Despite its recent introduction (2014), the NHIS is reported to have reached almost 70 per cent of the population (Agustina et al., 2019, p.76).

However, there appear to be substantial gaps in terms of coverage of the so-called ‘missing middle’, even though considerable subsidies and improved access to health care for those living in poverty have been established. This ‘missing middle’  represents approximately 34.4 million people who are working in informal employment but not living in poverty. While some argue that this group does not seek insurance cover due to the required premiums, others suggest that ‘availability of services and poor understanding of health insurance’ stops people from signing up (Agustina et al., 2019, p.94)

Agustina and colleagues (2019, p.76) further report that the availability and quality of primary care services, drugs, and medical supplies as well as the poor and disassociated health information systems pose challenges to the provision of universal health care in Indonesia.

References:

Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, Achadi, E. L., Taher, A., Wirawan, F., Sungkar, S., Sudarmono, P., Shankar, A. H., Thabrany, H., Susiloretni, K. A., Soewondo, P., Ahmad, S. A., Kurniawan, M., Hidayat, B., Pardede, D., Mundiharno, … Khusun, H. (2019). Universal health coverage in Indonesia: concept, progress, and challenges. The Lancet, 393(10166), 75–102. https://doi.org/10.1016/S0140-6736(18)31647-7