BJPS, there
is an effect of a chance of occurrence on the use of the National Health Insurance
Program (NHIP). The right to health hypothesis states that health adjustment
depends on the nature of the increase in health insurance that speaks to healthy
citizens. This implies that the nature of health assurance is communication that
will determine the progress of changing individual perspectives and behavior
(Ni'mah, 2015; Manullang, S. O. 2021; Manullang, et al. 2020); Wirawan, et al.,
2021; Maruf, et al. 2022; Revida, et al. 2021). Conversation This examination
demonstrates that understanding is essential in cultivating a thought that spurs
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or empowers to carry out a movement that is seen as very valuable, during which
time spent understanding in a more definite course can help towards methods
involved in dealing with and working on individual expectations for daily
convenience such as health insurance errands which incorporate directing and
getting member enrollment, endlessly gathering commitments from members and
bosses, getting commitment help from the Government, overseeing Social Security
Funds to assist members, and gathering and overseeing program member
information in federal retirement aide (EP, 2018). This can be understood if the
local area can get data about the BPJS Health National Health Insurance
Program. This follows the SOR hypothesis by Hovland et al. (1953), which
expresses that the upgrade or message passed on to the communicant through
the dispersal of data might be gotten or then again dismissed. This review
observed that individuals partaking in the National Health Insurance utilized
informal channels more than proper channels. The correspondence model utilized
is two-way intuitive between members, as expressed (Saro et al., 2019), which
considers correspondence as an exchange between members in which everybody
adds to the exchange. The power of getting messages was generally acquired from
socialization held at the sub-area office by BPJS Health Maros Regency.
Individuals in the community were exceptionally keen on messages about the
National Health Insurance program since they felt it could further develop their
wellbeing (Reger et al., 2017). This concentrate additionally shows that the spread
of data on the National Health Insurance program fundamentally affects the
degree of local area interest in the National Health Insurance members village and
District in using the National Health Insurance program by BPJS Health. This
concentrate likewise shows that the disposition of the people group cannot be
isolated from the job completed by BPJS Health officials in a joint effort with the
subdistrict sub-locale all through Health Center as a level wellbeing
administration focus. Something else that decides the adjustment of demeanor is
the pretended by change specialists in scattering the data/messages passed on.
Manifest in conduct. This follows the mental reaction hypothesis, which expresses
that the course of progress and information on the communicant (mental
reaction) causes changes in the behavior of beneficiaries of data excellent in the
utilization of JKN BPJS Health. This end can be perceived because of the
aftereffects of information investigation on the connection coefficient esteem (Zein
et al., 2020).
The Health Social Security Administering Body (BJPS) is a Public Legal Entity
that is straightforwardly capable of the President. It has the errand of
coordinating the insurance of National Health for each Indonesian, particularly
for Civil Servants, Recipients of a civil servant and military and police Pensions,
Veterans, Joint Independence Pioneers, their families, and other business
components or standard people (Wiasa et al., 2022). BPJS Health is the organizer
of the public authority-run annuity program in the government assistance area,
one of five activities in the National Social Security System, be specific Health
Insurance, Work Accident Insurance, Old Age Pension, and Death Security.
Protection as expressed in the Act. Number 40 of 2004 concerning the National
Social Security System (Roziqin, 2020).
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BPJS Health, along with BPJS Employment (previously known as Jamsostek), is a
managerial program inside the National Health Insurance (JKN) unit that began
on December 31, 2013 (Mansur, 2019). BPJS Health began chipping away on
January 1, 2014, while BPJS for Employment began dealing with July 1, 2015.
BPJS Health also finished managerial work (regulating limit) in policy
implementation, which was recently run primarily by state-claimed endeavors
and halfway by government workplaces. The blend of the two components of
business and government limit is currently reflected in the circumstance of BPJS
Health as a component of public regulation that completes policy management
assignments in the field of bureaucratic public oversight of resigned associates
(Anggara, 2018).
BPJS Health is additionally framed with beginning capital financed from the
APBN and subsequently has its abundance, including BPJS Health assets and
government annuity and reserve investment funds assets from sources specified
in the law (Apriani, 2020). The powers of BPJS cover the whole domain of the
Unitary State of the Republic of Indonesia and may have a location in Indonesia
for the state related to worldwide workplaces. This approval is a particular brand
name that is not equivalent to other legitimate substances and lawful elements.
Besides, BPJS is a kind of State-Owned Legal Entity (BHMN), meaning to do its
commitments to be dependable to the President as the head of state government.
The Logo of Public Health Insurance BPJS was recently known as Askes (Health
Insurance) fronted by PT Askes Indonesia (Persero), but as indicated by Law no.
24 of 2011 concerning BPJS, PT Askes Indonesia changed to BPJS Health on
January 1, 2014 (MHD et al., 2020).
Method
Furthermore, the author will describe the steps for implementing health literature
which aims to gain new knowledge of the importance of understanding health
insurance programs from the perspective of law and human rights in Indonesia
(Samerski, 2019). For this reason, we have searched for supporting data on many
databases of health and legal science publications, both domestic and
international publications. The data source for this study is secondary data in the
form of a thought-provoking perspective which is evidence of fieldwork that has
sharpened the understanding of public health insurance programs in human
rights (Sørensen et al., 2015). We have done the data search mechanism
electronically by using the Google engine with the help of keywords.
