Indonesia's JKN faces chronic deficit; experts call for evidence-based spending reforms
The government will inject Rp 20 trillion into the JKN fund this year, but analysts say lasting solvency requires stricter spending controls and health technology assessments.
Indonesia's national health insurance, JKN, will receive a Rp 20 trillion boost from the 2026 budget, scheduled for disbursement in October and November, to sustain hospital claim payments. Despite this bailout, the scheme posted an audited deficit of about Rp 10.93 trillion in 2024 and an unaudited shortfall of Rp 14.49 trillion in 2025, with the claims ratio climbing to 111.8 percent by early 2026. Premium revenues, unchanged since 2020, fell short of the Rp 175.1 trillion spending level recorded in 2024.
While raising premiums is politically sensitive, analysts argue that sustainable financing hinges on smarter purchasing decisions. They propose expanding Health Technology Assessment to scrutinize each pharmaceutical and medical device entry in the national formulary, weighing clinical benefit against cost. The approach aims to prioritize high-impact treatments, such as timely alteplase for ischemic stroke, which can reduce long-term care expenses and improve patient outcomes.
Why it matters
JKN's financial health affects access to affordable care for millions of Indonesians.
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