Open AccessThe politics of funding universal healthcare: Diverting local tobacco taxes to subsidise the national health scheme in Indonesia
Author(s) -
Ahsan Abdillah,
Kramer Elisabeth,
Adani Nadhila,
Muhammad Askar,
Amalia Nadira
Publication year - 2021
Publication title -
asia and the pacific policy studies
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.529
H-Index - 14
ISSN - 2050-2680
DOI - 10.1002/app5.334
Subject(s) - revenue , public administration , politics , government (linguistics) , tobacco control , local government , tax revenue , health policy , public economics , order (exchange) , business , service delivery framework , service (business) , economics , health care , political science , finance , economic growth , public health , marketing , medicine , law , linguistics , philosophy , nursing
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.