Constructing the National Health Insurance Policy Model for the Poor in Indonesia: A Qualitative Analysis




Health Insurance, Policy Construction, Poor People, Dynamic Governance, Universal Health Coverage


Objective: This study aims to explain the construction of the Indonesian national health insurance policy model for the poor and its theoretical and practical implications for policy implementation.

Method: The study employs qualitative research methods, utilizing in-depth interviews, observations, and document analysis. Data analysis includes data reduction, data display, conclusion drawing, and verification.

Results: The construction model of the Indonesian national health insurance policy highlights several interacting components: apparatus performance patterns, apparatus capabilities, bureaucratic culture, political interests, principles of universality, and health coverage financing. Theoretically, the policy touches on broader dimensions including political, legal, economic, social, and cultural aspects, and philosophically addresses civil, political, and social rights. Practically, the findings emphasize the need for improving human resources, population administration systems, financing, and quality and cost control in health services. The study identifies challenges such as bureaucratic rigidity, non-participatory data collection, and insufficient health facilities, which hinder effective policy implementation. The model suggests that adaptive policies, supported by dynamic governance capabilities like thinking ahead, thinking again, and thinking across, are essential for achieving Universal Health Coverage (UHC).

Conclusion: The study concludes that a dynamic governance system, incorporating performance culture, political interests, and future uncertainties, is crucial for the effective implementation of the national health insurance policy for the poor. The successful realization of UHC requires significant attention from central and regional governments and support from various stakeholders.

Author Biography

Adi Fahrudin, Universitas Bhayangkara Jakarta, Raya

Dr. Adi Fahrudin is a Professor in Social Work at the Faculty of Psychology, Universitas Bhayangkara Jakarta Raya, Indonesia (from 1 March 2022 until present). Prof Adi was early trained at Social Work Senior High School in Palembang, Indonesia, and became the best graduate (1986). He graduated and obtained a Doctorandus (Drs) in Social Work from the Bandung College of Social Welfare in 1991 (the best graduate), a Master of Social Science (Social Work) at the University of Science Malaysia in 1996, and then obtained a Ph.D. in Social Work from the same university in 1999. He also studied at the undergraduate level after his Ph.D. and obtained a Bachelor of Psychology (B.Psych) from PASIM University of Bandung (2010). In June 2022, Prof Adi was appointed as Director of the Institute for Research, Community Service and Publication. Since August 2023, he has been appointed Acting Dean of the Faculty of Psychology, Universitas Bhayangkara Jakarta Raya.


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How to Cite

Fahrudin, A. (2024). Constructing the National Health Insurance Policy Model for the Poor in Indonesia: A Qualitative Analysis. Review of Sdgs in Emerging Countries, 6(sdgs), e057.