EVALUATION OF NATIONAL HEALTH INSURANCE POLICY IN DISTRICTS NORTH BOLAANG MONGONDOW

Abstract

This article aims to analyze and find theoretical gaps and empirical gaps regarding the evaluation criteria for the National Health Insurance policy in North Bolaang Mongondow Regency. The research results show that: 1) The effectiveness of the national health insurance program policy has not been optimal enough. This is due to the lack of employee commitment to the work agreement mechanism between the Regional Government of North Bolaang Mongondow Regency and BPJS Health Boroko Branch which is not implemented effectively by the relevant agencies; 2) The efficiency of the national health insurance program policy shows that it is quite optimal. This is due to the implementation of services related to JKN, the regional government has established Standard Operating Procedures for every membership administration process up to the payment mechanism. However, there are still people who have not met the administrative requirements but are eligible to enter as JKN participants; 3) The responsiveness of the national health insurance program policy shows that it is not effective enough. This is caused by problems validating the criteria for PBI recipients (Contribution Assistance Recipients) sourced from the APBD of North Bolaang Mongondow Regency. Apart from that, submitting a Poverty Statement at the Village level does not involve direct data entry when the applicant makes the application; 4) The accuracy of the national health insurance program policy shows that it is not optimal enough. This is due to the limited APBD to finance all communities covered in the PBI-APBD of North Bolaang Mongondow Regency.