National Social Security System Research Articles

Overview of the Monopoly Rights of the Social Security Administering Body (BPJS) from the Perspective of Citizens' Health Protection

The monopoly right to health protection granted to the Social Security Administration Agency (BPJS) in Law no. 24 of 2011 concerning BPJS is an attempt to organize a health insurance program effectively and efficiently. However, this monopoly right also raises several problems, first, institutional problems in the implementation of the national social security system (SJSN) and related to choosing a hospital location that is not in accordance with the wishes of BPJS participants. In this legal research, it has a normative research type with a statutory approach related to the BPJS monopoly right in health protection. The research results show that in order to ensure that the national health insurance program can run effectively, coordinated and integrated efforts are needed between the government, BPJS Health, health service providers, and the community. The government needs to increase the allocation of the health budget, ensure efficient use of funds, and find alternative sources of funding

Development of National Social Insurance Systems in Ukraine and European Countries as a Factor in the Evolution of Human Rights to Social Security

"The purpose of this study is to investigate the state of social security in Ukraine and its comparative analysis in comparison with European countries, as well as to establish the concept, content, features, and purpose of this sphere in Ukraine. The methods used to study this subject can be distinguished as follows: dialectical method, formalisation method, law-cognising method, formal legal method, hermeneutical method, logical legal method, systemic, structural-functional method, axiomatic method, methods of analysis and synthesis, induction and deduction, etc. The results of this study are the definition and clarification of the characteristics and features of legal regulation of social security in Ukraine; established the list of types of social security in Ukraine. The authors investigated the development of social security in Ukraine since 1990; analysed the development of social security in Europe and identified four main models of social protection through the implementation of social security; identified the main problems in the field of social security as one of the factors of social protection of the population. The authors defined the term “social security”, established the content and features of the national social security system of Ukraine; investigated the development of social security in Ukraine and in European countries."

Justice-Based Old Age Guarantee Payment Arrangements in Indonesia

One of the objectives of establishing the Unitary State of the Republic of Indonesia as stated in the Preamble to the 1945 Constitution of the Republic of Indonesia is to strive to improve the welfare of the people. The welfare in question must be enjoyed in a sustainable, fair, and equitable manner reaching all people. Where this is the right for every citizen to obtain social security that allows the full development of himself as a dignified human being, guaranteed by the 1945 Constitution of the Republic of Indonesia as stipulated in Article 28H paragraph (3) and Article 34 paragraph (2). Social security is also guaranteed in the United Nations Declaration on Human Rights of 1948 and affirmed in the International Labour Organization Convention No. 102 of 1952 which advocates all countries to provide minimum protection to every workforce. The national social security system is basically a state program that aims to provide certainty of protection and social welfare for all Indonesians. Through this program, every resident is expected to be able to meet the basic needs of a decent life in the event of things that can result in loss or decrease in income, due to illness, accidents, loss of work, entering old age, or retirement. The government has several programs in implementing social security, one of which is the Old Age Security Program. Old age insurance is a benefit in the form of cash that is paid in a lump sum after the participant retires, passes away, or experiences permanent total disability. The old-age Guarantee program is designed to provide protection when a person enters old age or retirement, when they no longer have income. Therefore, the name is old age guarantee.

The role of mutuals and community‐based insurance in social health protection systems: International experience on delegated functions

AbstractThe institutional architecture for the provision of social health protection varies across countries, as do the actors and organizations involved. In some countries, mutual benefit societies and community‐based health insurance organizations (CBHI) play a role in this area. In the 1990s, these were promoted particularly as a means of extending social security coverage, especially in sub‐Saharan Africa. In the current context, the adoption of the 2030 Agenda for sustainable development, as well as renewed political will to realize universal coverage, has led to a questioning of the role of mutuals/CBHI. However, the literature on the roles they play in national social security systems remains limited. For this scoping review, 49 documents were analysed, covering 18 countries worldwide, focused on the delegation of functions to mutuals/CBHI in national social health protection systems. The results reveal the dynamics of the delegation of functions within social protection systems over time and their implementation processes. These provide areas for reflection that can inform policy processes.

The application of the services of the social security administration agency in Hospitals in the perspective of the national social security system

The relationship between the parties is a relationship based on law. Social security must cooperate with hospitals. Social security participants can use these hospitals under a tiered referral system, except in emergencies. This research examines the law conceptualized as norms or rules that apply in society by using a juridical approach through a statutory procedure, historical method, philosophical approach, and futuristic approach. Sources of data obtained using literature studies this literature study is carried out to find secondary data related to conceptions, theories, and opinions related to the problem under study. From the research, the state guarantees all cost difficulties, improves health services, and improves health status by implementing Universal Health Coverage. The ease of the treatment process using insurance is considered a significant benefit as a manifestation of the mandate of the Constitution. The guarantee of health costs for the community is realized in health financing. The government can also control the quality and cost of health organized by hospitals considering the impact received by the community as service recipients.