After the data was collected and then started from more than 100 literature
sources, Lisa finally around 50 entered the telephone category to be studied and
get the results of this study (Rolindrawan, 2015). As for the system, we have
involved intensive data coding, short evaluation, in-depth interpretation, and
finally concluding by considering the data findings to answer the problem and
accept the hypothesis. Furthermore, we are going to design the article in a
descriptive qualitative design, how we do this situation with a phenomenological
approach, namely seeking understanding of a problem, in this case, is getting a
deal of the importance of public health insurance programs in the context of the
law and human rights in the country. Such is the process of carrying out the
study from problem formulation to final reporting (Bassuk & Washington, 2013).
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Discussion
Understanding public health insurance
Medical care in the United States is any program that helps pay for clinical
expenses, whether through secretly bought inclusion, social insurance, or an
officially upheld government social help program (Erlangga et al., 2019). The
reciprocals for these purposes join "prosperity consideration," "clinical
consideration," and "clinical benefit." Likewise, in Indonesia, the public clinical
benefit structure is headed to accomplish general clinical benefits. In 2014, the
state gave a compulsory medical coverage program called the National Health
Insurance (JKN). It is expected to make fundamental clinical contemplations and
workplaces available to all inhabitants. By 2020, it is assessed that the
arrangement will cover 83% of the populace (223 million people). The point is to
offer free help to all inpatients in a fundamental crisis facility bed (Laksono et al.,
2021).
We can all say, "Wellbeing is vital because it is a significant part of bliss
throughout everyday life," except we, when all is said and done, find it challenging
to apply this comprehension in our regular routines (Maurya, 2019). From how
we carry on with a solid life to getting ready for things we would instead not
occur, specifically "falling wiped out," which requires short-term or ongoing
consideration. Obliviousness about the comprehension of the significance of
health care coverage for the local area regularly prompts tragic stories where we
lose friends and family because of the inaccessibility of assets for the therapy of
somebody who is wiped out. We felt the significance of health care coverage when
we took a postgraduate program in Sydney, Australia. As per unofficial Australian
laws, each understudy is expected to take an interest in a medical coverage
program. Citizen never had any difficulty when we were wiped out while
examining in Australia since all clinical costs were covered by health care
coverage (Evans & Stoddart, 2017).
Community feel many advantages about the importance of medical insurance
coverage (Dang et al., 2021). The main benefit is that keeping a limited number of
assets in the form of money held by paying guarantees security. There is no need
to stress over assets or trouble other people or close relatives when a person is
sick. To the point of bringing a protection card and going to an emergency clinic,
an insurance agent's accomplice, we get health administration at the clinic. An
example one gets is transferring all bets to an insurance agent. Overall, protection
is a health net and a guarantee of health assets for a person to avoid calamity and
burden other relatives with increasingly expensive clinic fees. With the unit-
connected type of insurance, Citizen get two benefits at once as health care
coverage and a limited amount of reserve funds that can be used to pay the
following protection installments or be issued after ten years of participation
(Obermann et al., 2018). The third benefit I feel is protecting our health from
diseases that come from nowhere.
Finally, we also obtain information about primary diseases such as diabetes,
hypertension, heart disease, and disease through instructions directed by health
care insurance. Customers believe that through this article, the entire population
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can save assets to put resources into something significant in life called "welfare"
(Nambiar et al., 2020). So one can choose the medical protection item he wants
accurately and precisely, the correct item and cost, the proper protection
situation, and a good reputation. We have to look at the welfare programs run by
our Government. To further develop the nature of the welfare of the Indonesian
people, since January 1, 2014, the public authorities have established the state
program as a government-supported public pension framework which means
providing guarantees and government social assistance for all individuals by
establishing a legal substance in the form of directing managed pensions
government called the National Security Administration (Pearson et al., 2013).
This uplifting news opens the door to more Indonesians getting well being
insurance with more reasonable charges or commitments (Tangcharoensathien et
al., 2011). For poor people and the oppressed, they will be the beneficiaries of
commitment help. In light of Presidential Decree 12 of 2013, BPJS Health
Regulation No. 1 of 2014, the extent of wellbeing administrations covered by BPJS
(Erniaty & Harun, 2020) are; 1) First Level Health Services First level wellbeing
administrations, including non-expert wellbeing administrations: a)
Administration organization; b). Promotive and preventive administrations; c).
Assessment, therapy, and clinical discussion; d). Non-expert clinical measures,
both employable and non-usable; e). Administrations for medications and clinical
consumables; f). Blood bonding as indicated by clinical requirements; g).
Essential level lab analytic help assessments; and h). First Level Hospitalization
as per clinical signs. 2). Progressed level reference wellbeing administrations,
including short-term and ongoing wellbeing administrations: a). Administration
organization; b). Assessment, treatment, and expert conference by trained and
sub-trained professionals; c). Expert clinical activities, both careful and non-
careful as per clinical signs; d). Administrations for medications and clinical
consumables; e). Progressed demonstrative help administrations as per clinical
signs; f). Clinical recovery; g). Blood administration; h). Clinical scientific
medication administrations; Administration for cadavers for patients who passed
on after being hospitalized at a wellbeing office that participates (Dahliana, 2019).
Health as a human right
Fundamental liberties are freedoms inborn in people because of their introduction
to the world as people. These freedoms are acquired not by others or the state but
because of his introduction to the world as an individual (Zanariyah et al., 2021).
