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Misconception Behind the Welfare of Healthcare Workers

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A health worker checks the health of residents at the Kampung Long Pahangai Community Health Center, Mahakam Ulu, East Kalimantan, on Tuesday (20/10/2026). The Mahakam Ulu Health, Population Control, and Family Planning Office conducted free health checks (CKG) for local residents, including internal disease examinations, pediatric services, and general health checks, as an effort to help them assess their health conditions and prevent other symptoms.(ANTARA FOTO/Angga Palguna)

Government hospitals, including those applying a BLUD financial management format, have obligations to provide public services while maintaining financial sustainability.

The Minister of Home Affairs Regulation No. 79 of 2018 gives BLUD financial management flexibility to support effective and accountable service delivery.

Meanwhile, JKN payments through INA-CBG represent bundled hospital service payments. The value must cover various needs, including medications, medical devices, supplementary examinations, actions, treatments, and operational costs.

Hospital claims are not identical to doctors' earnings. When the real cost of services exceeds payments received, financial pressure can affect a facility's ability to fund services and remuneration.

Conversely, increased hospital revenues do not necessarily improve employee welfare if the revenue-sharing mechanisms are not proportional.

This issue highlights the need to distinguish between state revenue, healthcare facility income, and professional earnings. While interrelated, they operate under different regulatory mechanisms.

Furthermore, labeling hospital financing as a burden on the state without measuring the benefits produced ignores health economic evaluation principles.

Successfully preventing disabilities due to stroke can reduce the need for long-term care.

Timely cancer treatment can increase survival chances and maintain patient productivity.

Effective healthcare services yield social and economic benefits that are not fully recorded as hospital income.

This is why health expenditures need to be evaluated based on service outcomes, efficiency, and community benefits, not just how much facilities generate revenue.

So, should healthcare workers' welfare wait until tax revenue increases?

Strong government revenues indeed expand public financing capacity. However, income tax rates, tax-to-GDP ratios, and government spending capacity are different measures.

There is no universal tax rate threshold that guarantees fair remuneration for healthcare workers.

Framing high taxes as the only pathway to healthcare workers' welfare represents a false dilemma.