JUSTICE IN THE IMPLEMENTATION OF NATIONAL HEALTH INSURANCE IN INDONESIA

This article provides an analysis of the implementation of the National Health Insurance (JKN) based on the Law of the Republic of Indonesia Number 40 of 2004 concerning the National Social Security System. In the implementation of the National Health Insurance, which is part of social security, only provides guarantees to the poor, this is contrary to the purpose of the establishment of social security legislation which guarantees to provide Jamian to all Indonesian citizens without being based on the social, cultural and economic conditions of citizens which causes injustice because it is contrary to the constitution of the republic of Indonesia. Another fact that can be observed is the gap in health facilities and health resources between provinces, districts/cities. The number of doctors who are only scattered in big cities, hospital facilities and health centres between the island of Java and eastern Indonesia which creates a very large gap and is very influential in health services. People in cities and on the island of Java can enjoy all the benefits of health insurance, this is inversely proportional to JKN participants on the islands, especially those in eastern Indonesia.

The Economic Impact of the Covid-19 Pandemic in China

Background: The outbreak of the COVID-19 Pandemic has exposed the world to the biggest decline in economy since the Second World War. What are the most profound impacts on the economy caused by Covid-19? And what does current research reveal about worldwide economic impacts on the socical security systems? Covid-19 virus related pandemic restrictions lasted over a long time. Negative impacts from a variety of pandemic prevention and control measures posed great economic pressure upon health systems around the world, but also on national social security systems. This article puts together recent evidence and research results exploring the economic impacts of the Pandemic on social security systems. Objectives: The main aim of the article is to systematically explore and identify economic impacts of the Covid-19 Pandemic on the social security systems and related challenges to the sustainable development of a country or region. Thus, generating a review of knowledge to support evidence-based policy-making intervention is the fundamental objective of the article. Methods: The rapid literature review is a form of evidence synthesis that provides timely information for decision making and evidence-based practice compared with standard systematic reviews and other types of reviews. This review used Web of Science, Proquest and CNKI as database sources. Keywords included ‘Covid-19’ ‘Social security’ and ‘Unemployment、Pension insurance’. The publications are confined from July 2021 to June 2022. Results: Seven publications in English and three in Chinese were identified as relevant to the objectives of this article. These were individually evaluated on the contribution to economic impact of the Covid-19 on the social security systems. The economic impact seems obvious, but it is not easy to assessment. The follow-up articles measure this effect in different ways. Main Contribution to Evidence-Based Practice: The article puts together recent evaluations of economic effects of the Covid-19 Pandemic on social security systems to support evidence-based policy making and the international debate.

Analisis Kepesertaan Jaminan Sosial Ketenagakerjaan di Usaha Mikro dan Kecil

Social Security employment is one of the government's programs to protect Indonesian workers because this is the mandate of Article 28H paragraph (3) of the 1945 Constitution, after which the government established Law No. 40 of 2004 concerning the National Social Security System and Law No. 24 of 2004 concerning the Social Security Organizing Agency. The regulations mentioned are an active form of the state to protect its people, one of which is from the labor sector. The authors took a study based on some of these rules by taking the title of the analysis of social security participation in employment for micro and small businesses. The formulation of this research problem is 1) what employment social security programs have been followed by job providers in micro and small businesses 2) What factors are the obstacles for job providers in micro and small businesses in participating in the employment social security program. This research is exploratory with a qualitative approach with research objects in small and small businesses, the use of data using primary and secondary data sources. The large number of participants who do not know and participate in BPJS Employment is an obstacle to the lack of participation of BPJS Employment.

Implementation of Criminal Liability for Companies That Do Not Fulfill Obligations to Workers in Employment BPJS Guarantee

This study aims to determine and analyze the criminal liability of companies that do not fulfill their obligations to workers in the employment BPJS guarantee. The research method used is sociological juridical research, using a descriptive qualitative research approach and interactive analysis techniques. The results of this study indicate that there are still many companies that neglect to provide fulfillment of workers' obligations in the Employment BPJS guarantee as stipulated in Law No. 24 of 2011 concerning the Social Security Organizing Agency (Law No. 24 of 2011), which protects workers' rights to obtain guarantees for compensation for work accidents. The establishment of the Social Security Organizing Agency (BPJS) is not a new thing in the field of employment, because social security for workers has previously been regulated in Law No. 14 of 1993 concerning Workers' Social Security or better known as Jamsostek. Law No. 40 of 2004 on the National Social Security System was enacted in 2004 with the aim of creating an integrated social security system for all Indonesians, and the social security system was institutionalized in a public legal entity.

