HEALTH FINANCING FOR CIVIL SERVANT BEFORE AND AFTER NATIONAL HEALTH INSURANCE IN INDONESIA

Abstract

ABSTRACT

Background: The health care subsystem is the amount of funds provided to organize and utilize the various health efforts required by individuals, families, groups and communities. Civil Servants are important element in carrying out tasks in national development. There is a system of health insurance financing for Civil Servants can be seen the difference with the system of Capitation (BPJS) and Non Capitation (Askes).

Materials and Methods: The type of this research is “literature review” with descriptive analysis characteristic done to see capitation and non-capitation financing system by Civil Servant.

Result: Decree of President No. 12 in 2013 explained that the financing system is the dues and is a subsidy from the government. However, for a capitation financing system for civil servants, the capitation fund is the amount of prepaid monthly payments to a first-rate health facility based on the number of registered participants regardless of the type and amount of health services provided.

Conclusion: Overall, Capitation financing system is by making advance payments with the consequences of health care done pre-effort or before the participant (BPJS) fell ill. As for the referral system, the members (Askes) can make a claim if they have used health facilities.

Keywords: Financing system, Civil Servant (PNS), Health Insurance (Askes), Capitation (BPJS)