National Social Security System Research Articles

Rethinking the Application of the Difference Principle in Arrangements for the Distribution of Job Loss Benefits

<p class="TableParagraph"><em>The philosophy of organizing labor social security aims to protect workers from socio-economic risks resulting from involuntary loss of income. This includes providing protection during and after the employment relationship. Job Loss Insurance (JKP) under the National Social Security System (SJSN) is designed to offer protection to workers experiencing Termination of Employment (PHK), but workers who resign voluntarily are not entitled to benefits under Article 19 in conjunction with Article 20 of Permenaker No. 37/2021. This paper proposes reinterpreting the concept of termination and applying the Difference Principle to extend JKP benefits to workers who resign involuntarily (Constructive Dismissal) in line with the principles of organizing social security.</em></p>

Is it really better to "die" than "live"? Reflections on the practice of "death with dignity" in China.

To analyze the causes of the controversy caused by "death with dignity" in China, and to provide some useful thoughts for the practical exploration of "death with dignity." By combing the periodical literature, legal texts and practice, we find that the Medical Regulations of Shenzhen Special Economic Zone, which was revised and passed by China in 2022, recognized the legal effect of "living will" for the first time in legislation, which triggered a wide-ranging social discussion on "death with dignity" and brought many controversies. Due to the influence of traditional culture, policies and laws, medical service supply capacity and other factors, death with dignity suffers from great practical resistance. The exploration of "death with dignity" system needs to start with the problems encountered in practice, focusing on cultivating a good system implementation environment, strengthening the top-level design of "death with dignity" system, and improving the national social security system for hospice care.

Reconstruction of The Social Security System Policy in National Development of Indonesia

This research aims to analyze the policy of the national social security system in Indonesia, which refers to the 1945 Basic Law stating that every citizen has the right to employment and a decent living. However, in its implementation, it has not yet fully reached all layers of society and citizens. Data collection was performed through literature review and policy analysis on the applicable legal regulations concerning the national social security system. The findings identified that since the enactment of Law No. 14/1969 concerning Basic Provisions Regarding Manpower, followed by Law No. 3/1992 concerning Social Security for Workers in Indonesia, and up to Law No. 13/2003 concerning Manpower, Law No. 40 of 2004 on the National Social Security System, Law No. 36 of 2009 on Health, and Law No. 24 of 2011 on the Social Security Administering Body, the national social security system in Indonesia has not reached all citizens, still focusing on providing protection for workers/laborers. The correlation analysis between economic growth and poverty rates from 1998 to 2019 shows a negative relationship, where economic growth can significantly reduce poverty levels. Micro, Small, and Medium Enterprises (MSMEs) contribute 61.41% to Indonesia's GDP and provide employment for 96.71% of the labor force, playing a crucial role in the country's economic growth, yet many are still not protected by the national social security system, especially those not working in the formal sector. During the Covid-19 pandemic, the government's role in providing national social security and health assurances for all citizens has proven the government's capability to provide health security and national assurances to all Indonesian citizens, and has managed to sustain the Indonesian economy which continues to grow robustly.

The Constitutional Perspective of Indonesian Social Security System

Some of the values contained in the regulation of the National Social Security System Law (SJSN) and the Social Security Management Agency Law (BPJS) are contrary to constitutional values. The purpose of this paper is to examine the conflict of values. The study was conducted using normative legal research methods, which focused on the statutory and theoretical approach. This study found that social welfare mandated by the 1945 Constitution to the state is developed through the national social security system: (a) as an obligation, (b) to empower the weak and incapable people to develop themselves in accordance with human dignity, and (c) in order to fulfill basic needs, both the right to education, the right to health, and the right to get a job. In addition, although the 1945 Constitution does not specify the pattern of the social security system to be developed, the SJSN Law and the BPJS Law use a mixed model between social insurance from participants and social assistance from the state to the poor. Based on this, it is recommended to adjust the formulation of legal norms of the SJSN Law and BPJS Law contained with constitutional values.

