Analyzing Kartu Indonesia Sehat: A Review Based on Implementation
Programs
Ucik Fauziah
Faculty of Publih Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
Keywords: Implementation, Program, Kartu Indonesia Sehat, Preventive effort.
Abstract: Quality and proportional health care is a dream for every Indonesian, because it is closely related to one
aspect of basic human needs fulfilment. In addition, the commitment of the service providers, especially in
the Sempaja Urban Village of Samarinda in supporting the implementation of government programs
through Kartu Indonesia Sehat (KIS). The commitment is realized with the ease in the process of making
KIS, but there are still some commitments that have not met patient satisfaction between service quality and
KIS system offered to the community. In addition to commitment, community perceptions related to the
KIS program to establish the health of the main thing for humans can be emphasized in the community that
KIS is a health insurance that acts as a preventive effort. In the selection of Sempaja urban village of
Samarinda on healthy card analysis Indonesia as one form of distribution of health programs outside Java
Island.
1 INTRODUCTION
1.1 History of Development of Preventive
Efforts in Indonesia
The development of public health in Indonesia is
divided into three periods namely pre-independence
era, the era of independence, and the development of
health promotion in Indonesia. In the pre-
independence era of 1851 preceded by the
establishment of a school doctors in Batavia Java
named STOVIA and in 1888 in Bandung established
the centre of the Medical Laboratory. The next
period is the era of independence. The era of
independence is divided into pre-reform and post-
reform. In pre-reformation in 1951 has been
introduced the concept of Bandung plan. The
concept is a service concept that combines curative
and preventive services. Year 1967 The concept of
Bandung plan continues to develop into the concept
of Primary Health Care (Puskesmas) so that in 1968
the concept of Puskesmas formed on type A, B, C
set in the national health work meeting. While in the
post-reformation formed JPS-BK program for the
poor citizen. Furthermore, the last period is the
development of health promotion. At this time there
has been a village community health development
program, a professional improvement of personnel
through Health Educational Service (HES) program,
there are UKS program in elementary school, the
formation of Posyandu (Arif, 2016).
1.2 Social Health Insurance (Jaminan
Kesehatan Nasional-JKN)
Social insurance is a mandatory collection
mechanism of participants, which is useful to
provide protection to participants for the
socioeconomic risks that affect them and / or their
family members (UU SJSN Number 40 Year 2004).
The mechanism has procedures for the
implementation of Social Security program by BPJS
Health and BPJS Employment. While social security
in question is a form of social protection to ensure
all people in order to meet basic needs of decent
community life.
So it can be concluded that Social Security
Insurance (JKN) which is developing in Indonesia is
part of National Social Security System (SJSN).
Based on Law number 40 Year 2004 states that
SJSN is conducted through a mandatory social
health insurance mechanism. It is intended for all
Indonesians to be covered under the insurance
system and to meet basic public health needs5.
Fauziah, U.
Analyzing Kartu Indonesia Sehat: A Review Based on Implementation Programs.
In Proceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 183-186
ISBN: 978-989-758-335-3
Copyright © 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
183

1.3 Kartu Indonesia Sehat Program
Health is the main thing and become one of the
sectors that can affect the sustainability of other
sectors. This is because the health must be met by
the livelihood of many people in nation and state. In
UU RI Number 36 Year 2009 states that health is a
human right and one of the elements of welfare that
must be realized in accordance with the ideals of the
Indonesian nation. This statement can mean that
everyone has equal rights in the effort to maintain
and improve health degree, one of them through
health services organized by the government based
on non-discriminative, participatory and sustainable
principles.
Health services that have been implemented by
the government one of them is the existence of
Kartu Indonesia Sehat (KIS). KIS is a card that has a
function to provide health insurance to people who
have a non-discriminatory principle in the handling
of health. The principle of non-discrimination in the
sense that the recipients of KIS do not require
administrative difficulties for the poor in accessing
the card although they do not have complete data
and still get service at the first level or advanced if in
an emergency, so that can be said KIS aims to
lighten the burden the poor on health. In addition
KIS will be given to members of National Health
Insurance or Jaminan Kesehatan Nasional (JKN) so
as not to shift the system JKN, while the
implementation of KIS has been channelled to poor
families who receive JKN dues as much as 86.4
people and still be covered by Kartu Indonesia Sehat
(KIS).
2 METHODS
In this study using literature review that is with other
research materials obtained from reference materials
to be the basis of research activities by
understanding the issues under study, including
problems implements JKN-KIS Program in
improving the welfare indicators of the community
in terms of health.
3 RESULTS
In the process of making and administrative process
Kartu Indonesia Sehat (KIS) in the administrative
scope of South Sempaja Urban Office quite easy
(Arif, 2016). The first thing to do is that participants
are required to make a Social Insurance Card or
Kartu Perlindungan Sosial (KPS). The process of
making KPS is by applying or get recommendation
from the village leaders. After obtaining a cover
letter or application file will be forwarded to the sub-
district office for follow-up by the village and then
the application file will be sent to Post Office. The
purpose of sending the application file is to make 3
cards, one of which is making Kartu Indonesia
Sehat.
One of the most important elements of KIS
services is the provision of basic health services
such as Rawat Jalan Tingkat Pertama (RJTP).