In a strict setting, these freedoms are a gift from God, and just God has the
privilege to renounce them. Since common liberties are privileges acquired upon
entering the world as people, fundamental freedoms incorporate privileges that,
assuming renounced or decreased, will bring about a diminished level of
humanity. The proportion of the level of humanity generally creates as per the
progress of individuals. The primary essential right is the right to life which has
ramifications for different privileges, for example, the right to a respectable life
and work, the option to have a family and keep posterity, the option to acquire
citizenship, and the option to offer viewpoints, partner and gather. In resulting
advancements, the level of humanity is not set in stone by the degree of schooling
and wellbeing, so instruction and wellbeing then become fundamental liberties
with any remaining freedoms to training and wellbeing (Raharjo, 2016).
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Subsequently, wellbeing is the premise of acknowledging the level of humanity.
Without wellbeing, an individual turns out to be restrictively inconsistent. An
individual can not acquire other freedoms (Rim & Tassot, 2019). An individual
who is not solid will consequently lose his right to life, cannot get and carry on
with fair work, cannot partake in his freedoms to affiliation and gathering and
offer viewpoints, and cannot get schooling for his future. To put it plainly, one
cannot wholly appreciate life as a person. Commitments of the Government The
fundamental premise that the insurance of common liberties is the public
authority's obligation is the rule of a vote-based system in which the public
authority is given the command of the force to safeguard the privileges of
residents. Also, the idea of the government assistance state as a cutting-edge
state has empowered the public authority to act. This power is exclusively to
advance and accomplish the satisfaction of everyday freedoms. The public
authority is not simply holding individuals back from disregarding or abusing
their freedoms, but it should make progress toward the satisfaction of these
privileges (Halimatussadiah et al., 2020).
Moreover, with the right to wellbeing, the public authority's commitment is to
satisfy it. Endeavors to satisfy the right to wellbeing can be completed differently,
including avoidance and fix. Anticipation endeavors incorporate the production of
appropriate circumstances for good wellbeing guaranteeing the accessibility of
food and occupations, great lodging, and a stable climate. In the meantime,
recuperating endeavors are completed by giving ideal wellbeing administrations.
Wellbeing administrations incorporate parts of Government-backed retirement for
wellbeing, satisfactory wellbeing offices, qualified clinical staff, and affordable help
financing by the local area (Abma et al., 2019). Article 12 of the Convention on
Economic, Social and Cultural Rights frames the means that should be taken to
accomplish the best expectations of physical and emotional wellbeing, to be
specific: Provisions for decreasing kid stillbirth rates and solid youngster
advancement; Improvement of all parts of natural and modern wellbeing; By and
large, Article 10 of the Health Law expresses that accomplish ideal wellbeing
status for the local area, wellbeing endeavors are done with a supportive
approach, wellbeing improvement (promotive), illness anticipation (preventive),
illness fix (therapeutic), and wellbeing recuperation (recovery)executed
thoroughly, incorporated, and maintainable (Mayka, 2021).
Future Challenges the Ministry of Health as the agent of government obligation in
the wellbeing area, has proclaimed Healthy Indonesia 2010. It is trusted that ideal
ailments can be accomplished in 2010 (Caballero-Anthony, 2018). As per
information from the Ministry of Health, a few upgrades have been accomplished
in the wellbeing area. In 2000, the future had arrived at 66 years, from 46 years
during the 1960s. The rate of birth from 1000 live births diminished to 45 infants
at the end passed on, from 1995 upwards of 55 children, at last, kicked the
bucket. For wellbeing administrations in 2000, pretty much every sub-area had a
Puskesmas. Around 20,000 specialists and around 5,000 dental specialists have
been allowed as Non-Permanent Employees (PTT). The number of birthing
specialists in the town contacts 54,956 individuals, and 20,000 Polindes has been
working with local area support. Different upgrades have likewise been
accomplished to understand and satisfy the local areas correct to wellbeing as a
1653
component of the satisfaction of everyday freedoms. Notwithstanding different
accomplishments, we are also confronted with different difficulties (Hadiprayitno,
2011).
The primary test is the state of the Indonesian individuals who are not out of the
squash of the emergency with the goal that it is challenging to get fantastic
wellbeing administrations (White, 2016). Destitution is, without a doubt, the
fundamental adversary of wellbeing. This condition is incorporated with the
pattern of wellbeing as an industry that regularly fails to remember the wellbeing
perspective as a philanthropic help. Wellbeing is a costly thing. In addition,
strategy producers do not yet have a promise to their obligations towards
wellbeing. This is confirmed by the absence of subsidizing apportioned to the
wellbeing area through giving offices and foundation and federal retirement aide
for wellbeing administrations. The present society should pay a significant
expense to get fantastic wellbeing administrations. Low-pay individuals regularly
do not get fantastic wellbeing administrations. A few occasions show that the
emergency clinic's direction to benefit can overpower humanity. Indeed, even a
patient is an essential condition in some cases needs to finish different monetary
prerequisites and administration prior to getting administration, and it is not
inconceivable around then the patient passed on (Jon & Purcell, 2018).
Wellbeing administrations can be given by the private area and the public
authority. Administrations by the private area are, for the most of better quality;
however, they are more costly and, here and there, exorbitant (Henry, 2015. While
the administrations given by the public authority are less expensive, however, the
quality is more terrible. Nonetheless, the rule that should be complied with is that
wellbeing should be arranged towards compassionate administrations, and the
public authority should satisfy it. Amidst an emergency and lack of circumstance,
strategy making is generally confronted with a quandary.
