Conceptually, BPJS Kesehatan (Social Security Agency for Health) represents the implementation of universal health coverage (UHC), which aims to ensure that all people can access quality health services without worrying about financial burdens. The primary goal of universal health coverage is to guarantee that anyone can obtain health services, including the poor and those at risk of falling into poverty due to medical expenses. However, the sudden deactivation of 11 million Contribution Assistance Recipients (PBI) of the National Health Insurance (JKN) program has sparked public controversy, as it was carried out abruptly and disrupted health services at healthcare facilities.
A lecturer at the UGM Faculty of Social and Political Sciences (FISIPOL UGM) Dr. Pradhikna Yunik Nurhayati, stated that the controversy surrounding the sudden deactivation of PBI participants indicates the need to improve data verification processes and policy transition mechanisms. Data-driven policies, she explained, should not only consider people’s economic conditions but also individual health vulnerabilities, particularly for patients with chronic illnesses.
“Patients with chronic diseases rely on routine health services. If membership is abruptly deactivated without a transition period, the impact could be very serious for patient safety,” she said on Thursday (Feb. 19).
Beyond data validity, Dr. Nurhayati noted that other issues lie in the design of business processes and standard operating procedures (SOPs) across institutions, which still require thorough evaluation. According to her, policy implementation problems often arise from weak coordination and inadequate execution mechanisms in the field.
She also emphasized the importance of improving policy communication to the public by BPJS Kesehatan. For Dr. Nurhayati, policy does not end at the formulation and implementation stages; it also requires adequate dissemination so that the public understands the changes taking place.
“Policies may already exist, but the socialization is often insufficient. As a result, the public is caught off guard, and those most affected are patients who depend on routine health services,” she explained.
Dr. Nurhayati added that the complexity of healthcare services is often overlooked by policymakers, particularly regarding geographic factors, transportation costs, and the need for patient companions. Therefore, health policies must consider real conditions in society, especially vulnerable groups with limited access to healthcare services.
In designing data-driven policies, Dr. Nurhayati stressed the importance of using forecasting methods and policy impact simulations before implementation. Every policy, she argued, must undergo analysis of various options and evaluation of potential risks to prevent service crises in the field.
“Policy decisions must be accompanied by impact simulations. The government must anticipate possible consequences so that policies are not only administratively sound but also substantively on target,” she said.
She further stated that in certain situations, the government may exercise policy discretion to respond to urgent public needs, as long as it remains within regulatory frameworks and is not misused. Dr. Nurhayati affirmed that public policy essentially reflects the government’s alignment with particular groups. Therefore, she underscored the importance of maintaining a balance between administrative accountability and the primary objective of policy, namely protecting public interests.
“Policies must prioritize those in need. Administrative mechanisms are important to ensure accountability, but they must not neglect the core objective of policy, which is fair and equitable public services,” she concluded.
Writer: Jelita Agustine
Editor: Gusti Grehenson
Post-editor: Zabrina Kumara
Photo: Shutterstock