Implementation of Indonesian Government Regulations Concerning the Job Loss Guarantee Program in the Special Capital Region of Jakarta

The Indonesian government expanded social security for the community, especially those who experienced layoffs or lost their jobs by issuing a Government Regulation to expand social security as amended and adding several provisions to articles in Law Number 40 of 2004 concerning the National Social Security System after the enactment of the Law. Law Number 11 of 2020 concerning Job Creation. The background to the policy is because during the COVID-19 pandemic many companies laid off employment. In Jakarta, the number of people who have lost their jobs has increased. The Central Statistics Agency of Indonesia report released that the number of unemployed people in the Special Capital Region of Jakarta in February 2022 was 410.59 thousand people. This research aims to legally analyze the decisions or beschikking issued by the Jakarta provincial government in implementing the job loss guarantee (JKP) program and analyze the implementation of the job loss guarantee program in the Jakarta. The research method used is a juridical-empirical research method using statutory and case approaches. The results of this research: 1) Decree (beschikking) of the DKI Jakarta Provincial Government in implementing the job loss guarantee program by issuing: Regional Regulation Number 27 of 2012 concerning the Implementation of Employment and Governor's Regulation of the Special Capital Region of Jakarta Province Number 15 of 2023 concerning Amendments to Governor's Regulation Number 55 of 2016 concerning the Implementation of Social Security for Workers through the Employment Social Security Administering Agency. 2) Implementation of PP 37/2021 in the DKI Jakarta Province area, based on employment conditions in February 2023, the working population in Jakarta area was recorded at 4.86 million people and a survey of 135 random respondents related to the dissemination of information about JKP concluded that the implementation JKP, especially in terms of socialization, is still lacking, because as many as 77% admitted that they had never been socialized about the JKP program which has implications for respondents' knowledge of the benefits of the JKP program itself, not many respondents fully know that the benefits of the JKP program are in the form of cash benefits. , benefits of access to job information, and benefits of job training. Of the respondents who knew about the benefits of the JKP program, generally they only knew about the cash benefits, while other respondents admitted that they did not know at all about the benefits of the JKP program. This number of respondents is not small, namely 53 respondents or around 55.8%. The benefits of the JKP program that were known to respondents were benefits in the form of cash as much as 32.7%, benefits from access to job market information as much as 14.7% and benefits from job training as much as 17% and the remaining 55.8% of respondents did not know what the benefits of the JKP program were.

Preventing Electoral Fraud in Indonesia: Protecting the Social Security of Election Management Personnel

Indonesia’s Election Management Bodies (EMBs), constitutionally mandated to manage legislative and presidential elections, face substantial risks, including accidents and fatalities. However, their social security rights are often overshadowed by the focus on civil servants and private-sector workers. This study, employing normative legal research, urges the need for state protection of EMBs’ social security rights, drawing on secondary data sources. EMBs should receive comprehensive work-related accident benefits, death benefit programs, and old-age protection schemes from the Workers Social Security Agency (BPJS Ketenagakerjaan). The legal basis for these social security rights can be found in several legislative provisions, including the Indonesian 1945 Constitution, the National Social Security System Law, and other related regulations. Recognizing EMBs as state-serving workers is a crucial step in safeguarding their social security rights. This recognition is not merely a matter of legal interpretation; it is a necessity to ensure a fair and secure electoral environment. By ensuring that EMBs are accorded the same rights and protections as other workers, the state can create a more equitable electoral process and reinforce the integrity of its democratic institutions.

Inequalities in women's health insurance coverage before and after the implementation of universal health insurance in Indonesia.

Indonesia implemented a National Social Security System (Jaminan Kesehatan Nasional, JKN) in 2014. To examine the changes in the magnitude of socioeconomic inequity in women's health insurance coverage among those of reproductive age, we conducted a repeated cross-sectional study design using data from the Indonesia Demographic and Health Surveys conducted in 2012 and 2017, before and after the implementation of JKN. Results showed that while the JKN program helped to increase health insurance coverage among Indonesian women of childbearing age, low education level and household wealth status were associated with an increase in inequalities in health insurance coverage. The findings highlight the need to sustain coverage for citizens and to extend the JKN program to informal workers to reduce health coverage disparities. Further research is required to explore the mechanisms responsible for health coverage inequality based on socioeconomic indicators.