Nonetheless, assuming it is understood that wellbeing is the primary reason for
accomplishing human pride and protecting ages, then it ought to be trailed by
approaches and substantial strides to satisfy the right to wellbeing as
fundamental liberty (Gill & Dalton, 2022). The real sign of the public authority's
obligation to wellbeing as fundamental liberty is arranging an excellent financial
plan for wellbeing administrations. The people group ought to have the option to
get essential wellbeing administrations at no expense. If the arrangement of such
administrations is not yet imaginable, it should be done bit by bit, particularly by
working on the nature of foundation and the nature of wellbeing administrations
to the overall population (Lang & Bachinger, 2017).
The birth of the right to health
The advancement of fundamental liberties has gone through three phases so that
everyday freedoms can be gathered into three classifications: original, second-and
third-era common liberties (Meier et al., 2020). The original fundamental liberties
are everyday freedoms in the standard and political fields, which T. Koopmans
calls "de klassieke grondrechten (old-style fundamental rights). The personality of
the original of basic liberties is pessimistic" because it requests opportunity from
a specific limitation (independence from). The second era of fundamental
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freedoms is portrayed by the rise of requests for basic liberties in the financial,
social, and social fields, which Koopmans calls de sociale grondrechten
(fundamental social rights), and along these lines have a positive person (right-
top). In contrast, the third era of fundamental liberties is known as "fortitude
privileges," which characterizes everyday freedoms to advance local area welfare
(Paim et al., 2011).
According to this classification of fundamental freedoms, the right to wellbeing is
frequently remembered for the second era of fundamental liberties and the
fundamental liberties of the future. Third, if the right to wellbeing is connected to
"individual wellbeing," it is remembered for economic, social, and social privileges;
however, assuming it is connected with "general wellbeing," it is remembered for
the right to advancement (Montenegro et al., 2020). The comprehension of the
three classes of fundamental liberties should not be "divided" because it will
prompt quality definition. However, the expectation is to work with distinguishing
proof. The treatment of fundamental freedoms, aside from being all-inclusive,
should be "inseparable and reliant. "In a few words, it is generally expected
noticed that the improvement of fundamental freedoms has started from
beginning to end, to be specific an understanding between the King of England
Henry and a gathering of blue-bloods whose substance incorporate, in addition to
other things, the King is ensured privilege freedoms yet should be dependent
upon limitations. Lawful limitations, both conventional regulation and material
regulation (Yamin & Habibi, 2020).
An individual may just be captured for genuine reasons and get equity by the
legal executive. Notwithstanding, the historical backdrop of the advancement of
current common liberties is, for the most part, set apart since the seventeenth
century, specifically after the French Revolution, the American Revolution, and
the Industrial Revolution in England. Furthermore, residents in the ordinary and
political fields related with their administration (Gillespie & Melching, 2010). At a
practically similar time in the United States, the Virginia Bill of Rights was
established, and the initial ten alterations to the Charter were consolidated into
the 1787 United States Constitution. Even though the personality of fundamental
liberties was more concentrated freedoms in the standard and political fields, one
essential liberty is perceived, which we currently known as economic privileges,
specifically the right to property. Locke proposed three extremely fundamental
freedoms: life, freedom, and property (Landman, 2018).
We underscored that "Each man has a property in his individual. This no one has
an option too, yet himself." In Locke's idea, an individual's private life is his own,
and if his private life creates a work, the work is his, which can be sold or
exchanged (Minkler, (2010). This is the thing known as the original of common
liberties, which depends on the psyche of progressivism. The overall attributes of
these common liberties, first, fundamental freedoms, are privileges. Regardless of
whether there is a commitment, the commitment is exclusive to guarantee the
execution of these privileges, as expressed in Article 29 of the Universal
Declaration of Human Rights: "Everybody commits to a general public where he
has the likelihood to foster his character completely and totally" (Everyone has
obligations to the local area in which alone the free and full improvement of his
character is possible). Second, these privileges are all-inclusive
1655
(comprehensiveness), which people have due to their human poise. Third,
fundamental freedoms are considered to exist without anyone else since human
life and do not rely upon acknowledging a broad set of laws (Minkler, 2010).
Fourth, common liberties are considered a significant standard. Albeit not
outright and regardless, common liberties have a good situation as a
standardizing thought to be upheld, assuming there is a contention with other
positive standards. Although at first, the "commitments" joined to privileges were
only to restrict the activity of one's fundamental freedoms not to disregard the
privileges of others, since the interests of others grew, new common liberties or
second era fundamental freedoms arose, in particular freedoms - privileges
connected with financial and social. Following the rise of the idea of the
government assistance state, public interests addressed by the state comparable
to one's everyday freedoms are at last seen as fundamental liberties (Kaminska &
Nazarko, 2017). Such is the situation with the right to wellbeing.
Similarly, as with freedoms in other monetary fields, the right to wellbeing was
just created around the nineteenth century. The Industrial Revolution in England,
which from one perspective prevailed with regards to making cost-effectiveness of
creation, however, then again welcomed an effect on the bringing down of the
negotiating posture and buying force of the laborers. Their capacity as work was
moved via programmed machines. Accordingly, there is much joblessness. The
laborers live in ghetto regions with unfortunate water dispersion and sterilization
frameworks. Accordingly, there are incessant assaults of irresistible illnesses that
influence actual and emotional wellbeing. Baby and youngster death rates around
then were very high because of a lack of healthy sustenance and disturbance of
the regenerative arrangement of moms (Shevchuk et al., 2021).
