The Indonesian long-term care system is funded through a combination of national and local government funding. For instance, Law No. 36/2009 article 171-172 regulates that a minimum of 5% of national government’s budget and a minimum of 10% of local government’s budget have to be used for public health services prioritizing poor people, older people, and neglected children (Regulation No. 36/2009 on Health (UU No. 36/2009 Tentang Kesehatan), 2009). In addition, the Ministry of Home Affairs established Regulation No. 130/2018, which establishes that a minimum of 5 per cent of the local government’s budget has to be used to develop public facilities on Kelurahan (urban village) level (Ministry of Home Affairs Regulation No. 130/2018 on Development of Facilities and Infrastructure and Community Empowerment in Kelurahan Level (Permendagri No. 130/2018 Tentang Kegiatan Pembangunan Sarana Dan Prasarana Kelurahan Dan Pemberdayaan Masyarakat, 2018).

Besides the establishment of national law and the provision of funding to local government bodies, the Indonesian government has placed responsibility for the public long-term care system largely in the hands of local governments. At the national level, the national government’s budget (Anggaran Pendapatan Belanja Nasional (APBN)) is regulated by the central government and the National House of Representatives.

Local governments receive a budget (Anggaran Pendapatan Belanja Daerah (APBD)), funded out of taxes, provincial taxes (retributions), grants, and other legal resources. These resources are then used to fund, the city’s health departments, local laboratory facilities, emergency ambulance units, regional/local public hospitals, public health facilities, social, and welfare department, city’s social departments and other departments depending on the local governments’ policies. Puskesmas Santun Lansia, Posyandu Lansia, Panti Werdha, geriatric services in public hospitals and any other public long-term care services are funded out of this budget (Ministry of Health Regulation No. 61/2017 on Technical Guideline of Use of Special Non-Physical Health Fund Allocation for Budget Year 2018 (Permenkes No. 61/2017 Tentang Petunjuk Teknis Penggunaan Dana Alokasi Khusus Nonfisik Bidang Kesehatan Tahun Angga, 2017).

Some provinces and cities allocated additional proportions of their local government budget towards services for older peoples. The central government is supportive of these visionary developments. For example, the Mayor of Depok city in the province of Jawa Barat implemented an act, which aimed to increase of budget to further develop services available through Posyandu Lansia in each of the Kelurahan (Syarif, 2019).

However, while the integration of LTC into health care may have some policy benefits, Scheil-Adlung (2015) reports that allocations of funds for the provision of LTC fall short. The report states that public expenditure on LTC was 186.3 PPP$ per year and person aged 65 and older (Scheil-Adlung, 2015, p.34). Translated into GDP, this means that only 1.9% of GDP per capita was public expenditure on LTC for the population 65 and older (Scheil-Adlung, 2015, p.83).

References:

Ministry of Health Regulation No. 61/2017 on Technical Guideline of Use of Special Non-physical Health Fund Allocation for Budget Year 2018 (Permenkes No. 61/2017 tentang Petunjuk Teknis Penggunaan Dana Alokasi Khusus Nonfisik Bidang Kesehatan tahun Angga, (2017) (testimony of Ministry of Health Republic of Indonesia).

Ministry of Home Affairs Regulation No. 130/2018 on Development of Facilities and Infrastructure and Community Empowerment in Kelurahan level (Permendagri No. 130/2018 tentang Kegiatan Pembangunan Sarana dan Prasarana Kelurahan dan Pemberdayaan Masyarakat, (2018) (testimony of Ministry of Home Affairs Republic of Indonesia).

Regulation No. 36/2009 on Health (UU No. 36/2009 tentang Kesehatan), (2009) (testimony of Republic of Indonesia).

Scheil-Adlung, X. (2015). Long-term care protection for older persons: A review of coverage deficits in 46 countries. Geneva: International Labour Organization. Available at: https://ideas.repec.org/p/ilo/ilowps/994886493402676.html

Syarif, M. (2019). Walikota Depok Usulkan Kelurahan Dapat Tambahan APBD Rp173,25 Miliar – Jelang Tahun Anggaran 2020. Neraca. http://www.neraca.co.id/article/112832/walikota-depok-usulkan-kelurahan-dapat-tambahan-apbd-rp17325-miliar-jelang-tahun-anggaran-2020