Cross-border workers - navigating the challenges of social security coordination rules in the era of telework in the European Union

In 1 2020, there were 1.7 million cross-border workers in the European Union, creating difficulties in determining the applicable legislation for social security matters. The reason for this complexity is that even in cross-border activities, the legislation of only one Member State is applicable according to the Coordination Regulation 883/2004. This article examines the evolving landscape of social security coordination in the European Union. It explores the interplay between the European principle of free movement of workers and the complexities arising from various national social security systems, combined with the increase in telework. The article outlines the foundational legal frameworks underpinning social security within the European Union, including the Coordination Regulation EC 883/2004, and discusses primarily the challenges in applying these rules to cross-border teleworkers. It further analyses the implications of the new Multilateral Framework Agreement, providing a nuanced understanding of its role in offering simplified procedures and legal certainty for habitual cross-border teleworkers. The article also highlights the Agreement's limitations, including its restricted scope and the persisting administrative burdens. The discussion extends to the broader context of ongoing legislative efforts and the need for more flexible and modern social security coordination rules in the European Union. The article aims to shed light on the critical issues surrounding social security coordination in an era of evolving work practices.

Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia.

The Indonesian government introduced universal health insurance through the National Social Security System (JKN) in 2014 to enhance overall healthcare. This study compares maternal health care (MHC) service utilization before and after JKN implementation in Indonesia. Using 2012 and 2017 data from Indonesia Demographic and Health Surveys (DHS), we conducted a two-period cross-sectional design study following the Anderson model. We assessed how the JKN policy and population characteristics influenced healthcare utilization for women aged 15-49 who had given birth in the last 5 years. Multivariable logistic regression models were used to assess the impact of the JKN policy and related factors. In two waves of Indonesia DHS with 14,782 and 15,021 subjects, this study observed a significant increase in maternal healthcare service utilization post-JKN implementation. Women were more likely to have at least four antenatal care visits (adjusted odds ratio, AOR = 1.17), receive skilled antenatal care (AOR = 1.49), obtain skilled birth assistance (AOR = 1.96), and access facility-based delivery (AOR = 2.45) compared with pre-JKN implementation. This study revealed a significant positive impact of JKN on enhancing MHS utilization. The introduction of universal health insurance coverage likely reduced financial barriers for specific demographics, resulting in increased service utilization. Our study may offer valuable insights for Asian countries with similar demographics and health insurance implementations.

The Relationship between the National Health Insurance Capitation Funds with the Quality of Health Services

This study aimed to analyze and describe the relationship between the National Health Insurance Capitation Fund and the quality of health services. The National Health Insurance is a government and community program that provides comprehensive health insurance for every Indonesian citizen to ensure that they can live healthy, productive, and prosperous lives. According to Law no. 40 of 2004 concerning the National Social Security System, a social security program that guarantees health care costs and fulfillment of basic health needs is held nationally in cooperation and is mandatory for all Indonesian people. The method used in this research was quantitative, using a questionnaire for data collection. The results of a simple linear regression analysis between Capitation Funds on Health Service Quality indicate that the Correlation Coefficient (R) value has a value of 0.567 which is to the interpretation table of the correlation coefficient between 0.40-0.599 which has a medium category. This means that the relationship between the Capitation Fund and Quality of Health Services has a moderate value. In the results of the Coefficient of Determination (R Square) test, the result is 0.613, which means 61.3% of the ability of the independent variable, Capitation Fund affects the dependent variable, Quality of Health Services, and 38.7% is influenced by other variables. The results show a positive and direct relationship between the Capitation funds and service quality. This means that if the Capitation Fund variable increases by one unit, then the Service Quality variable also increases by one unit.The theoretical novelty of this study lies in the application of linear regression analysis to analyze the relationship between capitation funds and health service quality.Practical novelty includes the correlation between capitation funds and health services quality.

