Decentralization of Health Financing Policies Legal Implications for Equitable Distribution of Health Services
Desentralisasi Kebijakan Pembiayan Kesehatan Implikasi Hukum Terhadap Pemerataan Pelayanan Kesehatan
Abstract
The decentralization of health financing policy in Indonesia has generated complex legal dynamics in efforts to equalize health services across regions. This study analyzes the legal implications of fiscal health authority delegation under Law Nomor 23 of 2014 on Local Government and its derivatives on the accessibility and quality of primary and secondary health services at the local level. Employing a normative juridical approach with qualitative analysis of policy documents, regional fiscal data, and administrative court decisions, the research reveals financing disparities due to uneven regional fiscal capacity and weak central oversight. Findings indicate that decentralization tends to undermine equity owing to budget fragmentation and inconsistent legal implementation, despite potential for enhanced local responsiveness to epidemiological needs. Reforms are recommended through strengthened performance-based fiscal transfers and cross-level accountability mechanisms to realize constitutional health justice as mandated by Article 34 of the 1945 Constitution.
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References
Agus Wibowo. Hukum Pemerintah Daerah. Semarang: Penerbit Yayasan Prima Agus Teknik, 2024.
Bappenas, Laporan Evaluasi Pelaksanaan RPJMN Bidang Kesehatan, 2020.
Budhy Prianto. Desentralisasi Penyediaan Layanan Kesehatan: Studi Tentang Penyediaan Jaminan Kesehatan Daerah (Jamkesda) di Kabupaten Malang Provinsi Jawa Timur. Malang: Media Nusa Creative MNC Publishing, 2021.
Dhea Tikha QA, and Sujarwoto. “Desentralisasi dan Kesehatan Keuangan Daerah di Indonesia.” Jurnal Ilmiah Administrasi Publik 1, no. 1 (2015): 39-42. https://doi.org/10.21776/ub.jiap.2015.001.01.8.
Enita Fransiska Tamba, Fatiha Farah, and Putri Ayu. “Efisiensi Alokasi Anggaran Di Era Desentralisasi: Tantangan Dan Peluang Pemerintah Dalam Sektor Ksehatan”. 2024.
Febri Endra Budi Setyawan. “Sistem Pembiayaan Kesehatan”. Saintika Medika 11, no. 2 (2015): 119-126. https://doi.org/10.22219/sm.v11i2.4206.
Hasbullah Thabrany, Manajemen Pembiayaan Kesehatan, Depok: UI Press, 2015.
Irwan Safwadi. Transfer Fiskal Dana Otonomi Khusus, Konvergensi dan Pembangunan Manusia, Banda Aceh: Syah Kuala University Press, 2018.
Kardin M Simanjuntak. “Implementasi Kebijakan Desentralisasi Pemrintahan di Indonesia”. Jurnal Bina Praja, 7, no. 2 (2015): 111-130. https://doi.org/10.21787/jbp.07.2015.111-130.
Kementerian Kesehatan RI, Sistem Keseatan Nasional (SKN), 2012. https://sharel.googlel/Pq1ELBchcxm99G4YJx.
Kementerian Kesehatan RI, Profil Kesehatan Indonesia 2022, Jakarta: Kemenkes RI, 2023.
Laksono Trisnantoro. Kebijakan Pembiayaan Dan Fragmentasi Sistem Kesehatan. Yogyakarta: UGM Press, 2021.
Ringgo Saprianto, Tiur Roida Simbolon, and Alexandra Hukom. “Implikasi Otonomi Daerah Pada Pembangunan Sektor Pendidikan Dan Kesehatan di Indonesia”. JELPP: Jurnal Ekonomi Pembangunan Dan Pariwisata 3, no. 2 (2023): 68-84. https://doi.org/10.52300/jepp.v3i2.11379.
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