Aceh Government have been implementing national health insurance program since 2010 under the name of Jaminan Kesehatan Aceh (Aceh Health Insurance) which later was integrated to the National Health Insurance (BPJS) in 2014. In the implementation of JKA, there is addition of specialists from year to year, although the number and distribution are still not enough and evenly. The mean ratio of specialists in Aceh is 6.5 per 100 thousand inhabitants. “This ratio is lower than the projection of Directorate General of Higher Education in 2014, which was as many as 12 specialists or lower than the target of Healthy Indonesia 2010 program,” said by the Chief of Medical Agency, Government of Aceh, dr. M.Yani, M.Kes, PKK., in his open examination of doctoral program at the Faculty of Medicine Universitas Gadjah Mada, Friday (29/1).
Efforts have been made to fulfill specialist doctors quota in the district/city by improving financial factors and incentives in order to attract doctors to work in the area. However, local governments, according to Yani, still ignores other factors that could encourage a specialist doctor to work in the area for a long period.
Research finding shows that the addition of specialist doctors and facilities from the period of 2010 to 2014 in Aceh was due to the intervention program of Rehabilitation and Reconstruction Agency for Aceh and Nias (BRR Aceh-Nias), which was set up following the Boxing Day tsunami back in 2004. “The role of government in Aceh is still weak in the provision of specialist doctors,” he said.
Whereas in the regional autonomy law, the government should have more role in the provision of specialist doctors in the area, while the district/city government need to provide other strategic positions.”The availability of general practitioners and specialists showed the Aceh region is not yet fully prepared to carry out the mandate of National Social Security System (UU SJSN) on social justice,” he said.
According to the man, the government of Aceh needs to improve specialist inequality among districts/cities. In addition, bed facility and a hospital hemodialysis unit at the district/city are badly needed.
Besides, he thinks that local government and local universities need to organize the effort of monitoring and evaluation program regularly for JKA to encourages the implementation of the program to be more effective, efficient and equitable. “JKA program should be continued by strengthening the membership system,” he said.