Conclusion
Finally, we would like to summarize the main points that have been presented in
the results and discussion section, with the aim of the study being to gain new
knowledge on how to understand the health insurance program when viewed from
the perspective of human rights law in Indonesia. As explained earlier, the citizen
health protection program under the law requires the state to provide health
protection in insurance when sick. Likewise, what has been described by the
experts that we have summarized in general illustrates that the state's obligation
to provide health protection to every citizen is following health law number 24 of
2011 where every citizen has the right to obtain health assistance, including
insurance that group it into the category of health and safety protection network.
As for the critical points that we have received, we found the importance of public
understanding of health insurance as we know that Indonesia is a democratic
country that upholds human rights, including health protection for every
inhabitant. Furthermore, we also summarize how the health law requires every
human being to obtain health insurance protection following the nature given by
God where humans must get welfare and the environment.
Next, we also note how human rights were born, freely given by God, and
protected by law; every citizen has the right to live and be healthy. Therefore,
Indonesia, a democratic country, upholds the protection of human rights,
1656
including the right where citizens need to be protected. On that basis, the health
law gives the Government the authority to exercise the people's right to obtain
health. This is in line with every regulation made by the Government, providing
an understanding that every citizen must receive health protection regardless of
the transition they have to pay for or have been provided by the state. Through
this movement, we believe that this study has fulfilled the requirements to answer
the main problem where the understanding of the rights and responsibilities of
citizens to obtain a healthy and prosperous, and intelligent life is per the ability of
the state to provide the fairest protection. We believe this finding certainly has
many weaknesses; therefore, appropriate input and feedback will be for the sake
of improving the quality of future studies.
Acknowledgments
The author, at this moment, expresses his most profound gratitude for the
support and contributions from our colleagues and seniors at Universitas
Krisnadwipayana and the attention and support from the ministry of education.
We have carried out this study as expected.
References
Abma, T., Banks, S., Cook, T., Dias, S., Madsen, W., Springett, J., . . . Wright, M.
T. (2019). Participatory research for health and social wellbeing Springer.
Anggara, S. (2018). Hukum administrasi negara.
Apriani, L., & Rumana, N. A. (2018). Karakteristik dan pengetahuan pasien
tentang BPJS kesehatan di puskesmas kecamatan kebon jeruk. Jurnal
Penelitian Dan Pengembangan Pelayanan Kesehatan, , 191-197.
Apriani, R. (2020). Strategi Komunikasi Humas BPJS Dalam Mengubah Pola Pikir
Masyarakat Mengenai Asuransi Kesehatan (Studi Pada Warga RT 11 Desa
Gasing Kelurahan Talang Kelapa Banyuasin)(Skripsi*) (Doctoral dissertation,
UIN Raden Fatah Palembang).
Bassuk, J. A., & Washington, I. M. (2013). The A3 problem-solving report: A 10-
step scientific method to execute performance improvements in an academic
research vivarium. PloS One, 8(10), e76833.
Caballero-Anthony, M. (2018). Health and human security challenges in Asia:
New agendas for strengthening regional health governance. Australian Journal
of International Affairs, 72(6), 602-616.
Dahliana, A. (2019). Motivasi kepesertaan mandiri BPJS di era universal health
coverage jaminan kesehatan nasional. KELUWIH: Jurnal Kesehatan Dan
Kedokteran, 1(1), 11-18.
Dang, A., Dang, D., & Vallish, B. (2021). Importance of evidence-based health
insurance reimbursement and health technology assessment for achieving
universal health coverage and improved access to health in India. Value in
Health Regional Issues, 24, 24-30.
EP, A. A. (2018). Faktor-faktor penyebab klaim tertunda BPJS kesehatan RSUD
dr. kanujoso djatiwibowo periode JanuariMaret 2016. Jurnal Administrasi
Rumah Sakit Indonesia, 4(2).
Erlangga, D., Ali, S., & Bloor, K. (2019). The impact of public health insurance on
healthcare utilization in Indonesia: Evidence from panel data. International
Journal of Public Health, 64(4), 603-613.
1657
Erniaty, E., & Harun, H. (2020). Understanding the impacts of NPM and proposed
solutions to the healthcare system reforms in Indonesia: The case of
BPJS. Health Policy and Planning, 35(3), 346-353.
Evans, R. G., & Stoddart, G. L. (2017). We are producing health, consuming health
care Routledge.
Fitriati, R., Rahmayanti, K. P., & Salomo, R. V. (2012). A critical review of the
triple helix to Quanto-tuple helix: Lesson learned from social security system
act implementation. Procedia-Social and Behavioral Sciences, 52, 217-225.
Gill, M., & Dalton, G. (2022). License to Lead: Lessons for public bodies from the
pandemic response in health.
Gillespie, D., & Melching, M. (2010). The transformative power of democracy and
human rights in nonformal education: The case of the total. Adult Education
Quarterly, 60(5), 477-498.
Hadiprayitno, I. I. (2011). Challenges facing the use of human rights to address
adverse impacts of development: The case of Indonesia. The Law and
Development Review, 4(1), 247-268.
Halimatussadiah, A., Cesarina, A., Siregar, A. A., Hanum, C., Wisana, D.,
Rahardi, F., & Azar, M. S. (2020). Thinking ahead: Indonesia’s agenda on
sustainable recovery from COVID-19 pandemic. Institute for Economic and
Social Research Faculty of Economics and Business, Universitas Indonesia
(LPEM FEB UI) and Ministry of National Development Planning/National
Development Planning Agency (BAPPENAS).