Problems with the Institutional Form of the Implementing Agency of Social Security in Indonesia

The administration of social security in Indonesia is entrusted to two newly formed institutions as mandated by Law Number 40 of 2004 concerning National Social Security System, namely BPJS for Health and BPJS for Employment. The basis for the operation of these two institutions is Law Number 24 of 2011 concerning the Implementing Agency of Social Security. These two bodies are public legal entities that were formed from the transition to the previous form of a limited liability company, namely PT Jamsostek (persero) and PT Askes (persero). The new form of the social security implementing agency as mentioned creates problems that need to find solutions to various problems that occur. Therefore, the purpose of this research is to find out what are the problems with the institutional forms of the Implementing Agency of Social Security in Indonesia. The method used in this research is to use juridical, namely by examining the legal materials, both primary legal materials, secondary legal materials, and tertiary legal materials used. The approach used is a statutory approach and a comparative approach. The research results show that there are problems that arise in the institutions administering social security in Indonesia. These problems are related to the governance of the agency, from the formation process, changes in characteristics from a limited liability company to a public legal entity, the failure to merge social security administering bodies as contained in Law Number 24 of 2011 concerning Social Security Administering Bodies and related to employment aspects in the social security administration body.

Social protection of the self-employed in old age in the EU

In most European Union (EU) Member States, self-employed individuals receive, on average, lower retirement pensions than employees. Furthermore, the number of self-employed pensioners is lower, and there is a significant proportion of self-employed workers in the EU who are not entitled to a retirement pension. The situation is even more delicate for the new self-employed, as their mode of labour market participation, career trajectory, and the income level they reach can potentially compromise their future pension prospects. This paper analyses the position of self-employed workers within national social security systems, with a particular focus on their methods of contribution and the consequential impact on their ability to access adequate retirement pensions as a form of replacement income, thus avoiding the risk of poverty and ensuring a decent standard of living in old age. In this area, the Member States and the EU interact within the framework of their respective competences, with the manifest aim of improving the social protection of self-employed workers in their senior years.

The Existence of the National Social Security System as a Form of Fulfillment of Welfare to the Constitutional Rights of the Community

At this time the Social Security System is expected to make a positive contribution to improving people's rights. Therefore, the community is expected to be actively involved in development activities, especially in social security. The contents of this journal aim to recommend efforts that can be made to maximize the existence of improving the community's economy, analyzing social changes that occur in society. And provide information regarding factual conditions of activities in the form of fulfillment of welfare and steps that can be taken to encourage improvement.

Effects of virtual reality on pain during intrauterine device insertions: A randomized controlled trial

ObjectivesThe trial aimed to compare the pain perceived by women during intrauterine device (IUD) insertion, with or without virtual reality (VR) therapy. Furthermore, anxiety during the insertions, pain after the insertions, and satisfaction with the insertions were compared. MethodsThe trial was designed as a prospective, bi-centric, randomized, open-label interventional trial. All adult women that chose an IUD during a contraceptive consultation, and who provided informed consent were eligible. Women under legal guardianship, not affiliated to a national social security system, and with pre-existing dizziness, severe facial wounds, or epilepsy were not eligible. Eligible women were randomly allocated either standard care without VR therapy (Control group) or with VR therapy (Experimental group). Pain, anxiety, and satisfaction were measured using a 10-cm numerical scale. ResultsBetween September 2020 and April 2022, 100 women were randomized: 50 to each group. The mean pain scores during IUD insertion were 5.4 cm in the Control group versus 5.1 cm in the Experimental group (p = 0.54). Mean anxiety during insertion were 4.8 cm in the Control group versus 4.2 cm in the Experimental group (p = 0.13). While mean pain perceived after insertions were 2.4 cm in the Control Group and 2.4 cm in the Experimental group (p = 0.98). Mean satisfaction with the insertions was 9.6 cm in both groups (p = 0.87). Anxiety before IUD insertion, as well as anticipated pain, were significantly correlated with pain perceived during insertions. ConclusionsVR therapy performed during the procedure did not alleviate perceived pain in women undergoing IUD insertions.