Health services including RJTP have several
substances including examination and treatment
handled by general practitioners as well as by
dentists, family planning services, maternal and
child health and diagnostic services. The provision
of some substances contained in the RJTP is also
directly proportional to the supporting facilities that
have been provided by the government in the scope
of Puskesmas of South Sempaja Sub-district. This is
evidenced by the supporting facilities in the form of
Puskesmas rooms in accordance with their
respective utilities and the provision of complete
medical equipment. Supporting facilities in the form
of the provision of room and complete medical
equipment can be seen from some substance or poly
contained in the scope of Puskesmas such as
examination of dentist serves special action in dental
patients only, contraception services and child and
maternal health services include special services of
mothers and children with diagnoses of certain
diseases, as well as providing referral letters if the
patient experiences an emergency and the ability and
capacity beyond the scope of the Puskesmas. At the
service of Puskesmas in South Sempaja Sub-district,
it is proved that the application of KIS to RJTP has
fulfilled the public welfare indicator with the RJTP
implementation in accordance with the SPM.
The next section Emergency Unit service can be
used by users of Kartu Indonesia Sehat (KIS) in
times of emergency situations such as accident. On
one of the informants KIS users tell the experience
related to the emergency that had happened ie an
accident. Handling emergencies can be rushed to the
ER directly and get medical action in the form of
wound care. In addition to medical treatment, other
services are also given in the form of prescription
drugs. In the statement can be seen that the
Emergency Unit service on KIS users have been in
accordance with the basics and act in accordance
with applicable rules. This is in accordance with
Indonesian Republic Law Number 36 Year 2009
section of health service article 53 that the
implementation of health services should prioritize
INAHEA 2017 - 4th Annual Meeting of the Indonesian Health Economics Association
184

the safety of patient's life compared to other interests
so that it can be interpreted that the meaning of
patient's life safety covering health services
individuals and families for the healing process to
restore health (Health Office, 2014).
4 DISCUSSION
Based on the description related to the
implementation of KIS in South Sempaja Village
Office and health service there is easy access to
making Healthy Indonesia Card. Prospective KIS
users only follow the path that has been determined
by first requesting an application or later of
introduction from the village device and then the
introductory letter will be returned to the village
office and immediately followed up by the
authorities of the village. The ease of making the
KIS or the system contained in the KIS program
becomes a positive trend for health insurance
providers in a country including Indonesia. This is
apparent from the index of satisfaction of health
insurance participants who fall into the high
category that is equal to 78.9%. The achievement of
the positive trend was also followed by the increase
of JKN-KIS program participants to 156,790,287
million. This achievement is in line with the
expectation of the Indonesian government targeting
the increase of Indonesian society in JKN-KIS
ownership by 2020. It is also proven by the
government-funded free health guarantee fund in
2015 reaching 57.08 Trillion.
Implementation of health services is the
provision of basic health services Rawat Jalan
Tingkat Pertama (RJTP). Health services including
RJTP have several substances including examination
and treatment handled by general practitioners as
well as by dentists, family planning services,
maternal and child health and diagnostic services. It
is also supported by the data that health insurance
has cooperated with 19,969 Primary Health Care and
1,874 Hospital and with 2,813 Supporting Health
Facilities such as pharmacies, optics and others. The
provision of health facilities makes the existence of
JKN-KIS can be utilized by the community in the
process of restoring their health condition.
Utilization of health services is seen from the
amount of community visits as much as 100.62
million in the primary health care (Puskesmas,
private doctors, primary clinics), 39.81 million
advanced outpatient visits (Hospital Polyclinic) and
6.31 million inpatients advanced level (hospital).
At the achievement of the JKN-KIS era which is
considered positive between the program objectives
and the implementation system does not mean that
JKN-KIS has been running in the right path or not
have a negative trend for a repair. Some things that
still occur in the JKN-KIS program that still cause
dissatisfaction KIS participants such as long queue
in general policemen, want to perform operations
until related to the availability of competent health
personnel and must meet operational standards. The
problem must be improved immediately in order to
maintain the positive trend of JKN-KIS service to
better support the welfare of the community in terms
of health.
The existence of the JKN-KIS program in
addition to curative and rehabilitative efforts, also
emphasizes promotive and preventive efforts. This
has been supported by the provision of health-free
funds amounting to 99.39 billion. Health service
activities related to promotive and preventive efforts
include health counselling, family planning, routine
immunization, health screening for disease risk
detection to prevent the continued impact of the risk
of a particular disease. Nevertheless, the ownership
of JKN-KIS slightly shifts the healthy paradigm to
the sick paradigm. This is evidenced by the
existence of data mentioning 6.31 million inpatient
cases so that it can be said with the existence of
JKN-KIS healthy behaviour for prevention before
illness should still be cultivated and not true if JKN-
KIS ownership make life behaviour becomes
arbitrary regardless of health. Healthy paradigm
must keep going straight with the aim of JKN-KIS
program that is improving welfare indicator for
society.
5 CONCLUSIONS
Quality and proportional health care is a dream for
every Indonesian, because it is closely related to one
aspect of basic human needs fulfilment. This is
realized with the JKN-KIS Program with ease in the
health care system. Nevertheless, the existence of
JKN-KIS must also go straight with a healthy
paradigm to realize the welfare improvement for the
community.
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2014 about Kartu Indonesia Sehat Program In The
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