Several years ago, it might still have been commonplace that room availability was still a hospital secret. Now with existing technology, said the Main Director of BPJS Kesehatan, Prof. Dr. Ali Ghufron Mukti, MSc., PhD., AAK., hospitals can no longer lie about this. If that happens, it can be reported to BPJS Kesehatan for action to be taken.

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The era of openness has indeed minimized disgraceful behavior that often occurs and has become commonplace because outside parties cannot monitor it. In the context of the availability of treatment rooms for BPJS Kesehatan patients, this is one example. Only people who have insider access can penetrate this.

But that was before. Now, explained Ali Ghufron Mukti, various improvements have been made by BPJS Kesehatan. One of them is through the Mobile JKN (National Health Insurance) application. The existence of Mobile JKN makes everything transparent. "We know what hospitals and doctors do," he said, adding that hospitals can no longer lie about services and room availability.

If not, there will be action from BPJS Kesehatan. "There is something called BOR (Bed Occupancy Rate), we ask hospitals to be transparent about this. People can check this. If he says the rooms are full, but in reality there are rooms, the hospital can be reported to the nearest BPJS office or via the hotline service," he stressed.

In Ghufron's assessment, Indonesian people's literacy is still low. It is not surprising that many functions and benefits of BPJS Kesehatan are not widely known. However, if this is known, many things can be saved. Such as the problem of queuing for services, finding out membership status, referral lists, moving health facilities, disease screening, and so on.

Another thing that was confirmed by Ali Ghufron Mukti was the news that there would be a change in BPJS services from classes 1, 2 and 3 to Standard Inpatient Classes (KRIS). "What is clear is that up to this moment and possibly until June 30 2025 everything remains the same. So there is no change," he stressed to Edy Suherli, Bambang Eros, and Irfan Medianto from VOI who met him at the BPJS Kesehatan Central Office, in the Cempaka Putih area, Jakarta, not long ago. Here's the excerpt.

There are already many BPJS Kesehatan members, but they are still collaborating with other parties such as the National Police Traffic Corps, the requirement for obtaining a SIM/STNK is to be an active BPJS member. How much influence will collaboration like this have on increasing BPJS participants?

The additions are not too much, but making previously inactive participants become active is very meaningful. In accordance with Presidential Decree Number 1 of 2022 concerning Optimization of the JKN Program, where there are 30 ministries and institutions including the police whose main duties and functions are to strengthen participation and also the JKN KIS program. In the JKN Law, this is mandatory, but there are people in our society who forget. One of them is that we collaborate with agencies related to public services.

So you have to include proof of BPJS Kesehatan's activity?

Yes, and now checking participant activity is very easy, just use the Mobile JKN application. In less than three minutes it was known.

For various reasons, people still like to complain about BPJS services, what about this?

Indeed, our society often complains, there are those who say thank you, but not too many. That's why you asked about cases that complained of queuing for 6 hours (the viral case of Ikang Fauzi queuing for 6 hours) or other complaints. This cannot be generalized, because the reality is not like that.

What is also being discussed by the public is the change in BPJS services from classes 1, 2 and 3 to KRIS. Can you explain this?

What is clear is that up to this moment and possibly until June 30 2025 everything remains the same. So there is no change.

Does that mean you just have to wait for it to be realized?

Yes, it could happen, but we don't know what it will be like.

So what do you want BPJS to be like?

We desire; First, the quality of service becomes better. Second, we want to not reduce access to beds. Third, we want class standardization. The problem is that currently, there is no standardization. For example, what is class 3 like, what is class 2, class 1 and VIP class like? Now the utility and public confidence in health services is increasing. It used to have less than 100,000 users. Now a day around 1.6 million people. The increase is very sharp.

Can hospitals refuse BPJS patients if their rooms are full?

There is something called BOR (Bed Occupancy Rate), we ask hospitals to be transparent about this. The public can check this, if they say the rooms are full but in reality there are rooms, the hospital can be reported to the nearest BPJS office or via the hotline service. In hospitals there are usually officers on standby. We are grateful to VOI who can help communicate this to the public.

We received public complaints, but they were misdirected. For example, regarding the location of a hospital that is very far away. BPJS has never built a hospital. There were also those who complained that the doctor wasn't there. BPJS never places doctors. So there are a lot of complaints about wrong addresses. There are things called supply side and demand side, well BPJS is demand side but not all of it. We guarantee access to services for UKP (individual health efforts) not public health.