Henry, N. (2015). Public administration and public affairs Routledge.
Hovland, C. I., Janis, I. L., & Kelley, H. H. (1953). Communication and
persuasion.
Irdawati, et al. (2020). Pengantar Manajemen Risiko dan Asuransi Medan:
Yayasan Kita Menulis.
Jon, I., & Purcell, M. (2018). Radical resilience: Autonomous self-management in
post-disaster recovery planning and practice. Planning Theory & Practice, 19(2),
235-251.
Kaminska, N., & Nazarko, Y. (2017). Euthanasia and the human right to health
protection. Науковий вісник Національної академії внутрішніх справ, (4),
28-39.
Laksono, A. D., Wulandari, R. D., & Matahari, R. (2021). The determinant of
health insurance ownership among pregnant women in Indonesia. BMC Public
Health, 21(1), 1-7.
Landman, T. (2018). Democracy and human rights: Concepts, measures, and
relationships. Politics and Governance, 6(1), 48-59.
Lang, G., & Bachinger, A. (2017). Validation of the german Warwick-Edinburgh
mental wellbeing scale (WEMWBS) in a community-based sample of adults in
Austria: A bi-factor modeling approach. Journal of Public Health, 25, 135-146.
Mansur, M. (2019). Perjanjian Peserta Mandiri Dengan BPJS Kesehatan (study di
desa kauman kecamatan bojonegoro kabupaten bojonegoro). JUSTITIABLE-
Jurnal Hukum, 1(2), 131-156.
Manullang, et al. (2020). The Questioning for Investigations Application According
Government Regulation No. 58 of 2010 in the Area of the Border. Journal of
Advanced Research in Dynamical and Control Systems, Volume 12 | 07-Special
Issue, 2020 DOI: 10.5373/JARDCS/V12SP7/20202203 Pages: 1061-1067.
Manullang, S. O. (2021). Understanding Review of Economic Loss Due to
Government Policy Respond to the COVID-19 Disruption in Indonesia. Journal
1658
of Business, Economics & Management 2021, 4(1), 180-188,
https://sloap.org/journal/index.php/ijbem/article/view/1479/407.
Manullang, S. O. (2021). Giving COVID-19 vaccines to citizens: Understanding
legal basis. International Journal of Health Sciences, 5(3), 364-372.
https://doi.org/10.53730/ijhs.v5n3.1598.
Manullang, S. O. (2021). Understanding the sociology of customary law in the
reformation era: complexity and diversity of society in Indonesia. Linguistics
and Culture Review, 5(S3), 16-26.
https://doi.org/10.21744/lingcure.v5nS3.1352.
Maruf, I. et al. (2022). Covid-19 Vaccine Act According to World Health Experts
and Institutes. Budapest International Research and Critics Institute-Journal
(BIRCI-Journal) Volume 5, No 1, February 2022, Page: 2342-2354.
Maurya, D. (2019). Understanding public health insurance in India: A design
perspective. The International Journal of Health Planning and
Management, 34(4), e1633-e1650.
Mayka, L. (2021). The power of human rights frames in urban security: Lessons
from bogotá. Comparative Politics, 54(1), 1-35.
Meier, B. M., Murphy, T., & Gostin, L. O. (2020). The birth and development of
human rights for health. Foundations of Global Health & Human Rights, 23.
MHD, K., Nurbeti, N., & Suamperi, S. (2020). Pelaksanaan Jaminan Kesehatan
Bagi Pekerja Setelah Pt. Askes Menjadi BPJS Kesehatan Menurut Undang-
Undang Nomor 24 Tahun 2011 Di Kota Padang (Doctoral dissertation,
Universitas Bung Hatta).
Minkler, M. (2010). Linking science and policy through community-based
participatory research to study and address health disparities. American
Journal of Public Health, 100(S1), S81-S87.
Montenegro, L., Velasque, L., LeGrand, S., Whetten, K., de Mattos Russo Rafael,
Ricardo, & Malta, M. (2020). Public health, HIV care and prevention, human
rights, and democracy at a crossroad in brazil. AIDS and Behavior, 24(1), 1-4.
Nambiar, D., Bhaumik, S., Pal, A., & Ved, R. (2020). Assessing cardiovascular
disease risk factors and screening inequalities in India using lot quality
assurance sampling. BMC Health Services Research, 20(1), 1-13.
Negara, S. D., & Ramayandi, A. (2020). Laying the Foundations for Future Growth
Acceleration?. Bulletin of Indonesian Economic Studies, 56(1), 1-21.
Ni'mah, L. N. (2015). Implementasi Pemasaran Dalam Meningkatkan Kepesertaan
Perusahaan Pada BPJS (Badan Penyelenggara Jaminan Sosial) Kesehatan
Cabang Malang (Doctoral dissertation, Universitiy of Muhammadiyah Malang).
Obermann, K., Jowett, M., & Kwon, S. (2018). The role of national health
insurance for achieving UHC in the Philippines: A mixed-methods
analysis. Global Health Action, 11(1), 1483638.
Paim, J., Travassos, C., Almeida, C., Bahia, L., & Macinko, J. (2011). The
Brazilian health system: History, advances, and challenges. The
Lancet, 377(9779), 1778-1797.
Pearson, T. A., Palaniappan, L. P., Artinian, N. T., Carnethon, M. R., Criqui, M.
