Access Inequity, Health Insurance and the Role Of Supply Factors


December 2017

Authors: Meliyanni Johar, Retno Pujisubekti, Prastuti Soewondo, Harsa Kunthara Satrio, Ardi Adji

Given the improvement in health indicators and health facilities worldwide, inequity in access to health services is one of the most pertinent and relevant issues for health policy and public health. This paper analyses the extent of the access inequities to various health care services in Indonesia, in conjunction with its recent rapid move towards universal social health insurance (SHI).

The sample is derived from individuals in the national socio-economic data, SUSENAS, years 2011-2016. We find that only access to outpatient care at public health centres is pro-poor whilst access to other types of health care is prorich. The expansion of SHI reduces the extent of the pro-rich access by weakening the relationship between utilisation and a household’s economic status.

Despite wider coverage, however, the poor were still disadvantaged in the health care market. Progress towards universal coverage, supply-side improvements, pro-poor insurance schemes and policies that can stimulate economic growth may further reduce the wealth-related access gaps to health services.



The TNP2K Working Paper Series disseminates the findings of work in progress to encourage discussion and
exchange of ideas on poverty, social protection and development issues.

Support to this publication is provided by the Australian Government through the MAHKOTA Program. The findings, interpretations and conclusions herein are those of the author(s) and do not necessarily reflect the views of the Government of Indonesia or the Government of Australia. You are free to copy, distribute and transmit this work, for non-commercial purposes.

Suggested citation: Johar, M., Pujisubekti, R., Soewondo, P., Satrio, H.K., Adji, A. 2017. Inequity in access to health care, supply side and social health insurance. TNP2K Working Paper 1-2017. Jakarta, Indonesia.

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