Harimurti, PanduPambudi, EkoPigazzini, AnnaTandon, Ajay2013-05-062013-05-062013-01https://hdl.handle.net/10986/13305This case study describes and assesses Jamkesmas, Indonesia's government-financed health coverage program for the poor and near-poor. It provides a detailed description of the scope, depth, and breadth of coverage provided under Jamkesmas, and highlights ways in which the program interacts with the rest of Indonesia's health system. It also summarizes and discusses evidence on whether Jamkesmas is attaining its stated objectives of removing financial barriers and improving access to health care by the poor and near-poor, what could be improved, and what lessons can be learned from the experience of Jamkesmas that could help inform Indonesia's quest for universal coverage. The primary theme underlying the study is that supply-side constraints and supply-side subsidies have not been leveraged to increase the effectiveness of the Jamkesmas program. There are significant geographic deficiencies in the availability and quality of the basic benefits package, especially for those living in relatively remote and rural locations of the country, and this limits the effective availability of benefits for many Jamkesmas beneficiaries. The remainder of the case study is organized as follows. Section two provides general background and information on health system outcomes in Indonesia. Section three is an overview of health care financing and delivery. Section four describes the institutional architecture of Jamkesmas. Section five highlights the process of targeting, identification, and enrolment of beneficiaries under the program. Section six focuses on the role of public financing. Section seven outlines the basic benefits package. Section eight provides an overview of the information environment of Jamkesmas. Section nine discusses the special theme of supply-side constraints and supply-side subsidies that dilute the effectiveness of the Jamkesmas program. Section ten discusses the pending agenda around some of the architectural and operational features of Jamkesmas in the context of universal coverage.en-USCC BY 3.0 IGOaccess to health careaccess to health servicesaccess to servicesaccountability mechanismsadministrative costsAdult mortalityAdult mortality rateadverse selectionagedalternative medicineambulatory careambulatory servicesbasic health servicesBedscancercapital investmentscapitationcapitation paymentcatastrophic expenditurecatastrophic health spendingCenter for Healthcertificationchild mortalitychild mortality ratesclinical guidelinesCommunicable diseasescomplicationscontraceptionContraceptive prevalenceContract Monitoringcost of carecost of provisioncost sharingdelivery mechanismsdelivery of health servicesdental prosthesisDependency ratiodeveloping countriesDevelopment Planningdoctorseconomic growtheconomic statusemergency careemergency obstetric servicesemploymentessential drugsexpendituresfamiliesfamily membersfee schedulesfee-for-servicefertilityfertility ratefinancial barriersFinancial ManagementFinancial Protectionfinancial risksFinancing Health Carefixed costsGross domestic producthealth careHealth Care Deliveryhealth care financinghealth care providershealth care serviceshealth centersHealth CoverageHealth Expenditurehealth facilitiesHealth FinancingHealth IndicatorsHealth Insurancehealth insurance programhealth insurance schemehealth insurance schemesHealth Organizationhealth outcomeshealth planhealth providersHealth Researchhealth sectorHealth serviceHealth Service DeliveryHealth service utilizationhealth servicesHealth Spendinghealth spending shareHealth SystemHealth System Financinghealth systemshealth workershealthcare serviceshearing aidshospitalhospital bedsHospital expenditurehospitalshousehold sizeHuman Resourcesill healthimmunizationincentives for doctorsincomeincome countriesincome groupsinequitiesinfantinfant mortalityinfant mortality rateinformal sectorinformation systemsinpatient careInstitutional CapacityintegrationInternational CooperationLife expectancyLife expectancy at birthlive birthslocal governmentsmarketingMaternal MortalityMaternal mortality rateMaternal mortality ratiomedia attentionMedia coveragemedical doctormedical equipmentmedical ethicsmedical facilitiesMedicinesmental hospitalsmidwivesmilitary personnelMillennium Development GoalMinistry of HealthmorbidityMortalityNational Developmentnational governmentNational SecurityNeonatal mortalitynursesNutritionoutpatient carepatientpatientsphysicianPhysicianspopulation groupspotential abusepregnant womenprenatal careprimary careprimary health careprint mediaprivate careprivate doctorsprivate hospitalsprivate sectorPrivate spendingprogressprovider paymentprovision of careprovision of health careprovision of health servicesprovision of servicespublic awarenessPublic Expenditurepublic healthPublic health expenditurepublic health providerspublic hospitalspublic providerspublic sectorpublic servicesPublic spendingquality of carequality of healthquality of servicesradiologyreferral servicesReimbursement ratesResearch Policyrespectrural areasSafety Netsanitationsanitation facilitiesSkilled birth attendanceSocial Health Insurancesocial health insurance schemesSocial Insurancesocial marketingsocial programsSocial securitysocializationspecific incentivesSpousesurgerytelevisionTuberculosisunder-five mortalityuniversal accessUniversal Health Insurance Coverageurban areasurban developmentvaccineswomanworkersWorld Health OrganizationWorld Bank10.1596/13304