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Challenges and Opportunities for Future Public Spending

Challenges and Opportunities for Future Public Spending. Investing in Indonesia’s Health. Health Public Expenditure Review 2008. Indonesia’s Health System and Financing Challenges. Indonesians are living longer and child mortality has fallen dramatically.

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Challenges and Opportunities for Future Public Spending

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  1. Challenges and Opportunities for Future Public Spending Investing in Indonesia’s Health Health Public Expenditure Review 2008

  2. Indonesia’s Health System and Financing Challenges

  3. Indonesians are living longer and child mortality has fallen dramatically

  4. Indonesia’s Health System Challenges • Stagnating Health Outcomes • Geographic Inequalities • Under-funding • Inefficiencies (low utilization) • Financially Unsustainable • Limited Health Insurance Coverage • Weak Stewardship

  5. Particular challenges remain in MDG related areas • Maternal mortality • Child malnutrition • Female literacy and access to clean water • Geographical disparities

  6. Demographic transformation will demand a different, more expensive, health care system Indonesia 1970 Indonesia 2025

  7. Indonesia’s Health Financing Challenges • Ensuring Adequate Fiscal Space • Ensuring Adequate & Equitable Financing • Improving Efficiency in Provider Payment Systems • Enrolling Informal Sector Workers • Defining Basic Benefit Package • Developing Data for Decision Making (DDM)

  8. Policy Options: 9 Ideas for Better Health Outcomes in Indonesia

  9. 1. Make better use of existing resources, while also making more resources available in the medium term

  10. 2. Increase spending on maternal health Allocate more resources for referral and institutional deliveries

  11. 3. Improve resource allocation for preventive care & allow sufficient resources for O&M

  12. 4. Devote additional resources and attention to all major public goods that determine health outcomes

  13. 5. Adjust DAU to provide incentives for local civil service reform and amend PP No. 55 to allow operational use of the DAK

  14. 6. Increase coverage of the Askeskin Program

  15. 7. Ensure financial sustainability of Askeskin by introducing cost-containment options

  16. 8. Increase efficiency by including private providers in insurance schemes

  17. 9. Improve reporting and budgeting systems as well as data availability and transparency

  18. Thank You

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