Jakarta. The future of Indonesia’s National Health Insurance Program (JKN) has once again come under the spotlight, as academics, practitioners, and social security observers gathered in a national seminar titled “Sustaining Health Social Security, Strengthening the Institutions: Building a Fair and Sustainable National Health Insurance System” on Tuesday.

Chairman of the National Social Security Council (DJSN) Nunung Nuryartono underscored that one of the key issues is the financial resilience of the system. He reaffirmed that JKN must remain a vital instrument of social protection to strengthen the overall welfare of the Indonesian people.

“We hope this seminar can produce policy recommendations that will enhance the quality and sustainability of our national health system,” Nunung said.

From the academic side, Gunardi, an actuary from Gadjah Mada University (UGM), stressed that projections of BPJS Kesehatan’s financial condition show the urgency of balancing income and expenditure.

“We are facing a situation where claim payments are starting to exceed income, leading to potential deficits. This means financial planning for the coming years must be a government priority to ensure JKN continues to provide fair benefits to the people,” Gunardi explained.

New Revenue Streams
He suggested that, in addition to participant contributions, new funding streams should be explored, such as endowment funds, crowdfunding, and supply chain financing.

Echoing this, fellow UGM actuary Danang Teguh Qoyyimi highlighted the importance of actuarial analysis for social security sustainability.

“Actuarial methods for social security differ from commercial insurance. We must consider demographics, economic conditions, and disease trends. Sustainability must be embedded at the design stage -- not only once the program is running,” Danang said.

He added that long-term risk analysis is essential to prepare for extreme scenarios that could impact claims.

Meanwhile, medical practitioner and lecturer Yulita Hendrartini stressed the need for efficient management of healthcare purchasing to balance service quality and costs, particularly in remote areas.

“The challenge is to balance pricing with quality, and ensure fair allocation of resources across regions,” she said.

Social security expert Hasbullah Thabrany also noted that proportional premium adjustments are critical.

“JKN tariffs must adapt to the economic capacity of the people. Higher earners should pay more, while lower-income groups must receive greater subsidies, so the principle of fairness is preserved,” Hasbullah explained.

Prominent constitutional law scholar and Chairman of the Jimly School of Law and Government Foundation, Jimly Asshiddiqie, pointed out that strong institutions are key to effective management.

“Regulations are already in place, but management and implementation still need strengthening. Policies must align with Pancasila and reflect social justice,” Jimly said.

Similarly, Dr. Ahmad Anshori of UNISKA emphasized social security as a constitutional right.

“There is no social justice without social security, and no social security can function without a state that obeys the constitution,” he remarked.

During the seminar, experts proposed concrete recommendations, including mitigation of health sector liberalization, stronger audits of INA-CBG, and broader financing diversification through taxes, excise, and endowment funds. They also recommended evidence-based policy reforms, such as iDRG tariff adjustments, with active involvement of academics, to ensure improved access, better quality services, and cost efficiency.

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