Bagian Pertama

tentang
Universal Coverage

Bagian Kedua
tentang
Prospective
Payment System

Bagian Ketiga
tentang
Payment for
Physician Services
 Bagian Pertama
tentang
Universal Coverage
Pendahuluan

Three pillars for Analyzing Health Financing Policy

Pendahuluan

Conceptual framework for understanding the

organization of health financing systems
Pendahuluan
Pendahuluan
Universal Coverage - Definisi

Universal Coverage of health care means that everyone

in the population has access to appropriate promotive,
preventive, curative and rehabilitative health care when
they need it and at an affordable cost.1

Universal coverage thus implies equity of access and

financial risk protection.

It is also based on the notion of equity in financing, i.e.

that people contribute on the basis of ability to pay
rather than according to whether they fall ill.

This implies that a major source of health funding

needs to come from prepaid and pooled contributions
rather than from fees or charges levied once a person
falls ill and accesses services.2
 age
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The transition to universal coverage may take several years, even
several decades. The length of time is also not predictable. There
could be some interruptions in the middle of best-laid plans, because
of changes in government policies, particularly when the changes
include different political ideologies regarding solidarity and equity
in access to social services and privatization.1
There may also be delays because of economic crises.

Essential elements that would determine the speed of transition are:

1. relative acceptance of the value and concept of solidarity in
society,
2. effectiveness of government stewardship/governance, and
3. people's trust in the government and its institutions.
4. availability of skilled managerial personnel to facilitate the
effective management of a nation-wide SHI schemes.

1. Carrin, G. Reaching universal coverage via social health insurance: key design features in the
transition period, Health Financing Policy Issue Paper, Department of Health Systems
Financing and Resource Allocation, WHO/EIP
 3 Dimensi
Universal Coverage 3. Financial (Cost) Coverage

g e
ra
o ve
l C
ci a
f i
e
Ben
1. Population Coverage 2 .
Catastrophic
Expenditure
Catastrophic
Expenditure
 World Health Report
(WHR) 2010
Health Systems Financing
–
the path to
Universal Coverage