After BPJS Kesehatan was established, the frequency of public visits increased. This could be because firstly, many people are sick, secondly, because of easy access and utility. Is there any other possibility?

I think the first assumption is incorrect. The problem is that our life expectancy is increasing. I think the public is going to health facilities more because awareness of their health is higher than before. Now not only sick people, healthy people can also use health facilities.

Prevention is better than cure. Is there a campaign to encourage people to pay more attention to maintaining their health rather than seeking treatment after being sick?

Obviously there is. Even our neighboring countries are surprised, how come BPJS can promote prevention such as screening well, even though it is not perfect. Participants can access their health screening history via Mobile JKN after answering around 45-47 questions. Later we will find out whether you are at low, medium or high risk for various diseases such as cancer, hypertension and diabetes. It is effective and cheap. Currently, more than 39 million participants have taken advantage of this screening. From the results of the screening there is a suggestion to see a relevant doctor. This technology is sophisticated, but many people don't know about it.

If so, perhaps the socialization has not been optimal?

We have been very aggressive in various ways. But our society's literacy is very low.

One of the entry points if there is a case?

Yes, when there is a case then it is generalized. That doesn't fit either.

So that the case of Ikang Fauzy's complaint about queuing for BPJS for 6 hours does not happen again, what should be done?

Many. Before that, my question is, why do you have to queue? Just register via Mobile JKN, then wait at home while writing songs or composing rock songs. When your turn comes, come to the BPJS Kesehatan office where you can register. But for the Ikang Fauzi case, we apologize. There are gaps in our society, some people really understand it, some don't. So use Mobile JKN to make things easier. If you want to move health facilities, you can also use the application.

For BPJS services, is it 24 hours?

You can contact us, but the process is according to office hours. It is important to note that the ratio of BPJS officers to participants is very poor. I will give a comparison with a similar institution in France, called CNAM, they serve 70 million people. Its employees are 85 thousand people. Compare this with BPJS Kesehatan serving 272 million, with 8,500 employees.

So the demands on BPJS to improve services are okay, but they have to be rational. Therefore, when compared with similar institutions in America, I would bet that BPJS is better, in terms of coverage and technology used. America is technologically advanced, but they are not yet integrated.

BPJS once targeted the number of participants to be 98% of the Indonesian population. Has this target been achieved? Currently, how many BPJS Kesehatan members do we have?

The target is the state, as an institution established by the state we carry out that target. We are grateful that now we have reached 97.6%, so there is just a little more left. In terms of the population covered, it is more than 272 million. In ASEAN countries, no one exceeds Indonesia.

Of all those who have registered, how many are active?

Most are active, only a small part are inactive. To make those who are inactive active, we carry out outreach, collaboration with various parties, interviews, and there is something called PESIAR: Map, Comb, Advocacy, and Registration. This reaches the villages, we do CRUISE.

To date, how many participants have experienced the benefits of BPJS, especially for diseases that are the biggest causes of death such as hypertension, stroke, diabetes, cancer, kidney failure, heart failure, etc.?

There's been a lot. Every year we can spend up to IDR 34 trillion on diseases in the catastrophic category. Hemodialysis patients usually undergo the procedure twice a week. In a small hospital the cost is 800 thousand per procedure, in a large hospital it costs 1.2 million per procedure. If so, how many months has it been? Very far from the contribution amount. That is the benefit of the principle of mutual cooperation. What program can hundreds of millions of people carry out together? Yes BPJS Kesehatan.

Currently, are there still complaints that BPJS Kesehatan does not pay arrears at certain hospitals?

There are almost no complaints anymore. If there is, please let me know, so we can solve it. We have no outstanding outstanding debts. What's interesting is that many countries are learning from BPJS Kesehatan. How to manage health services for the public. Previously we had a deficit, now we are positive. In real time, we know the behavior of doctors and hospitals throughout Indonesia.

JKN KIS belongs to us together, we must defend and protect it together. This is already good, don't make changes that are not clear. Moreover, fundamental changes are only because they are not clear.

A change in power can usually be transformative. What are your hopes for the new leaders who will be installed?

Even if there is to be change, it must be better. That is our hope for the new leader who will be installed in the near future. So that it can be sustainable. Remember, our BPJS Kesehatan is a reference for many other countries.