International labor organization and international non-governmental organizations: interaction on human rights

The interaction of representatives of civil society – INGOs – with specialized international organizations at the global level involves the development of recommendations, the adoption of international conventions and other acts aimed at the effective legal regulation of socio-economic human rights. As a rule, the result of consultations, exchange of views, search for a compromise on complex and controversial issues of ensuring socio-economic rights is the development of the most general variant of behavior, which further forms a specific legal norm in the national social security system and other areas of current legislation. The article analyzes interaction of the International Labor Organization and international non-governmental organizations regarding human rights promotion. As a tripartite organization, the ILO does not just cooperate with non-governmental organizations, but actually integrates sectors of civil society into its structure. The ILO interacts with INGOs that have a consultative status, cooperates at the operational level with various international, regional, national and local organizations. The article also analyzes the procedure for monitoring the practical application of the conventions is the consideration of complaints from various public organizations, as well as states.

Factors Affecting the Effectiveness of Regional Health Insurance Services in North Buton Regency

The National Social Security System aims to guarantee the health of all Indonesian people in stages. This study aims to examine the factors that influence the effectiveness of regional health insurance services in the North Buton Regency. The research data collection techniques used three approaches, namely observation, interviews, and documentation which were then analyzed using a qualitative approach. The results of the study indicate that the facilities and infrastructure as support for health insurance services are not adequate, the internet network is not optimal, and the apparatus resources are not adequate. In general, this study can conclude that the effectiveness of regional health insurance services in the North Buton Regency is not adequate

Job Loss Guarantee Program Policy as Legal Protection for Terminated Workers Based on Job Creation Law Article 46

To provide legal protection for workers who have experienced termination of employment, the government of Indonesia has issued a new policy in the form of Article 46 of Law No. 11 of 2020 concerning the Job Creation Law. This increases the type of protection for social security programs, namely the job loss guarantee program. This paper uses a juridical-normative research method. The results indicate that the legal protection policy for workers affected by termination of employment was not appropriate. Therefore, an amendment was made to Law Number 40 of 2004 concerning the National Social Security System. Specifically, Article 46A of the Job Creation Law states: "Workers or employees who have their activities terminated are entitled to collateral due to loss of profession." Article 46C(2) also states that the Central Authority should pay the professional burnout insurance contributions. In this case, non-professional collateral benefits are not focused on money but on cash, access to actionable market data, and job training. It is not explained in detail what percentage of the total compensation will be obtained by workers affected by termination of employment through this job loss guarantee scheme. This is only stated in Article 46D paragraph (2), "Job loss guarantee will be provided for 6 (six) months of wages."

IMPLEMENTASI PELAYANAN KESEHATAN PESERTA BADAN PENYELENGGARA JAMINAN SOSISIAL (BPJS) DI KAJI DARI UNDANG – UNDANG NO.24 TH.2014 DI RSUD DR. SOEWONDO KENDAL

The implementation of social insurance for all citizens as mandated in Article 28H Constitution of the Republic of Indonesia in 1945, Amendment IV, Paragraph (1), (2) and (3) Chapter XA of the right to social security which say:
 
 Each person has a right to a life of well-being in body and mind, to a place to dwell, to enjoy a good and healthy environment, and to receive medical care.
 Each person has the right to facilities and special treatment to get the same opportunities and advantages in order to reach equality and justice. 
 Each person is entitled to social security enabling him to develop his entire self unimpaired as a dignified human being.
 
 Through the enactment of Law No. 40 of 2004 on the Social Security, the Indonesian nation has actually had a social insurance system for all Indonesian people. In accordance with the article 5 of the Law mandates the establishment of the agency called the Social Security Agency (BPJS) which on November 25, 2011, stipulated Law No. 40 of the National Social Security System and Law No. 24 of 2011 on the Social Security Agency (BPJS) which commenced on January 1, 2014. 
 The aim of this study is to analyze the quality of the implementation of healthcare service, the payment system and factors obstracting it.
 This study uses descriptive qualitative methodology with informants representing the health care workers and health service user or patients. The data was collected by using in-depth interview and field observation. Qualitative data analysis was conducted to answer the problem of research in the form of data reduction that is described in narrative. 
 Based on the result, it revealed that the implementation of Health Care For BPJS Participants studied of constitution No. 24 of 2011 in dr. H. Sowondo Kendal in general has been running well according to Standard Operational referring to the public services Law No. 25 of 2009.

