ABSTRACT

The development program in the health sector is part of national development where the government as the highest institution responsible for health care must fulfill its obligations in providing health service facilities. Development in the health sector involves all Indonesian people where this can be understood because health development is closely related to the sector another development. The Ministry of Health established a policy to focus more attention on health services for the poor and underprivileged. The JKN BPJS Kesehatan program has been running, but there are still many problems that occur in the field, ranging from problems with services at the hospital, unity and monthly fees or premiums that must be paid which are not in accordance with what BPJS Kesehatan participants receive. During the implementation of the health insurance program, there were still many obstacles and obstacles so that the benefits felt were not optimal. Therefore this study aims to describe and analyze the implementation of the National Health Insurance Program policy based on Presidential Regulation of the Republic of Indonesia Number 82 of 2018 in the working area of the Kaliorang Public Health Center, Kaliorang District with the aim of describing and analyzing the inhibiting and supporting factors in the implementation of the Health Insurance program. Nationally, through a descriptive-qualitative approach, this study has succeeded in concluding that the implementation of the National Health Insurance program by BPJS based on Presidential Regulation of the Republic of Indonesia Number 82 of 2018 in the work area of the Kaliorang Health Center, Kaliorang District, East Kutai Regency has not been optimal. Encouraging and inhibiting factors include the problem of participation (wrong target), not reaching immigrants who do not have a KTP, inaccurate membership data, inadequate socialization, participants who do not use cards during treatment, due to complicated service procedures, presence of participants who have to pay a fee for treatment due to an invalid membership card and a fee when treated.