Ombudsman Notes BPJS Complaints Are Increasing, Most Are About Services

JAKARTA - The Ombudsman of the Republic of Indonesia stated that the number of public complaints received about health services from BPJS Health continues to increase every year and most of them complain about service standards.

"Since 2021 we have mapped out that every year, there has been an increase in the number of public complaints received by the Ombudsman," said Assistant to the Main Assistance of Indonesian Ombudsman VI, Belinda Wastitiana Dewanty, as quoted from ANTARA Tuesday, 28 February.

Belinda said that based on the supervision of the implementation of health services by the Ombudsman, the number of complaints or public reports related to BPJS Health in 2021 was 300 complaints.

This rate will then increase by 400 matches in 2022, bringing the total number of complaints now to 700. The fact found in the field is that the number of complaints has increased due to limitations on the provision of services or quotas for BPJS Health participants.

If there really is a quota rule, she said, the distribution should really be done transparently and in accordance with the specified amount. For example, hospital A is able to serve as many as 30 patients where the quota is divided among 20 BPJS participants, five from independent and five from insurance participants.

Belinda emphasized that BPJS Kesehatan should be able to really ensure that all participants receive services according to their quota. Thus, there are no complaints that people feel denied access to health services.

In this case, the Ombudsman considers that the absence of standardization results in the unmeasurable number of quotas that have been set so that the ability of the hospital to provide services is not in line with the expectations of the community.

“This reflects that there is actually a big question mark. What's wrong with the health system in this republic? Are the quotas 'in quotation marks' really discussed as something that really happens in society or are these quotas part of the actions that should be taken by health providers such as public health centers or hospitals? This is a serious problem," she said.

In line with Belinda, Member of the Indonesian Ombudsman Robert Na Endi Jaweng said that recently the Ombudsman received a report on the discovery of a kind of service quota at a health facility.

The distribution of the quota consists of patients with BPJS, insurance, and independent contributions. This is not only happening at First Level Health Facilities (FKTP), but also at Advanced Level Referral Health Facilities (FKRTL).

Therefore, a serious policy or strategy is needed that can monitor and observe closely so that the problem can be resolved properly. He emphasized that everything is for the sake of providing equitable access to health services for the community.

Especially with the 700 complaints that were found, Robert thinks this should be watched out for and is one of the major tasks of the state in channeling the rights of its people.

"This becomes a serious problem, when we then face that this is part of the community's right to get services and the state's responsibility to fulfill and guarantee public health rights," said Robert.