Ali Ghufron Mukti and the Idea of a Friendly and Free Doctor

It turns out that childhood experiences made a lasting impression on Prof. Dr. Ali Ghufron Mukti, MSc., PhD., AAK., who currently serves as Main Director of BPJS Kesehatan. One day he came to a doctor's clinic, where he met an unfriendly doctor. He was scolded by the doctor who examined him. After being examined, his parents still had to dig deep into their pockets to pay for the doctor's services.

This experience made him dream of becoming a doctor when he grew up. “Since then I dreamed of becoming a doctor. But I want to be a different doctor, one who doesn't get angry with patients and if he needs to finish examining someone, he doesn't have to pay or it's free," recalled the man born in Blitar, East Java, 17 May 1962.

Long story short, after completing elementary school, continuing on to middle school and high school, he entered the Faculty of Medicine, Gadjah Mada University (UGM). Because his education was relatively smooth, Ghufron continued on to Masters (Tropical Medicine, The Department of Tropical Hygiene, Mahidol University, Bangkok, Thailand, 1991) and Doctoral (Faculty of Medicine, University of Newcastle, Australia, 2000).

When he served as Dean of the Faculty of Medicine at UGM (2008), he was the youngest dean (he was 46 years old when he took office). He began to make unusual policies, one of which was waiving tuition fees for students at the Faculty of Medicine who could not afford it. "In the second year as dean, I increased the amount free to pay tuition fees by 100%, in the third year we wanted to increase it again by 100%, but there was a BIDIK MISI program from the Ministry of Education and Culture. Those who cannot afford it are paid from the BIDIK MISI program," said the man who once served as Director General of Higher Education at the Ministry of Education and Research and Technology.

Between Academics and Bureaucrats

The problem of the insufficient number of doctors in Indonesia will be addressed by opening a number of Medical Faculties throughout the country, the number of which will be opened in 20 universities. The following year the number will continue to increase to around 300. "In my opinion, the addition of the Faculty of Medicine must be planned so that it is not excessive, which can create intellectual unemployment," said the man who once served as Deputy Minister of Health in the United Indonesia Cabinet II.

In general, the ratio of doctors to the population in Indonesia is still low, especially specialist doctors. “In the past, universities were the ones who printed them, now hospitals can also produce specialist doctors. There are several hospitals that have been prepared. "Because it is still in process, hopefully this will be realized soon," he hoped.

When asked whether he would prefer to be an academic or a bureaucrat, Ali Ghufron Mukti explained that he really wanted to be a public policy maker who understood the concept. "The concept of people working must be clear and how morality must be maintained together. The difference is that on campus there is academic freedom. In bureaucracy there are lots of signs and lots of supervisors. "Including me being interviewed now, this is also a form of supervision from the public through the press," admitted the former Head of Management of Gama Medical Center.

The only weakness is if there are too many people supervising, sometimes he said, the input is contradictory between one supervisor and another. And the results are inefficient. "If there are too many people supervising, we will be busy serving the supervisors, even though our main task is serving the community," he stressed.

Potential Optimization

Even though the funds collected from the community are not small, the state budget still receives BPJS Kesehatan's operations; Ministry of Finance. “So our operational funds are limited. Therefore we optimize existing resources. For socialization, inviting professional musicians and singers is very expensive. "Finally I joined in singing, which was filled with friends' music, basically none from outside," said the man who is also the youngest professor at UGM, at the age of 40.

Ghufron deliberately creates a happy and meaningful work climate. “I created a work system that is fun and meaningful. In our office there are many communities; there are musicians, sports, writers. "All my friends who are members of the community are campaigning for the BPJS message to the community," said the award recipient as a researcher from Brown University and the University of California, Los Angeles (UCLA).

Creativity carried out by optimizing existing resources turned out to produce results. BPJS Kesehatan received an award from the institution owned by Hermawan Kartajaya. "We won Gold Champion from the WOW Brand led by Hermawan Kartajaya two years in a row. "The international health insurance that has representatives here lost," said Ali Ghufron Mukti proudly.

"What's interesting is that many countries are learning from BPJS Kesehatan. How to manage health services for the public. Previously we had a deficit, now we are positive. In real time we know the behavior of doctors and hospitals throughout Indonesia,"