| Abstract: | This paper describes health care financing and expendituresin Indonesia, a developing country spending around $US 9.40per capita annually for health care (2.6% of GOP). Per capitahealth care spending has held constant in real terms over thelast five years. The public sector accounts for 36.8% of allhealth care expenditure, or 43.1% if health care spending bystate enterprises is included. About 13% of the population,almost all of them government employees and their families,are covered by some form of health insurance. In 1984, 62% ofthe population was spending privately – at then currentexchange rates – an average of $US 2.70 per capita annuallyfor health care, another 30% averaged $US 8.35 each, and theupper 9% $US 31.90. The Government is reviewing various ‘social financing’mechanisms with a view to expanding health insurance coverageboth for those in formal wage employment and the bulk of thepopulation which remains either on the land or is part of the‘informal’ sector. Steps are also being taken toincrease the efficient use of resources by, among other things,making greater use of evaluation techniques and economic methodologies.Such efforts are coupled with more decentralized authority beinggiven to the provinces and districts. Particularly importantto future health efforts is the further expansion of community-basedactivities, especially in the form of the Posyandu (integratedhealth post).
Brotowasisto, MD, is the director of the Planning Bureau ofthe Ministry of Health. He studied epidemiology and public healthin Thailand and the United States, and has been a WHO consultantin the areas of diarrhoeal disease control and immunization.He has published a number of papers in these fields. He is apermanent member of the delegation of Indonesia to the WorldHealth Assembly and represents his country at the annual meetingof the WHO Southeast Asian Regional Office.
Oscar Gish is WHO Senior Health Planner in Indonesia attachedto the Indonesian Ministry of Health and working, in particular,with the Planning Bureau of the Ministry's Secretariat. He hasconducted research and consultancy activities in Africa, Asiaand Latin America. He has also published articles and booksconcerned with health and health care issues in the Third World.
Ridwan Malik, MD, is head of the Division of Evaluation andReporting, Bureau of Planning of the Ministry of Health. Hehas taken part in international workshops and conferences concernedwith epidemiology, public health administration, health financingand economics and health development.
Paramita Sudharto, MD, is with the Bureau of Planning of theMinistry of Health where she has been engaged in a number ofplanning activities, in particular with studies concerned withfinancial and economic issues. Before joining the Bureau shewas responsible for primary health care development in Jakarta. |