Reconstruction of Legal Protection for National Health Insurance Contribution Assistance Recipients Based on Justice Value

One of the government's efforts to realize the highest health status and goals, especially for people who cannot afford it, is regulated in Law Number 24 of 2011 concerning the Social Security Administering Body. However, in practice, several problems were found, such as a tendency for the public to assume that the Social Security Administering Body for the Health Sector bears all the financing for health services and there is no guarantee of comfort received by the participants of the Social Security Administering Body for Contribution Assistance. This shows that the enforcement of legal protection regarding the rights of the poor as participants in the Health Insurance Contribution Assistance has not been realized from the perspective of human rights. The purpose of this study is to identify and analyze legal protection and problems for participants of the National Health Insurance Contribution Assistance Recipients (PBI), to identify and analyze the legal factors that affect the implementation of the National Health Insurance system for Contribution Assistance Recipients and to identify and analyze the reconstruction of Article 11 Law on the Social Security Administering Body for participants in the National Health Insurance for Contribution Assistance Recipients based on the value of justice. This study uses a type of research and a Socio-Legal (socio-legal research). The paradigm used is the Constructivism Paradigm to understand that the existing reality cannot be generalized to a particular context at a specific time. The results of the study show that it can be seen clearly both from theoretical studies and empirical studies, including a review of the products of laws and regulations as well as government policies and institutions in the context of the Welfare States and the government's effort to provide social security and social services to all its people in an integrated manner. fair. Legal protection for patients participating in the National Health Insurance Contribution Assistance Recipients (PBI) is an important thing because this is closely related to the handling and health services that will be received by patients. The implementation of legal protection for people who cannot afford has been implemented but is not optimal. The legal factors that most influence the implementation of protection for poor people in hospitals today are community factors, namely not being aware of the law and or not obeying the law, so there is no effectiveness. In addition, there are still differences in the health services received by patients participating in the Health Social Security Administering Body for Contribution Assistance Recipients with patients from the Social Security Administering Body for Non-Contribution Assistance Recipients. The Ideal Construction of the National Social Security System in the Health Sector Based on Welfare Values can be realized by reconstructing the law against Article 11 of Law Number 24 of 2011 concerning the Social Security Administering Body by reconstructing 3 (three) components, namely strengthening the legal substance component, strengthening the legal structure component and strengthening the legal culture component.

The Influence of Customer Experience and Electronic Word of Mouth on the Participants’ Loyalty Through Customer Value as an Intervening Variable in BPJamsostek, Medan City Branch

Indonesia's social security system implementation has entered a new stage. Since the implementation of Law No. 40 of 2004 about the National Social Security System and Law No. 24 of 2011 regarding the Social Security Administering Body or “BPJS,” the social security system has also been implemented on a national scale. Social security implementation may rely heavily on customer experience and word of mouth. Participants in BPJamsostek will get personal experience using BPJamsostek services. Satisfaction influences whether or not participants will stay loyal to participants at their productive age and even recommend them to others. Experience determines whether or not participants will remain loyal to them and even recommend them to others. This research intends to examine the impact of customer experience and electronic word-of-mouth on participants' loyalty at the BPJamsostek branch in Medan City, Indonesia, using customer value as an intervening variable. Accidental sampling is used for sampling. The population of this research consisted of claimants for JHT under the age of retirement, with a total of 100 respondents. Using the SmartPLS 3.0 application, PLS-SEM was used for data analysis. The findings indicate that customer experience has a significant and positive impact on customer loyalty. Customer loyalty is positively and significantly affected by electronic word of mouth. Customer value has a significantly positive influence on customer loyalty. Customer experience has a significantly positive impact on customer value. Customer value is positively and significantly affected by electronic word of mouth. Customer value may mediate the link between customer experience and customer loyalty, as well as electronic word of mouth's effect on customer loyalty. Keywords: Customer Experience, Electronic Word of Mouth, Loyalty, Customer Value

WEBINAR PENGGUNAAN JAMINAN KESEHATAN NASIONAL (JKN) DI MASA PANDEMI COVID 19

The National Health Insurance (JKN) Program is part of the National Social Security System (SJSN) which is organized using the principle of mandatory social health insurance based on Undang-Undang Republik Indonesia Nomor 40 Tahun 2004. The implementation of the National Social Security System aims to provide guarantees for the fulfillment of the basic needs of a decent life for each participant and their family.
 In the use of JKN services, participants are required to follow the referral service procedures as stated in the regulations. During the Covid-19 pandemic, various service channels have been launched which are expected to make it easier for participants when they want to take advantage of the JKN program. So it is felt necessary to socialize to the community to understand the benefits and procedures of JKN services so that this program can be utilized as well as possible.
 This community service activity is carried out by providing education to private workers in Gianyar Regency. Education is carried out in the form of online webinars by utilizing zoom meeting media. After socialization, the results were obtained that there was an increase in participants' knowledge of JKN.

