The politics of funding universal healthcare: Diverting local tobacco taxes to subsidise the national health scheme in Indonesia

Abdillah Ahsan, Elisabeth Kramer, Nadhila Adani, Askar Muhammad, Nadira Amalia

Research output: Contribution to journalArticlepeer-review

Abstract

In Indonesia, the national universal health coverage scheme (Jaminan Kesehatan Nasional [JKN]) has consistently overspent against its budget since it was introduced in 2014. In 2017, a new regulation diverted 37.5% of tobacco tax revenue collected at the district and city level to the central government in order to increase government contributions to the JKN. Through a review of policy documents and interviews and focus group discussions with relevant stakeholders, this article explores the history of the JKN and its relationship to local tobacco taxes. Offering an ex-post assessment of the policy and its implementation, we find it negative on three fronts: funding for local anti-smoking initiatives and services was cut, the procedures for implementing the policy were complex and time-consuming, and it did not contribute as much as anticipated to the JKN. These findings underscore potential pitfalls of politically motivated policy that fails to consider implementation and impact. We recommend that the policy be revoked, and local tobacco tax revenue reallocated to its initial purpose, which includes promoting local smoking prevention programs and health service delivery.

Original languageEnglish
Pages (from-to)351-366
Number of pages16
JournalAsia and the Pacific Policy Studies
Volume8
Issue number3
DOIs
Publication statusPublished - Sep 2021

Keywords

  • government
  • health policy
  • Indonesia
  • tobacco
  • universal healthcare

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