Return to work after hospitalization for sepsis: a nationwide, registry-based cohort study

BackgroundSepsis survivors commonly experience functional impairment, which may limit return to work. We investigated return to work (RTW) of patients hospitalized with sepsis and the associations with patient and clinical characteristics.MethodsWorking-age patients (18–60 years) admitted to a Norwegian hospital with sepsis between 2010 and 2021 were identified using the Norwegian Patient Registry and linked to sick-leave data from the Norwegian National Social Security System Registry. The main outcome was proportion of RTW in patients hospitalized with sepsis at 6 months, 1 year, and 2 years after discharge. Secondary outcomes were time trends in age-standardized proportions of RTW and probability of sustainable RTW (31 days of consecutive work). The time trends were calculated for each admission year, reported as percentage change with 95% confidence interval (CI). Time-to-event analysis, including crude and adjusted hazard risk (HRs), was used to explore the association between sustainable RTW, characteristics and subgroups of sepsis patients (intensive care unit (ICU) vs. non-ICU and COVID-19 vs. non-COVID-19).ResultsAmong 35.839 hospitalizations for sepsis among patients aged 18–60 years, 12.260 (34.2%) were working prior to hospitalization and included in this study. The mean age was 43.7 years. At 6 months, 1 year, and 2 years post-discharge, overall estimates showed that 58.6%, 67.5%, and 63.4%, respectively, were working. The time trends in age-standardized RTW for ICU and non-ICU sepsis patients remained stable over the study period, except the 2-year age-standardized RTW for non-ICU patients that declined by 1.51% (95% CI − 2.22 to − 0.79) per year, from 70.01% (95% CI 67.21 to 74.80) in 2010 to 57.04% (95% CI 53.81–60.28) in 2019. Characteristics associated with sustainable RTW were younger age, fewer comorbidities, and fewer acute organ dysfunctions. The probability of sustainable RTW was lower in ICU patients compared to non-ICU patients (HR 0.56; 95% CI 0.52–0.61) and higher in patients with COVID-19-related sepsis than in sepsis patients (HR 1.31; 95% CI 1.15–1.49).ConclusionAbsence of improvement in RTW proportions over time and the low probability of sustainable RTW in sepsis patients need attention, and further research to enhance outcomes for sepsis patients is required.

Construction of BPJS National Health Insurance Membership Regulations in Indonesia

The issuance of the BPJS National Health Insurance Law was a government effort to enhance the welfare of citizens by making it mandatory for them to become BPJS health insurance participants, with a deadline set for January 2019. However, as of May 2022, around 13.79% (according to Worldometer) or 12.26% (according to the Home Ministry) of citizens have not yet joined, due to various factors, including issues related to the BPJS health insurance membership regulations. This paper aims to provide clarity on the construction of health insurance membership regulations as outlined in Law Number 24 of 2011 concerning the Social Security Agency connected to the National Social Security System. The research utilized a descriptive analysis with a statutory approach, along with secondary data obtained through a library study to collect data, and systematic and teleological analysis to analyze the data. The results of the study indicate that the construction of BPJS health insurance membership regulations follows the Stufen theory, which is in accordance with the hierarchy of occupying concrete norms (Hans Kelsen) or formalgezets (Hans Nawiasky).
 Keywords: construction, national health insurance, national social security system regulation

Badan Penyelenggara Jaminan Sosial Ketenagakerajaan Berdasarkan Undang-undang Nomor 40 Tahun 2004 Tentang Sistem Jaminan Sosial Nasional

The purpose of this study is to determine and analyze the Implementation of Policies Towards the Implementation of the Employment Social Security Program Based on Law Number 40 of 2004 concerning the National Social Security System and to determine and analyze the Form of Application of Administrative Sanctions Against Business Entities or Non-Governmental Institutions That Do Not Run the Employment Social Security Organizing Agency Program. In this study the authors used normative research methods, namely legal research conducted by means of literature review and study of legislation. In this research what is studied is legal events, legal relationships and objects of law. Implementation of Policies on the Implementation of the Employment Social Security Program Based on Law Number 40 of 2004 concerning the National Social Security System, namely the Government, among others, has made implementing regulations of the Act, has also continuously carried out all orders of the legislation. From the implementation of the Law, the labor social security program is a basic protection for workers and their families and can provide legal certainty. However, the practice of charging routine contributions by the BPJS as well as the imposition of sanctions on citizens is what actually denies the main principle of the social security system which should be borne by the state as the principle of the welfare state which is then transferred to the burden of citizens as well as accompanied by sanctions if citizens do not want to register as / participate in insurance organized by BPJS. Thus, it can be said that the Government has not succeeded in implementing the national social security system in realizing community welfare.