Emotional branding, corporate image and its effect on the loyalty of JKN-KIS participants

Health as a basic necessity of life, the ownership of health insurance is very important and very influential in ensuring a safe and secure life. The National Health Insurance as part of the National Social Security System aims to meet the basic health needs of the Indonesian people. This study aims to analyze the role of satisfaction in mediating the influence of emotional branding and corporate image on customer loyalty. Independent participants of JKN-KIS BPJS Health Malang Branch as the sampling in this study. The sampling technique used purposive sampling with a sample of 130 respondents. Data analysis in this study used Structural Equation Modeling-Partial Least Square (SEM-PLS). The results of the study concluded that emotional branding affects loyalty and satisfaction; the corporate image has an effect on loyalty and satisfaction; satisfaction affects loyalty; satisfaction mediates the effect of emotional branding and corporate image on loyalty. Satisfaction acts as a partial mediating variable.

The Public Policy Dynamics of Increasing Health Insurance Rates in a Developing Country

Health insurance plays an important role in the COVID-19 pandemic. As a part of public policy, examining increasing health insurance contributions in developing countries is important to understand the dynamics, formulation processes, pros and cons, and implications for public participation. This study considered the increasing contributions of Indonesia Health Insurance (BPJS) and the findings indicated that the government faces a dilemma. On one side, the income of citizens is relatively diminished due to the restrictions on mobility as a result of the pandemic. On the other side, during the pandemic, health services need to perform well. Considering that health insurance is part of a national social security system, which is a common feature in developing countries, public health costs should be the responsibility of the State. Therefore, the increase in the BPJS Kesehatan rate needs to consider the ability of the citizen, and also ensure a positive impact on improving health services for the citizen.
 Keywords: public policy dynamics, public participation, positive impact

ANALISIS PELAKSANAAN PROGRAM JAMINAN KESEHATAN NASIONAL DI DINAS KESEHATAN KABUPATEN ROKAN HILIR

The National Health Insurance is part of the National Social Security System organized by the Health Social Security Administration (BPJS) through a mandatory social health insurance mechanism. The Social Security Administering Body. is a legal entity established to administer social security programs. Participants of the Health Social Security Administering Body are divided into 2 groups based on the origin of the funding. The first group is Contribution Recipients, participants in the category of those with economic difficulties. The second group of BPJS Health participants are those who belong to the Non-PBI (Contribution Recipients) group. The Health Service is an office that facilitates health and provides technical implementers of public health services that provide non-specialist individual health services for observation, diagnosis, treatment, treatment and or other health services. The formulation of the problem in this study is why the management of the National Health Insurance budget by the Health Social Security Administration at Balai Jaya Health Center, Rokan Hilir Regency has not been maximized. planning for the National Health Insurance in the working area of ​​the Rokan Hilir Health Service. This research method uses a qualitative approach with a descriptive type of research. The results of this study indicate that the planning of the National Health Insurance at the Health Office of Rokan Hilir Regency has not been implemented properly. This is based on the fact that there are still many people who have not been integrated into the National Health Insurance . Based on the Minister of Social Affairs Regulation Number 170 of 2015 the quota for JKN PBI Rokan Hilir participants is 184,419 people, but for JKN PBI Rokan Hilir participants it is only 1,762 people.  Keywords        : Planning, National Health Insurance

Fraud Issues in the National Health Insurance (Causes, Legal Impacts, Dispute Settlement and Preventive Measures)

National Health Insurance which covers all financing of health services in terms of national insurance. This causes the National Health Insurance to manage a very large amount of money and has an impact on many challenges regarding overcoming fraud committed by various parties. This research is a literature search that analyzes the concept of fraud, legal impact, dispute resolution, and preventive actions in dealing with and preventing fraud. The legal basis used is very diverse, starting from the regulations governing national health insurance, as stated in Presidential Regulation no. 12 of 2013 concerning Health Insurance and the Law of the Republic of Indonesia Number 24 of 2011 concerning the Social Security Administering Body; The legal implications contained in the criminal code of law; and prevention of fraud as regulated in PERMENKES RI 269/MENKES/PER/III/2008 concerning Medical Records and Regulation of the Minister of Health of the Republic of Indonesia Number 36 of 2015 concerning Prevention of Fraud in the Health Insurance Program in the National Social Security System