{
  "id": 15538594,
  "title": "What it will take to make JKN financially sustainable",
  "url": "https://urgent.news/2026/10/19/what-it-will-take-to-make-jkn-financially-sustainable",
  "topic": "world",
  "section": "World",
  "published": "2026-10-19T02:09:09.000Z",
  "source": {
    "name": "The Jakarta Post",
    "slug": "the-jakarta-post",
    "url": "https://www.thejakartapost.com/opinion/2026/10/19/what-it-will-take-to-make-jkn-financially-sustainable.html"
  },
  "original_language": "en",
  "account": "To ensure the financial sustainability of the National Health Insurance (JKN) in Indonesia, it is essential to shift the focus from merely increasing premiums to adopting evidence-based decisions, standardized care, and smarter purchasing practices. Despite the government's temporary financial support, such as the Rp 20 trillion (US$1.1 billion) allocation in the 2026 state budget, the underlying reasons for the persistent deficit remain unresolved.\n\nIn 2024, BPJS Kesehatan, the national health insurer, experienced an audited deficit of approximately Rp 10.93 trillion and an unaudited shortfall of Rp 14.49 trillion. The claims ratio surged to 111.8 percent by February 2026, with premium income at Rp 165.3 trillion against program spending of Rp 175.1 trillion. Premiums have remained unchanged since 2020, a fact that exacerbates the issue given the escalating healthcare costs.\n\nThe conversation surrounding JKN's financial health should pivot towards evaluating how effectively premiums are spent. Every pharmaceutical product or medical device added to the National Formulary or e-catalogue represents a recurring commitment of public funds. Implementing Health Technology Assessment (HTA) can help policymakers assess these commitments with rigorous scientific and economic evidence. By determining the additional clinical benefit provided by an intervention and its cost to the fund, HTA ensures that approvals and rejections are based on transparent, defensible evidence rather than lobbying or short-term fiscal convenience.\n\nThis approach extends beyond innovation; it is about ensuring that every decision remains anchored in health economics, which are inherently more sound, objective, and defensible to all stakeholders. For instance, when considering the treatment of ischemic stroke, the leading cause of mortality from noncommunicable diseases in Indonesia, the use of alteplase—a thrombolytic agent effective only within a narrow time frame—highlights the importance of HTA. Administering alteplase in time significantly reduces both mortality and long-term morbidity, translating to substantial downstream cost savings in rehabilitation, long-term care, repeat hospitalizations, and lost productivity.\n\nIn essence, a sustainable JKN hinges on making informed, defensible decisions that balance upfront costs against downstream health benefits and net savings. This strategic shift in decision-making processes can pave the way for a financially stable healthcare system that delivers value to clinicians, patients, and taxpayers alike.",
  "summary": "Bailouts and premium hikes buy time. Only evidence-based decisions, standardized care and smarter purchasing can keep national health insurance solvent.",
  "key_points": [
    "JKN faces audited deficit of Rp 10.93 trillion in 2024",
    "Unaudited shortfall reaches Rp 14.49 trillion in same year",
    "HTA recommended to evaluate premium spending effectiveness"
  ],
  "editors_take": "Moving from simple premium increases toward evidence-based purchasing through Health Technology Assessment offers a way to stabilize the national insurer by prioritizing long-term clinical benefits over immediate fiscal convenience.",
  "illustration": null,
  "coverage": {
    "outlets": 1,
    "also_reported_by": []
  },
  "ai_generated": true,
  "disclaimer": "Summaries, key points and the editor’s take are written by software from other outlets’ reporting and may contain errors — always check the linked original."
}