H., Daniels, S. R., . . . Galloway, J. M. (2013). American heart association
guidelines for improving cardiovascular health at the community level, 2013
update: A scientific statement for public health practitioners, healthcare
providers, and health policymakers. Circulation, 127(16), 1730-1753.
Raharjo, P. (2016). The implementation of health insurance by social security
agency (bps). International Journal of Advanced Research, 4(4), 480-488.
1659
Reger, M. A., Luxton, D. D., Tucker, R. P., Comtois, K. A., Keen, A. D., Landes, S.
J., . . . Thompson, C. (2017). Implementation methods for the caring contacts
suicide prevention intervention. Professional Psychology: Research and
Practice, 48(5), 369.
Revida, et al. (2021). Manajemen Pelayanan Publik. Medan: Yayasan Kita
Menulis, 2021.
Rim, J., & Tassot, C. (2019). Towards universal social protection: Lessons from
the universal health coverage initiative.
Rolindrawan, D. (2015). The impact of BPJS health implementation for the poor
and near poor on the use of health facility. Procedia-Social and Behavioral
Sciences, 211, 550-559.
Roziqin, R. (2020). The urgency of reforming the social security organizing body in
the welfare state framework. AL WASATH Jurnal Ilmu Hukum, 1(1), 1-12.
Samerski, S. (2019). Health literacy as social practice: Social and empirical
dimensions of knowledge on health and healthcare. Social Science &
Medicine, 226, 1-8.
Saro, E., Ghofur, M. A., & Syahida, A. R. (2019). Pola komunikasi keluarga antara
menantu dan mertua yang tinggal dalam satu rumah. Jurnal Komunikasi
Nusantara, 1(2), 116-119.
Shevchuk, O., Matyukhina, N., BABAIEVA, O., Dudnikov, A., & Volianska, O.
(2021). The human right to security in implementing the concept of the" right
to health protection." Juridical Tribune/Tribuna Juridica, 11(3).
Sitompul, S., Suryawati, C., & Wigati, P. A. (2016). Analisis pelaksanaan program
pengelolaan penyakit kronis (prolanis) BPJS kesehatan pada dokter keluarga
di kabupaten pekalongan tahun 2016. Jurnal Kesehatan Masyarakat
(Undip), 4(4), 145-153.
Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., . . .
Uiters, E. (2015). Health literacy in Europe: Comparative results of the
European health literacy survey (HLS-EU). European Journal of Public
Health, 25(6), 1053-1058.
Sulistyaningsih, E., & Hartiwiningsih, I. H. (2021). Transformation of the social
insurance management agency on health. Prof.(Dr) RK Sharma, 21(1), 223.
Tangcharoensathien, V., Patcharanarumol, W., Ir, P., Aljunid, S. M., Mukti, A. G.,
Akkhavong, K., . . . Mills, A. (2011). Health-financing reforms in southeast
Asia: Challenges in achieving universal coverage. The Lancet, 377(9768), 863-
873.
Tanya, D. P. (2017). Pemanfaatan Program Jaminan Kesehatan Nasional (Jkn) Di
Puskesmas Daerah Terpencil Kabupaten Sumba Timur (Doctoral dissertation,
Universitas Gadjah Mada).
White, B. (2016). Remembering the Indonesian peasants' front and plantation
workers' union (19451966). The Journal of Peasant Studies, 43(1), 1-16.
Wiasa, I. N. D., Parsa, I. W., & Kartika, I Gusti Ayu Putri. (2022). Model of
national health insurance arrangements based on justice and social
welfare. International Journal of Multicultural and Multireligious
Understanding, 9(2), 701-710.
Wirawan, V., Manullang, S. O., & Sembiring, T. B. (2021). Law enforcement and
democracy feeling among Indonesians during 2010 to 2020 (international
publication analysis). International Journal of Social Sciences, 4(2), 303-310.
https://doi.org/10.31295/ijss.v4n2.1738.
1660
Yamin, A. E., & Habibi, R. (2020). Human rights and coronavirus: What is at
stake for truth, trust, and democracy. Health and Human Rights Journal, 1.
Zanariyah, S., Sulistiyono, A., Imanullah, M. N., & Suryono, A. (2021).
Optimization of social justice principles in health insurance by the health
social insurance administration agency (BPJS) in Indonesia. Multicultural
Education, 7(8).
Zein, R. A., Putri, N. K., & Ridlo, I. A. (2020). Do justice and trust affect
acceptability of Indonesian social health insurance policy?. International
Journal of Health Governance.
ResearchGate has not been able to resolve any citations for this publication.
