e-ISSN 2598-3849       print ISSN 2527-8878

Vol 5, No 1 (2020)

Ex Ante Moral Hazard Pada Sistem Jaminan Kesehatan Nasional (JKN) di Indonesia

Fajar Nurhaditia Putra

Abstract


Abstrak

Penelitian ini memberikan kontribusi berupa studi empiris ex ante moral hazard pada Sistem Jaminan Kesehatan Nasional (JKN) di Indonesia. Kami menemukan bahwa kepemilikan Program JKN memiliki hubungan negatif dengan aktivitas fisik dan hubungan positif dengan pengeluran rokok individu. Selanjutnya dengan menghitung efek marginal kami mendapatkan bahwa Program JKN mengurangi probabilitas individu untuk melakukan aktivitas fisik sebesar 2.7% dan mengurangi intensitas melakukan aktivitas fisik. Program JKN juga ditemukan berhubungan positif pengeluaran rokok individu bagi perokok. Hasil analisis menyatakan bahwa ada indikasi terjadinya ex ante moral hazard pada Program JKN karena terdapat hubungan yang positif antara kepemilikan JKN dan probabilitas individu melakukan perilaku kesehatan berisiko seperti aktivitas fisik dan perilaku merokok.


Abstract

This paper contributes to the empirical evidence of ex ante moral hazard on the National Health Insurance System (NHIS) in Indonesia. We find that JKN participation has a negative relationship with physical activity and positive relationship with smoking spending. Furthermore, by calculating marginal effect we obtained that JKN participation reduce the probability of physical activity by 2.7% and also reduce the intensity of individual physical activity. For the smoker, JKN Participation is expected increase in their spending for smoking. The result indicates that there is an evidence of ex ante moral hazard since there is a positive relationship between JKN participation and risky health behaviors such as physical activity and smoking behavior.


Keywords


Ex ante moral hazard; Jaminan Kesehatan Nasional; Perilaku kesehatan berisiko

References


Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, S., Achadi, E. L., … Thabrany, H. (2018). Universal Health Coverage in Indonesia: Concept, Progress, and Challenges. The Lancet, (18). https://doi.org/10.1016/S01406736(18)31647-7

Andi, F. A. (2015). Analysis of National Health Insurance Towards A Universal Health Insurance. Kajian Ekonomi Dan Keuangan, 19(1), 63–78.

BPJS Kesehatan. (2014). Seputar BPJS Kesehatan.

Cawley, J., & Ruhm, C. J. (2012). The Economics of Risky Health Behaviors. In Handbook of Health Economics, Volume 2 (Vol. 2). https://doi.org/10.1016/B978-0444-53592-4.00003-7

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health. Southern Economic Journal, 84(3), 660691. https://doi.org/10.1002/soej.12245

Dave, D., Kaestner, R., & Wehby, G. (2019). Does Medicaid Coverage for Pregnant Women Affect Prenatal Health Behaviors? Journal of Population Economics, 32(2), 419–453. https://doi.org/10.3386/w21049

Dong, W., Gao, J., Zhou, Z., Bai, R., Wu, Y., Su, M., … Wang, X. (2018). Effects of China’s urban basic health insurance on preventive care service utilization and health behaviors: Evidence from the China Health and Nutrition Survey. PLoS ONE, 13(12), 1–14.

Ehrlich, I., & Becker, G. S. (1972). Market Insurance , Self-insurance , and Self-Protection. Journal of Political Economy, 80(4), 623–648.

Erlangga, D., Ali, S., & Bloor, K. (2019). The impact of public health insurance on healthcare utilisation in Indonesia: evidence from panel data. International Journal of Public Health, 2(2), 1–11. https://doi.org/10.1007/s00038-01901215-2

Ghislandi, S. (2015). The impact of Universal Health Coverage on Health Care Consumption and Risky Behaviours: Evidence from Thailand. Health Economics, Policy and Law, 10, 251–266. https://doi.org/10.1017/S17441331140003 34

Irwandy. (2016). Kajian Literature: Evaluasi Pelaksanaan Program Jaminan Kesehatan Nasional di Indonesia. Jurnal Kebijakan Kesehatan Indonesia, 05(03), 110–114.

Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Queen, B., & Lowry, Ri. (2018). Youth Risk Behavior Surveillance — United States, 2017. MMWR Surveill Summ, 67(8), 3–114.

Lee, J. (2018). Effects of Health Insurance Coverage on Risky Behaviors. Health Economics, 1–16. https://doi.org/10.1002/hec.3634

Nurmansyah, M. I., & Kilic, B. (2017). Impact of National Health Insurance Policy towards the Implementation of Health Promotion Program at Public Health Centers in Indonesia. Kesmas: National Public Health Journal, 11(3), 103–110. https://doi.org/10.21109/kesmas.v11i3.12 62

Qin, X., & Lu, T. (2014). Does Health Insurance Lead to Ex Ante Moral Hazard? Evidence from China’s New Rural Cooperative Medical Scheme. The Geneva Papers on Risk and Insurance—Issues and Practice, 39(4), 625–650. https://doi.org/10.1057/gpp.2014.26

Simon, K., Soni, A., & Cawley, J. (2017). The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence From The First Two Years of The ACA Medicaid Expansions. Journal of Policy Analysis and Management, 36(2), 390–417. https://doi.org/10.1002/pam.21972

Stanciole, A. E. (2008). Health Insurance and Lifestyle Choices: Identifying Ex Ante Moral Hazard in the US Market. The Geneva Papers on Risk and Insurance Issues and Practice, 33, 627–644. https://doi.org/10.1057/gpp.2008.27

Strauss, J., Witoelar, F., & Sikoki, B. (2016a). The Fifth Wave of the Indonesia Family Life Survey(IFLS5): Overview and Field Report. March 2016.

Strauss, J., Witoelar, F., & Sikoki, B. (2016b). User’s Guide for the Indonesia Family Life Survey, Wave 5 Volume 2. March 2016.

Strauss, J., Witoelar, F., Sikoki, B., & Wattie, A.M. (2009a). The Fourth Wave of the Indonesia Family Life Survey: Overview and Field Report. March 2009. (No. WR675/1-NIA/NICHD). https://doi.org/10.7249/WR1143.1

Strauss, J., Witoelar, F., Sikoki, B., & Wattie, A.M. (2009b). User’s Guide for the Indonesia Family Life Survey, Wave 4. Volume 2. March 2009. https://doi.org/10.7249/WR1143.2

Suryanto, B. A., Setihadji, B., & Syukriani, Y. F. (2017). The Impact of National Health Insurance Program on Household Health Expenditures and Utilization of Health Services in Indonesia.

Willage, B. (2018). Unintended Consequences of Insurance: ACA’s Free Contraception Mandate and Risky Sex. Retrieved from http://bartonwillage.com/pages/working_p apers/JMP.pdf

Yusuf, E., & Awwaliyah, I. (2018). The Implementation of Indonesian National Health Insurance Programme: How Satisfied Where The Insured Participants and The Healthcare Providers? Journal of Consumer Sciences, 03(02), 27–42.


Full Text: PDF

DOI: 10.7454/eki.v5i1.3768

Refbacks

  • There are currently no refbacks.