Highlighting Medical Action Restrictions, IDI Proposes Reforms to JKN Management Regulations

JAKARTA, KOMPAS.com - The Central Board (PB) of the Indonesian Medical Association (IDI) has proposed that the government immediately reform the regulations governing the National Health Insurance (JKN) program.

"Regarding the JKN program, PB IDI urges the government to provide sufficient and equitable financing as well as reform the regulations related to the management of the National Health Insurance," said IDI's Deputy Chairman, Hamzah Hasan, during a press conference at the PB IDI Secretariat in Menteng, Central Jakarta on Saturday (24/10/2026).

In this regard, IDI drew attention to limitations in funding, service quotas, restrictions on referrals to specialist doctors, and suboptimal governance.

This situation is seen as potentially creating ethical dilemmas for doctors in their medical practice.

"This is because under such conditions, doctors are required to provide services based on professional and medical service standards while maintaining quality care for patients and fulfilling patients' rights to proper healthcare," he explained.

According to Hamzah, these limitations can impact service quality, participants' rights under JKN, and patient safety.

Restrictions on Medical Procedures

In addition to calling for regulatory reforms, IDI has also urged the Social Health Insurance (BPJS Kesehatan) to review and cancel policies and practices, including unwritten ones, that may disadvantage JKN participants.

IDI emphasized two key issues: first, restrictions or quotas on medical procedures, access to health services, and referrals to specialists that are not based on patient medical indications and needs.

Second, the prolonged delay in claim payments, or pending claims, which could disrupt healthcare services.

PB IDI believes these policies can degrade service quality and patient safety, incite discrimination, and place doctors in ethical dilemmas.

IDI also contends that these policies are inconsistent with the principles of the National Social Security System (SJSN).

"Every JKN participant is entitled to fair, quality, and non-discriminatory healthcare based on medical indications, patient needs, and professional medical standards," Hamzah stated.

"The efficiency of JKN financing should not sacrifice the rights of participants, the professional independence of doctors, or the quality and safety of patients," he added.