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Issues of Health Services

HSM Session 4. Issues of Health Services. Henni Djuhaeni Medical Faculty of Padjadjaran University. Learning Objectives. A t the end of this session , students are expected to: explain the define of decentralization

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Issues of Health Services

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  1. HSMSession 4 Issues of Health Services HenniDjuhaeni Medical Faculty of Padjadjaran University

  2. Learning Objectives • At the end of this session, students are expected to: • explain the define of decentralization • explain the Globalization and decentralization of health care • explain the Health care versus politic • explain the MDGs Program • explain Universal Coverage

  3. Issues of Health Services 1 Health development Human Development Index (HDI/ IPM) 2 Decentralization Transfer of authority 3 Eradicate extreme poverty and hunger, Promote gender equality and empower women, Reduce child mortality, Improve maternal health, Combat HIV/AIDS, malaria and other diseases Millennium Development Goals (MDGs) 4 Universal Coverage Health Finance System National Health System

  4. BACKGROUND Decentralization Health Politic Health Policy Maternal and child Mortality Rate The access of healthcare services DEVELOPMENT CHALLENGES OF HEALTH Healthcare finance To achieve the target of Millennium Development Goals (MDGs) competency To increase the roles of healthcare provider, policy maker, manager of healthcare services, insurance agency

  5. PEMBANGUNAN ? 1 Suatuprosesperubahan yang berkesinambungandisegalabidangkehidupan yang dilakukansecarasengajaberdasarkansuaturencanatertentu yang bertujuanuntukmeningkatkantarafhidupmasyarakat, baiksecara spiritual maupun material. • BERSIFAT POSITIF • KEARAH YANG > BAIK • PE STANDAR KEHIDUPAN • PRODUKTIFITAS • KEDUDUKAN, PERAN DAN KESEMPATAN YG SAMA • RASIONAL • BERDASARKAN FAKTA • ADA RENCANA • PROSES TERKOORDINASI TOLOK UKUR

  6. Health Development ? NATIONAL DEVELOPMENT Health status HEALTH DEVELOPMENT • Potential measures nation •  to increase awareness, willingness and healthy life Indicator: Life Expectancy, Maternal and Child Mortality Rate National Health System

  7. INDEKS PEMBANGUNAN MANUSIA (HUMAN DEVELOPMENT INDEX) Adalah sebuah ringkasan perhitungan dari perkembangan manusia. Perhitungan ini merupakan rata-rata keberhasilan pencapaian sebuah negara ditinjau dari tiga dimensi (faktor): UHH, pengetahuandan GDP perkapita.

  8. HDI (INDEKS PEMBANGUNAN MANUSIA) INDEX Long lived and healthy life Expectancy (average life expectancy in nation) Adult literacy index (score 2/3) Combined gross enrollment ratio (score 1/3) Human development measures Education Index GDP perkapita : bukan unlimited income, tetapi merupakan daftar logaritma dari pendapatan. Ability to pay

  9. GOALPOSTS Tabel 2.1. Goalpostsfor HDI measures Sumber: Human Development Report 2005

  10. HDI Measure Actual value – minimum value DEMENTION INDEX = maximum value – minimum value

  11. Life Expectancy Index= • Education Index= • Adult Literacy Index = =(ALI) = • Gross Enrollment Index = (GEI) = • GDP =

  12. IPM National Health System Health Development • Education sector • adult literacy index • Combined GE ratio Economic sector Income percapita • Health sector : • LE • Maternal and child mortality double burden of diseases Health finance problem

  13. Decentralization of health 2 as the transfer of responsibility for planning, decision-making, the generation and the use of administrative resources and authority high government level to a lower level in a hierarchical administrative political or territorial

  14. Bringing decision-making Local specific development Potential community empowerment Health status increased Human Development Index (HDI) Indonesia increased Indonesia sehat2025– “masyarakatmandiriuntukhidupsehat” Desentralization: Regional autonomy Devolusion: Political influences Deconsentration of central government Officials in region

  15. Healthcare finance is sum of money to purchase a range of health care services and products Healthcare provider Consumen is sum of money to production of health care services + Government Private

  16. Develop a global partnership for development Eradicate extreme poverty and hunger Achieve universal primary education MDGs Ensure environmental sustainability Promote gender equality and empower women 3 Combat HIV/AIDS, malaria and other diseases Reduce child mortality Improve maternal health

  17. Economy or Economic, what are you thinking about ?

  18. How about the doctor and hospital ?

  19. OIKONOMEA (greek= a household management / state) ECONOMICS ECONOMY cost containment Is the science that deals with the cosequences of resource scarcity efficiency Health economic deals with the cosequences of resource scarcity in the health care industry

  20. Health care finance problems ? No access to health care provider/ services Health care finance problems Scarcity of the health budget Cost of Heath services Community participation • Fee for services • supply induced demand • Administration fee increased OUT OF POCKET insurance

  21. Universal Coverage 2014 4 Seluruhmasyarakatdapataksesterhadap pelayanankesehatanbermutusesuaikebutuhandasardankebutuhanmediktanpamembeda-bedakantingkatpenghasilan, status sosialdantempattinggal . Sumberdanadapatmelaluipajak, asuransidandikeloladenganskemanasionalataubeberapaskema yang berbeda. Nitayarumphong & Mills

  22. THE HEALTH CARE TRIANGLE Third party insurer or purchaser The provision and financing of health care can be simplified as an exchange or tranfer of resources MONITORING allocation EKSEKUTIF, LEGISLATIF, BADAN INDEPENDEN funding Citizen Provider (PPK) delivery

  23. SUMBER PEMBIAYAAN • PEMERINTAH • PEMERINTAH PUSAT • PEMERINTAH DAERAH PROPINSI • PEMERINTAH DAERAH KAB/ KOTA SWASTA/ MASYARAKAT • PERUSAHAAN/ PEMILIK • ASURANSI KESEHATAN SWASTA • PENGELUARAN RUMAH TANGGA • SUMBANGAN SOSIAL • COMMUNAL SELF-HELP • PAJAK SECARA UMUM • PAJAK PENJUALAN • BANTUAN / PINJAMAN LUAR NEGERI • ASURANSI SOSIAL

  24. KEBIJAKAN PEMERINTAH ? UNDANG – UNDANG SISTEM JAMINAN SOSIAL NASIONAL (SJSN, 2004) DILAKUKAN SECARA BERTAHAP DALAM KURUN WAKTU 30 TAHUN

  25. Bukan gratis , tapi : • Sifatnya wajib • Premi : % pendapatan • Yankes sama • Bagi yg miskin , premi • dibayar Pemerintah ASKES SOSIAL ? KAYA SEHAT SAKIT MISKIN BESAR TUA KEL. KECIL MUDA

  26. 3 PILAR PEMBANGUNAN SISTEM JAMINAN SOSIAL NASIONAL SOCIAL ASSISTANCE : Jamkesmas, jamkesda, Jampersal, BawakuSehat • Jaminan > • Jaminan privat • Jaminan kesejahteraan Pemenuhan want, demand Suplemen Insurance • Compulsary • Seluruhpendudukberpenghasilan Social insurance • Memenuhi kebutuhan dasar yg layak • Need • Orang miskin • Tidak mampu • Penghasilan tidak tetap

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