Name : Tiffanny Ocktivianie Tobing

SRN : 6411419029

The purpose of health financing is to provide health financing on an ongoing basis with
sufficient amounts, allocated fairly and can be useful and efficient to ensure the implementation
of health development in order to increase the health status of the community as high as possible.
Health financing is one of the functions in the national health system (SKN). In meeting health
financing in Indonesia, there are various challenges that must be faced, including the increasing
number of Indonesian population, the poverty rate that is still increasing which requires
subsidies, many elderly people which cause various kinds of chronic degenerative diseases, etc.
The health financing system is carried out to fulfill the Sustainable Development Goals to
improve people's welfare in terms of meeting every community need, especially to access health
services easily and at affordable costs. The current health financing system in Indonesia is
relatively low, when compared to other countries with similar economic levels, where the need
for health spending should continue to increase in line with population growth and disease
development, but in Indonesia there is a partial trend that makes health financing in Indonesia
tends to ignore the need for funding for public health programs (SMEs) as well as programs to
strengthen the health system. In the National Health System (Perpres 72/2012) it is stated that
health efforts can be divided into two, namely Community Health Efforts (UKM) (Perpres
72/2012) which focuses on public health services which are public goods which cannot be
financed with tariffs or insurance and Individual Health Efforts (UKP) which are private goods
which can be financed by tariff and insurance mechanisms, in the implementation of UKM and
UKP cannot be financed leave it alone, this is because illness or health problems require SMEs
and UKP at the same time. According to WHO, one of the causes of the failure of health
programs is due to a lack of strengthening systems or even elements of the health system that are
not developed, elements of the health system include: regulation and governance supported by
information systems, health human resources, pharmaceuticals and medical devices, health care
system, health financing system. In running SMEs consistently governance is needed, which is to
strengthen the SME and UKP programs. The local government is responsible for providing
promotive and preventive service financing, which is provided by SMEs instead of UKP,
because individual treatment (UKP) will be covered by the national health insurance, in carrying
out health services at the regional level, the Public Health Center is the spearhead. SME and
UKP services at the regional level, the local government is also responsible for financing 4
health affairs, 12 basic services in the MSS (payment order) and other national priority programs
(outside the MSS).

The need for health financing is determined by several factors, including population, age
structure, fertility level, disease patterns, environmental conditions, intervention priorities which
are determined by each country to meet the demand (demand side) of the community. There are
several benchmarks used to estimate how much the health spending target should be, namely

a. The relative target, with % of health spending with a certain denominator

b. Absolute target, namely the nominal value per capita required for health spending.

The value of % of GDP is more comparative and does not describe the nominal amount of health
spending, the comparison of % of GDP between countries cannot be used as a benchmark to
determine the policy of what % the share of health spending should be in GDP In 2010 the funds
used to manage SMEs came from the allocation of Health Operational Assistance (BOK) funds
to run programs or activities outside the building, including: MCH program, family planning,
nutrition, immunization, health promotion and health, where BOK funds were not allowed.

Health Financing Strategic Issues include:

a) Challenges of health development and escalation of the need for health costs
b) Issues of understanding for health
c) What needs to be financed, where financing must be program-specific driven or input-
specific driven, this kind of financing will encourage financing to be partial and
fragmented, even though formal regulations and policies have determined health
programs that need to be carried out
d) Financing bias in UKPs, partialism and fragmentation in providing financing to UKPs
will override or allow ignoring indicators of health status, such as SMEs and PSK
e) Comprehensive health financing
f) UKP financing: misconceptions about universal health coverage
g) Government responsibility in financing UKP, SME and PSK
h) Regional fiscal capacity