Perlindungan Hukum Pekerja yang Terkena Pemutusan Hubungan Kerja (PHK) untuk Mengambil Jaminan Hari Tua (JHT) Sebelum Berusia 56 Tahun dalam Permenaker 2/2022

Social security is a crucial thing that everyone must have, as this has been regulated and guaranteed by the state, and the state has an obligation to fulfill the rights of these citizens. In connection with this matter, the Indonesian government has regulations regarding social security regulated in Law No. 40/2004 concerning the National Social Security System, including health insurance, work accident insurance, death security, and one that will be concern of discussion in this research is a program regarding Pension Security or commonly called Jamaican Hari Tua (JHT). The regulations regarding this matter have changed several times, but still aim to focus on ensuring that Indonesian citizens who are the JHT participants can enjoy a decent life after entering retirement. Provisions for disbursing funds for participants have changed from the initial regulations to the updated regulations, for example changes to implementing regulations regarding the JHT, namely the Ministerial Regulation of Manpower No 2/2022 concerning "Procedures and Payment of Pension Security", one of the problems that arises is regarding the conditions for disbursing the JHT funds especially by participants affected by Termination of Employment or commonly called Pemutusan Hubungan Kerja (PHK) different from the previous Ministerial Regulation of Manpower, which did not require the age of participants who were affected by the layoffs. This raises the pros and cons in society. This research focuses on protection for the JHT participants who are laid off before they are 56 (fifty six) years old, so they can withdraw the JHT contributions that have been paid, thus achieving the goal of Law No. 40/2004 to ensure people's lives.

Peranan Program Jaminan Kesehatan Nasional (JKN) Dalam Mendorong Sustainable Development Goals (SDGs) di Indonesia

The National Health Insurance has received great attention in the Sustainable Development Goals, where one of the main targets is to guarantee a healthy life and promote welfare for all people at all ages or later called Universal Health Coverage (UHC). The National Health Insurance is a social security program based on Law Number 40 of 2004 which aims to provide comprehensive health insurance coverage for every Indonesian so that Indonesians can live healthy, productive and prosperous lives. Whereas Universal Health Coverage is a health system that ensures that every citizen in the population has equitable access to quality promotive, preventive, curative and rehabilitative health services at affordable costs. In this study, in its implementation, there was an increase in the Community Health Development Index which was marked by an increase in health service efforts with cross-sector, central and regional synergy towards achieving Universal Health Coverage. The problem found in this study is that there are still many problems found regarding mothers, babies and toddlers. The nutritional status of the people who have a double burden, as well as problems regarding the quality and access to basic and referral health services which include fulfilling the conditions and facilities for basic and referral health services, fulfilling the availability of facilities and infrastructure for health service facilities both medical and non-medical, and not yet covering guarantee services national health as a whole. The purpose of this study was to find out the planning for the implementation of the National Health Insurance (JKN) program in Encouraging Sustainable Development Goals (SDGs) in Indonesia, especially in Medan City. This research is a descriptive qualitative research. The process of monitoring and evaluating the implementation of activities is carried out according to their duties and functions and in accordance with the procedures and provisions of the 1945 Constitution, Law Number 40 of 2004 concerning the National Social Security System
 Keywords: Role, National Health Insurance, SDGs

Expansion of BPJS Ketenagakerjaan BPU Membership through Marketing Mix Strategy and Regulation

Implementation of the social security system in Indonesia has entered a new era, in line with the implementation of Law no. 40 of 2004 on Social Security System (Navigation) and Law No.24 of 2011 on Social Security Agency (BPJS), one of which is where the mandated implementation of the national social security system. This study aims to do a comparison of the Indonesian social security system and how the expansion of its participants with marketing mix strategy and regulation. Analysis was performed on workers not wage (BPU). The analysis was performed on the program, promotion, distribution, amosunt of dues, processes, actors, and physical evidences, regulation, and provision of an age limit of 56 years. The study shows that the application of the social security system by the method of marketing mix and regulation will have a broad effect on the expansion of membership. Their overall strategy and emphasis through the regulation will affect the expansion of the BPU coverage. The addition of the age limit for BPU will increase the number of participants.