Access to healthcare in Indonesia and standards of service have much room for improvement. The country still suffers alarmingly high levels of maternal mortality, infant mortality and child mortality. What’s more, inequality is a major issue, with the rural population being underserved. Headline health statistics in Indonesia will not improve significantly until those inequalities are addressed.
Government’s role is supremely crucial in regulating the policies as development policies and economic strategies must be aligned to health objectives, as sustainable development is not possible where health is sacrificed for short-term sectoral or economic gains. There are several strategies and solutions in enhancing Indonesia healthiness:
1. Rectify Health System
The Healthcare and Social Security Agency (BPJS Kesehatan) has announced that the company’s deficit is projected to reach Rp 9 trillion (US$673.75 million) by the end of 2017. This massive deficit was mainly caused by fraud practice. Thus, health services will not be provided equally to society.
2. Improving Health Workers Quality
Human resources for health in Indonesia have grown rapidly over the last decade, as shown by the increasing ratio between health workers and the population. As of 2014, there were 73 medical schools in Indonesia producing an average of 5500 medical graduates a year. This represented an increase of 40% since 2001, mainly due to an expansion in the number of private medical schools – there are 42 private medical faculties (Indonesian Medical Council, 2014a). However, quality issues remain a concern, with 33 faculties (45%) only given C-class (the lowest level) accreditation. Indonesian Medical Association (IDI) has suggested a moratorium for C-Class faculties in concern to quality medical education, but until now it is still debated.
In addition, emphasizing the Academic Health System (AHS) will increase the synergy between public health facilities and medical school, thus influence the provision of health services.
3. Prevention preferable to cure
The foundations of an effective universal coverage program begin with prevention rather than cure, by reducing the need for doctors and clinics in the first place. Public awareness is crucial to keep the prevention effort of government succeed and sustained. Poor awareness or perception about prevention, especially immunization by the community will lead to an outbreak of a disease (e.g. diphtheria outbreak due to an anti-vaccine movement).
2.4. Relation of Pancasila and UUD 1945 to Good Health
Ensuring healthy lives and well-being for all people are a fundamental substance in developing society and implementing national aims. Health is a human right. The 1945 Constitution drafted by the Founder of the Nation (founding fathers) have mandated obligation to provide protection for all the people of Indonesia, including in the field of health.
Article 28H paragraph (3) of the 1945 Constitution states that every person has the right to social security that allows development of oneself fully as a dignified human being. It is also stressed in Article 34 paragraph (2) of the 1945 Constitution that the state develops a social security system for all people and empowers the weak and incapable in accordance with human dignity.
Pancasila as an ideal foundation and basis constitution is clearly bear citizens’ right and obligation. People’s rights and liberties will be perceived only in the context of their obligations to the life of the group (which values harmony, reciprocity, and balance) (David, 2003). As a philosophy, Pancasila emphasizes that in all aspects of national life must be based on the values contained in it, such as the value of deity, humanity, unity, democracy, and justice. If the values of Pancasila (das Sollen) have become daily reality (das Sein), it can build the good resistance by itself (Nikodemus, 2016). To build nation characters in the value of humanity, Pancasila has several principles. The fifth principle states: “Social justice for all of the people of Indonesia”, thus articulates the value of humanity. The fifth sila reflects how a person especially health workers to behave and serve the society equally.