Jakarta If the first we may know Health Insurance (Askes) or Health Insurance Workers (Jamsostek) and other health insurance. Currently, or rather since January 1, 2014, Askes has been transformed into the National Health Insurance. By using the National Health Insurance system (Navigation) which still continue to be refined, the Indonesian government now has also established the Social Security Agency (BPJS) which regulates changes tiered health services ranging from primary health care services such as health centers to referral health services such as hospitals.

Discussing JKN newborn in Indonesia, did you know that in fact, the Indonesian government has begun to try to introduce the principle of insurance since 1947, two years after Indonesia's independence. As mentioned by the Head of Economic Research and Health Policy, University of Indonesia, Prof. dr. Hasbullah Thabrany, MPH, Dr.PH related in his History of Health Insurance.

He revealed the idea JKN actually has long been prepared since the relative political stability achieved since 1960. It's just that these changes can not be changed simply considering health care system in Indonesia is still using patterns Fee For Service or a payment system in which hospitals or pharmacies billed in accordance with service given. These payments will be much more expensive when people experience complications of the disease. And certainly, the poor can not seek treatment because of the high payment item.

Total change people's minds to health care, has now developed a system that is both social insurance JKN alias cross subsidies. That is, almost equal to the commercial insurance from the premium payments each month. But the difference, much more effective. Because by paying a premium, the entire disease will be borne by BPJS without having to think about age or disease burden. In addition, poor public health insurance has also been regulated by Government Regulation No. 101 of 2012 concerning the Recipient Contribution (PBI). That is, approximately 86.4 million poor people enrolled in the Ministry of Social Affairs premium will be borne by the government.

Unfortunately, both primary care facilities such as health centers or the number of doctors is still a problem despite continued sounded. Readiness JKN rated Hasbullah still lacking, especially with patterns JKN now, people should be confronted with changes in the pattern of tiered services. In a sense, people should check in advance at the new health center or clinic next to the hospital if it can not be handled.

Besides that, a glance at other countries which first have National Health Insurance, almost all of them indeed have led to the strengthening of primary care health facilities such as health centers or clinics. And certainly not an easy thing because of new European countries feel the benefits after decades.

Furthermore, Hasbullah said JKN differences with the national security system that applies in other countries, as follows:

Thailand

According Hasbullah, as much as 70 percent of health problems in Thailand, can be completed in primary care. In addition, earnings doctors there could reach approximately USD 20 million per month. But, he also explained the prevailing social insurance system there, there are some constraints on the early years, such as the collection of social security participants and the number of participants who register pain.

Health insurance in Thailand consists of civil servants health insurance system which is very liberal bail package and guarantee not only the family members of employees, but also includes the parents and law clerks. The whole private employees receive comprehensive health insurance through the Social Security Agency managed by Depnakernya Thailand.

While informal workers obtain assurance through the National Health Security Office, an independent agency to manage the system 30 baht (Thai currency). With 30 Baht system, the entire population outside the employee's private party and civil servants are entitled to comprehensive health care to pay only 30 Baht (approximately US $ 6,000) a medication or treatment, including intensive care and surgery. Thus, the entire population of Thailand has now also been freed from the threat of being poor when it fell ill and therefore would be more productive to build the country.

English

In the UK, said Hasbullah, its national social security system called the National Health Service (NHS). Health insurance is funded and managed by the national government (not decentralized), but the nature of its management is partly financed from mandatory contributions by workers (including in the informal sector) and the employer. While channeling funds through the state budget is mainly financed from general taxation (tax-funded). For the coverage, NHS covers the entire population (universal coverage). In addition, there are no classes at the hospital because the health center is on primary health care.

Canada

The Canadian health insurance system called Medicare. Prior to the 1940s, Canadians get health care by paying from their own pockets (out of pocket) in accordance with their respective capabilities. Residents who could afford to buy commercial health insurance, but most residents can not afford it. It raises a lot of problems and humanitarian access due to the population can not afford the health care they need.

Businesses provide health insurance to all new residents began in 1947 when the province Saskathcwan start implementation of mandatory health insurance is often called public health insurance, for hospital services only. Ten years later, the federal government keen to expand the security system provided by the province Saskatchwan.

In 1956, the federal government stimulate other provinces to organize hospital care insurance contributed 50 percent of the funds needed provinces. In 1961 all provinces and two territorial regions have agreed to provide guarantees at least hospitalization.

Medicare uses the basic principles that guarantee universal access, portable, packs the same guarantee to all residents and executed autonomously in each province. Now the entire population of Canada can enjoy comprehensive health services without having to think about how much it costs to be paid from their own pockets even for severe disease even though outpatient services at the doctor's office, either independently or in group practices, they should be paid by residents.

USA

Peek neighboring Canada, at this time, the US can be said to have a national health insurance hospitalization for people over 65 years (elderly) called Medicare Part A, B and C. But because national insurance is only valid in the United States for the elderly population, not all American population of about 280 million people have health insurance.

