TEMPO.CO, Jakarta – BPJS Kesehatan CEO Ali Ghufron Mukti explains the standard inpatient class system stipulated in the Presidential Regulation on Health Insurance.
According to Ali Ghufron Mukti, the Health Care and Social Security Agency (BPJS Kesehatan) is often the target of harassment, mostly due to misinformation regarding its services. The Chief Executive Officer (CEO) of BPJS Kesehatan is certain that the public does not fully understand the information, including the information regarding the standard inpatient class (KRIS) system stipulated in the recently issued Presidential Decree No. 59/2024 on Health Insurance.
The government, Ghufron said, had no plan to implement a single-class system nor eliminate the inpatient ward class system. “There is not a single word whatsoever in the regulation that says the ward class system will be abolished,” Ghufron told Tempo on May 29. He explained that the KRIS system was formulated as a standardization guideline to regulate medical services such as building quality, room temperature, number of beds, etc.
Ghufron also discussed the uproar over a social media post uploaded by a veteran musician who lamented a long queue for BPJS Kesehatan services at a South Tangerang hospital in Banten. However, BPJS Kesehatan ambassadors—as Ghufron calls his employees—had explained to the singer that he could wait at home. “There are a lot of false perceptions,” remarked the former Deputy Health Minister.
During the two-hour interview, Ghufron elucidated the innovations he created to counter the hoax on BPJS Kesehatan. He, for example, wrote a song titled Belum Tahu (Uninformed) and sang it with Gadjah Mada University Rector Ova Emilia. Here is the song excerpt, “I know you don’t know yet that BPJS is very advanced. Many countries want to copy it, with its quality cost control.”
Not only did Ghufron compose songs, but the doctor who hailed from Blitar, East Java, also wrote a book titled Roso Telo Dadi Duren, Biyen Gelo Saiki Keren (Cassava now tastes like durian: From feeling disappointed to feeling cool). The book chronicled BPJS Kesehatan’s 10-year journey in the past decade. Ghufron said the title was a comeback at the mockery by some doctors who criticized BPJS by saying, “BPJS Kesehatan rasa telo, BPJS Kesehatan gawe gelo,” meaning BPJS Kesehatan is disappointing. “Our task is to raise awareness and build perceptions,” he said.
Ghufron also explained the controversy surrounding health care insurance standardization to Raymundus Rikang, Sunudyantoro, and Yosea Arga Pramudita from Tempo at the BPJS Kesehatan Head Office in Central Jakarta. The former Dean of the Faculty of Medicine of Gadjah Mada University also expounded his agency’s recipe for successfully improving the once-unbalanced balance sheet that recorded deficits before the Covid-19 pandemic. Excerpts:
Please explain the KRIS concept in the Presidential Regulation on Health Insurance.
The Presidential Regulation (Perpres) No. 59/2024 regarding Health Insurance says nothing about eliminating inpatient classes. I have no idea where that information originates. It regulates that members who are recipients of premium subsidies or who cannot afford (to pay premiums) are not eligible for upgrade to the VIP class, among others. Sometimes, people have the money but only pay the class III premium. But, once they get sick, they want to use the VIP class facilities. This is ridiculous. Presidential Regulation No. 59 governs these matters.
Do you guarantee that there won’t be a single-class system?
I don’t know where that term came from. If you read (the Presidential Regulation) carefully, there is no mention of a single-class system or the abolishment of different classes.
There is already a public perception that the single-class system will be implemented.
Someone did mention it but it’s not about scrapping classes. That’s why I created the song Belum Tahu, a duet with the Gadjah Mada Rector. There’s also another song titled Konten Viral (Viral Content). The idea for the song came from the BPJS Kesehatan’s experience.
About what?
There was a hospital involved in a fraud case. Essentially, they engaged in a practice that benefitted them but violated the regulations. We ended the partnership. The owner freaked out. They were disappointed and contacted the Health Ministry and the House of Representatives (DPR). We suspected that he also contacted a content creator who shared a viral post in which BPJS Kesehatan was accused of arbitrarily terminating the partnership, leaving a patient (the creator’s father) in a life-threatening situation. How did the creator know this (partnership) problem? Someone must have told that person. We then contacted this person and said that their message was not true. The content creator eventually acknowledged their mistake and shared another remedial post. But what went viral was still the first incorrect content. That’s why I made the song.
What is the meaning of ‘standard’ in Presidential Regulation No. 59?
What needs to be understood is that it is not about standard classes but standardization of hospital wards. So far, there haven’t been medical and non-medical service standards. The meaning of standard in Presidential Regulation No. 59 is established through 12 criteria, namely ventilation, light, building components, room temperature, bathroom, and hospital bed density, among others. That is the health care standardization the regulation seeks to govern.
What is the background?
I’ll give you an example. A hospital in South Tangerang does not implement a class system. I asked what their aim was. They said it was to avoid discrimination. As a result, most of their patients are from underprivileged communities. Meanwhile, well-to-do patients definitely go to hospitals that apply the class system. The purpose was not to differentiate, but it clearly differentiates.
Is the standardization realistic, given the unequal healthcare facilities in various regions?
The said 12 criteria were initially the minister’s criteria for hospital construction. The National Social Security Council later adopted them as a standard. Presidential Regulation No. 59 seeks to overhaul the previous regulations and improve service quality.
How did hospitals respond to this standardization plan?
The KRIS system is about improving quality. But I don’t want to improve only quality. Access to services must also improve. We should not allow a situation where quality increases but access decreases. In the past, there was an adage that said the poor are forbidden to fall sick. I want to change that to ‘the poor are forbidden to pay when they fall sick,’ as long as they are active participants.
