In the Republic of Indonesia, out of pocket expenditures on health reached 75.32 per cent in 2015. In 2002 the Government of Indonesia made fundamental steps to address barriers to health care through amendments to the 1945 Constitution. As a result, the 1945 Constitution now recognizes the right to social security and the responsibility of the State in ensuring access to essential health care for all.
Article 28H of the Constitution of Indonesia states that “every person shall have the right to live in physical and spiritual prosperity, to have a home and to enjoy a good and healthy environment, and shall have the right to obtain medical care.” This constitutional provision has encouraged legislative milestones in the progressive implementation of the National Social Security Law (Law No.40/2004), which mandates the extension of social protection to the whole population with entitlements to healthcare. The Law follows a staircase approach prescribing non-contributory schemes for the poor, contributory schemes for the self-employed and statutory schemes for formal sector workers. In 2014 this law was implemented. From July 2015 onward, five social security schemes were set up, including a healthcare protection scheme that entailed a contribution of 5 per cent, with 4 per cent paid by employers and 1 per cent paid by employees.
Constitutional advancements for strengthened social protection in Indonesia were realised through an inclusive and open constitutional debate in which stakeholders were invited to participate in the People’s Consultative Assembly between 1999 and 2002. Based on these constitutional provisions that resulted, the Government of the Republic of Indonesia now has a strong mandate to provide access to effective and accessible health care. Through this process lawmakers in Indonesia have shown political will to uphold equality and ensure that constitutional and legal provisions for health care form strong legal foundations for the creation of a social protection floor.
Further Reading:
- Government of the Republic of Indonesia (1945) with access from the database of the International Labour Organization. Constitution of the Republic of Indonesia. Accessed from http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---ilo_aids/documents/legaldocument/wcms_174556.pdf on December 2016.