About 50 million US residents under the age of 65 years (about 25 percent of the productive population) do not have health insurance. This is a proof of the failure of the market mechanism in the health field, because the US does didominisasi by commercial health insurance. With health spending per capita is now more than US $ 5,000 per year, the US is the only developed countries that can not afford to have national health insurance.

Germany

Hasbullah explained, Germany is seen as the first country to introduce a social health insurance in the days of Otto von Bismarck in 1883. In the past, the number of carriers and social health insurance (sickness funds), which is entirely non-profit, totaling about five thousand. However, because of the encouragement of efficiency and portability, many fund managers are joined so that now the number has menysut to 270 only.

Now the largest social health insurance held by entities called AOK that manages nearly 70 percent of participants of social health insurance in Germany. All residents with income below EUR 3,375 per month mandatory shall pay the contributions for health insurance which has now reached 14 percent of the monthly wage. Residents who earn above it, may not be a participant in national insurance, but once they did not participate (opt out) to buy commercial health insurance, they are no longer allowed to participate social insurance. As a result, only 10 percent of Germans who buy commercial health insurance.

Netherlands

State windmills that once crowned the country with the best health insurance all over the world have the health insurance system more or less follows the patterns of Germany with modifications. Netherlands actually also enact national health insurance at the risk of major medical expenses (exceptional medical expenses) which is managed by a national body known as the AWBZ (Algemene Wet Bijzondere Ziektekosten).

Health services are not expensive administered by a variety of social health insurance carriers and non-profit governed by the Law on Sickness Funds Act (ZFW). Most high-income residents are allowed (opt out) to buy commercial health insurance.

Liputan6.com never met a senior researcher from NIVEL (Netherlands Institute for Health Services Research) dr. Wienke Boerma, PhD at the Hall of the Faculty of Medicine, University of Indonesia some time ago. He explained, compulsory premiums paid employers depend on income there over 18 years old in 2013 amounted to 110 euros per person per month (USD 1.7 million). While personal dependents when filing a claim, Dutch citizens are required to pay for 350 euros per month (USD 5.5 million) for health care. It also does not include the cost of family doctors and childbirth.

"There are additional personal dependents when filing a claim between 100-500 euros. But this particular premium does not include the cost of a dental examination. And again, because medical personnel can be remuneration, doctors are required to work hard. They are schools (Community School) for 6 years to handle the number of Common complaints include regular health checks, especially with regard to lifestyle and its effect on the cardiovascular (heart and blood vessels), "said Wienke.

Met in the same place, expert structure, finance and primary health organizations from Tilburg University, Prof. Dinny De Baker PhD said, the power of national insurance in the Netherlands is a family physician who should be ready to serve the public within 24 hours 7x. Physician services also includes prevention and promotion of healthy living, the handling of mental illnesses such as stress (somatic) and psychosocial problems.

Australia

Australia itself is delivered Hasbullah has issued its National Health Insurance Act in 1973 by providing a comprehensive service assurance to the entire population of Australia, both in Australia and who are in some neighboring countries such as New Zealand and the citizens of several European countries who live in Australia. Insurance called Medicare and administered by the Health Insurance Commissioner in the Federal state level.

Since 1973, the entire population of Australia do not have to think about the cost of care if they are sick. Therefore the disease will not make them fall into poverty. Reform of the Australian National Health Insurance system occurred in the 1990s by stimulating people to buy commercial health insurance. But as good as Medicare's management, the number of Australian residents who choose to purchase health insurance komerisal increasingly little.

Japan

As an ally of Germany in World War II in Asia, Japan has a pattern of health insurance system which follows the German pattern with various modifications. The Japanese national insurance terms named Kokuho, Kokumin Kenko Hoken used for the provision of health insurance for the self-employed (self-employed), private and retired civil servants, and members of his family.

Insurance providers were handed over to local governments. While health insurance for active workers in the formal sector is regulated by the Law on social health insurance separately. Japan has started to develop social health insurance since 1922 by requiring workers in the formal sector social health insurance program. However, requiring health insurance for formal sector workers alone can not guarantee the population in the informal sector and residents who have reached retirement age get health insurance. To expand health insurance to all residents (universal coverage), Japan then expand health insurance coverage by issuing national insurance laws.

In the health insurance system in Japan, the participants and their family members must pay a fee (cost sharing) which vary between 20-30 percent of the cost of health care in health facilities. This has become part of the cost share of the commercial health insurance market.

South Korea

South Korea's launch of social insurance in December 1963 by requiring companies that employ 500 or more employees offer health insurance to employees. The obligations increased up to companies employing one employee. Coverage of health insurance for the self-employed has been tested since 1981 and in 1989 the entire population has to have insurance. A remarkable achievement, because in a relatively short time Korea has been able to achieve universal coverage.

Even so, penyelenggaraanya still staffed by more than 300 health insurance agencies that are managed by non-profit groups or local government worker. Given the high mobility of the population and the low efficiency of the management of social insurance programs, the reforms toward a single system. Since 2000, social insurance in South Korea managed by a national agency with a maximum contribution of 8 percent of wages, equally shared between workers, employers and government subsidies.