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

 

However, it is hoped that this will be a challenge of the government and the synergy of all parties. So at this time Indonesia is in a dilemma, will Indonesia prioritize the economy or health? because if one of these choices is eliminated it will harm both. Therefore, Indonesia needs careful planning and repositioning priorities in development. The following is data related to the realization of the health budget starting from 2017 - 2020, an average growth of 22.5 percent per year, from Rp. 57,225.1 billion in 2017 to Rp. 105,088.5 billion in 2020. In addition, the growth in the realization of the health budget is also influenced by the high allocation of government spending for various needs for handling the Covid-19 pandemic, namely for payment of patient care costs, incentives for health workers or health workers, as well as the procurement of Medical Devices (Alkes) and Infrastructure (Sarpras). If referring to the increase in the health budget of that size, is there a ratio in the realization outcomes in the field if the budget has covered the needs and interests of health service activities in Indonesia.

 

In fact, it can be seen from the current national health challenges in Indonesia which mainly include: 1) The quality, equity, and affordability of health efforts are not yet optimal; 2) Health management, information, and regulation are still not strong enough; 3) Equitable distribution and quality of health human resources have not fully supported the implementation of health development, (4) Ease of Access to Health Services at JKN, in addition to that it is coupled with other health problems and issues that are important to pay attention to, namely Geographical and Economic Conditions Resulting in unequal health services in remote and remote areas of Indonesia.

 

In addition, the proportion of the health budget is 5% of the State Revenue and Expenditure Budget (APBN) and is divided for each local government. This figure shows the difficulty of providing equitable health services for the community.Indonesians living in rural and remote areas have to face problems such as a lack of basic health services and almost non-existent secondary health services. With the complexity of health problems in Indonesia, other problems also arise, such as the welfare of health workers in Indonesia, which is still far from prosperous. The salary of nurses in Indonesia is relatively small. Someone who wants to go to school to become a nurse must pay a lot of money. Not to mention, the fate of doctors who work in remote areas. Apart from having a duty and dedication, a doctor also deserves to get proper welfare. Medical schools in Indonesia are very expensive and there are not many doctors in Indonesia. Based on data sourced from Source: World Bank 2018 The number of doctors in Indonesia is the second lowest in Southeast Asia, at 0.4 doctors per 1,000 population.

 

This means that Indonesia only has 4 (four) doctors serving its 10,000 population. This number is much lower when compared to Singapore which has 2 (two) doctors per 1,000 population. Apart from doctors, Indonesia has limited other health workers. The availability of nurses and midwives in Indonesia also has the worst position among other countries. The ratio of nurses per 1,000 population is 2.1, which means 2 (two) people serve 1,000 residents in Indonesia.

(To be continued....)