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Buku ini merupakan kolaborasi dari berbagai penulis di bidang Hukum Administrasi Negara dari berbagai perguruan tinggi ternama di Indonesia. Dalam Ilmu Hukum, salah satu cabang ilmu yaitu Hukum Administrasi Negara memiliki peran yang sangat strategis dalam dinamika perkembangan hukum yang ada di negara kita tercinta dalam kehidupan berbangsa dan bernegara seiring dengan dinamisasi yang ada dalam kehidupan demokrasi yang ada. Buku ini dapat di gunakan sebagai acuan dalam perkuliahan Hukum Administrasi Negara sebagai salah satu mata kuliah wajib yang harus di tempuh oleh setiap mahasiswa Fakultas Hukum. Buku ini juga dapat digunakan oleh pengajar atau pengampu mata kuliah Hukum Administrasi Negara dalam menyusun materi perkuliahan selama satu semester. Tidak hanya untuk kalangan akademisi dan mahasiswa, buku Hukum Administrasi Negara ini juga bisa di jadikan literatur oleh masyarakat umum dalam memahami dan mendalam keilmuan hukum khususnya Hukum Administrasi Negara. Buku ini terdiri dari 20 Bab yang terdiri dari Bab 1 Pengantar Hukum Administrasi Negara, Bab 2 Hukum Administrasi Negara dalam Kerangka Hukum Nasional, Bab 3 Hubungan Hukum Administrasi Negara dengan Ilmu Hukum yang Lainnya, Bab 4 Asas Asas Hukum Administrasi Negara, Bab 5 Sumber Hukum Administrasi Negara, Bab 6 Kewenangan, Bab 7 Sistem Hukum Administrasi Negara, Bab 8 Organisasi dan Tata Kelola Pemerintahan, Bab 9 Perbuatan Administrasi Negara, Bab 10 Keputusan Administrasi dan Proses Pembuatan Keputusan, Bab 11 Partisipasi Masyarakat dalam Pembuatan Keputusan Administrasi, Bab 12 Pengawasan Administrasi Negara, Bab 13 Sanksi Administrasi Negara, Bab 14 Mekanisme Penyelesaian Sengketa Administrasi Negara, Bab 15 Proses Peradilan Administrasi Negara, Bab 16 Alternatif Penyelesaian Sengketa Administrasi Negara, Bab 17 Aspek Hukum Pengujian, Bab 18 Good Governance, Bab 19 Hukum Administrasi Lingkungan dalam Pengelolaan Pertambangan, dan Bab 20 Tantangan dan Isu Kontemporer Hukum Administrasi Negara.
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Background: National Health Insurance has been performed since The implementation aims of performing National Health Insurance to facilitate access and utilization of health care. Public Health Center (PHC) as the forefront of health care and has major role to facilitate utilization of health care for members of National health Insurance. Nowadays, utilization of National Health Insurance in PHC has not reached national target amounts 15%. Objective: To explore determinant factors on utilization of national health insurance in remote PHC, East Sumba. Methods: The study type is qualitative with case study design. Variable included access of health care, health resources, medical needs and other factors. Amounts 20 informant involved this study. The informant included patient as members of National health Insurance, provider and head of district health office. Collecting data by indepth interview. Data analysis was conducted systematically by transcript, coding and analysis. Results: The higher utilization of national health insurance when traditional market was opened (market day). Limitation on access affected patient prefer to got services in outside. Limitation of health resources such as, unavailability of medicine and always exhausted, no lighting, and unavailability of water so utilization of PHC by patient was low. Most of patient need medical care in PHC such as need injection and unavailability of medicine so patient sought care out of PHC. Cultural factors still retained by society that diseases just be cured by a shaman. The pregnant women giving birth at home was high due to unavailability of waiting home (Rumah Tunggu) and village regulation has not examined about punishment of birth at home. Conclusion: Utilization of nasional health care in PHC remote area is less than optimal. It is not supported by adequate transportation facilities, the availability of drugs, and cultural changes.
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Background Health insurance ownership is one indicator of the readiness of pregnant women for the delivery process. The study aimed to analyze the determinants of health insurance ownership among pregnant women in Indonesia. Methods The study population was pregnant women in Indonesia. The study involved 2542 pregnant women in Indonesia. The variables analyzed included type of place of residence, age group, education level, employment status, marital status, parity, wealth status, and know the danger signs of pregnancy. In the final step, the study employed binary logistic regression to explain the relationship between health insurance ownership and predictor variables. Results The results show that pregnant women with higher education were 3.349 times more likely than no education pregnant women to have health insurance. Pregnant women with wealth status in the middle category were 0.679 times the poorest pregnant women to have health insurance. Meanwhile, the richest pregnant women had 1.358 times more chances than the poorest pregnant women to have health insurance. Grande multiparous pregnant women were 1.544 times more likely than primiparous pregnant women to have health insurance. Pregnant women who know the danger signs of pregnancy were 1.416 times more likely than pregnant women who don’t see the danger signs of pregnancy to have health insurance. Conclusions The study concluded that four variables, including education level, wealth status, parity, and knowledge of the danger signs of pregnancy, were significant determinants of health insurance ownership in Indonesia.
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Article
Objective To review the importance of evidence-based methods in health insurance reimbursement for achieving universal health coverage in India. Methods A narrative literature review was performed. Results The out-of-pocket (OOP) healthcare expenditure in India is among the highest in the world. This situation is despite the implementation of numerous government health schemes and the availability of a large number of health insurance programs, both public and private. Compromised quality of care in many public healthcare facilities is a major factor driving the average Indian citizen to increasingly depend upon private healthcare facilities, further escalating OOP spending. The low awareness and poor uptake of insurance policies among Indians is one of the biggest challenges in the implementation of universal health coverage (UHC) in India. The catastrophic burden of high OOP expenses on individual households could be reduced by taking steps to enhance health insurance uptake, which can be in turn achieved by strengthening the healthcare reimbursement system in India. Conclusions The application of the principles of evidence-based healthcare for reimbursement requires the systematic assessment of all health technologies, which is already being done in developed countries. The enactment of health schemes such as Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana and setting up of Health Technology Assessment in India are steps toward reducing OOP expenditure and achieving UHC in India. We review the importance and challenges of evidence-based reimbursement and health technology assessment toward achieving UHC in India.