State Budget Allocation (APBN) of Indonesian Health Expenditure and Its Implications for Community Welfare, Hospitals and Health Workers in Indonesia.

 Introduction/ Background

Health is an invaluable asset for people all over the world. Without good health and health services there can be no prosperity. Health is the heart of all human life because without good health, it will be difficult for every human being to carry out their daily activities. A healthy nation is a nation that has people with healthy and strong bodies. For this reason, health has an important role in the life of society, nation and state. As stated in the following Law, namely Health Law no. 36 of 2009 which states that: Everyone is obliged to respect the rights of others in an effort to obtain a healthy environment, whether physical, biological, or social. Everyone is obliged to behave in a healthy life to realize, maintain, and promote the highest possible health. Health is a symbol of the prosperity of society in a nation. In concept, health is part of the main aspects of human life as a whole. As the WHO definition of Health is the concept of "health", the World Health Organization (WHO) defines it in a very broad scope, namely "a state of complete physical, mental and social well-being, not only free from disease or infirmity/disability". 

In this definition, healthy is not just free from disease or disability. In another definition, every individual who is capable of his health, will certainly be able to contribute positively to the nation and state. This is in line with Tompa's (2022) theory, which states that individual health can directly increase output. This increase in output can be interpreted as an increase in the productivity of the individual. This is supported by the results of a survey conducted by the Commonwealth Fund Biennial Health Insurance Survey which shows that the decline in productivity is caused by three factors, namely: individuals who are unable to work due to poor health or disability, workers who lose time for work due to health problems, and workers who are less productive at work.

Public health has an important role in improving the quality of human resources, poverty alleviation and economic development. The Human Development Index places health as one of the main components of measurement besides education and income. Along with the times with various social dynamics that occur such as technology, infrastructure and transportation, in fact it will facilitate access and mobility of people so that they can migrate from one place to another. This progress certainly has an impact, not only bringing access to health services closer to the community, but also has implications for increasing the risk of public health threats. Therefore, the government must be sensitive in responding to various health issues that occur in this country. 

However, this will not be resolved without a strong commitment through the synergy of the central and local governments, priorities, facilities, empowerment of competent health experts and adequate governance and hospitals. This is a big challenge for every nation in achieving it. Every country must have a source of health fund allocation that can be used fairly and equitably and proportionately for its nation. The allocation of funds in Indonesia from year to year and various targets or priorities so far are seen from how they are achieved. And whether these achievements have been able to make health services in Indonesia better and more advanced.

The right to a healthy life for every citizen depends on how much of the allocation of health funds is given to be managed and utilized and developed in accordance with the achievement targets of each nation or country itself. The allocation of health funds is important because it is useful for increasing access and quality of basic health services and focusing on achieving health facility management services at the provincial and regional levels. The allocation of health funds in Indonesia gets a proportion in the RAPBN for the 2022 Fiscal Year which is allocated at Rp. 255.3 trillion or 9.4 percent of the total state expenditure. This was conveyed by the Minister of Finance Sri Mulyani Indrawati at the Plenary Meeting of the House of Representatives of the Republic of Indonesia to discuss the Draft Law (RUU) on the State Revenue and Expenditure Budget (APBN) for Fiscal Year 2022, along with its Financial Note. This figure is much higher than the mandate of the law, which is 5 percent of the APBN. If we refer to the size of the health budget in several other countries, the proportion of Indonesia as a large nation is still far from an ideal concept.