Diskusi 4.2
Apakah ada situasi Principle-Agency Relationship dalam hubungan antara BPJS dengan pemerintah dan masyarakat?
Diskusi 4.1 | Diskusi 4.2 | Diskusi 4.3 |
Apakah ada situasi Principle-Agency Relationship dalam hubungan antara BPJS dengan pemerintah dan masyarakat?
Diskusi 4.1 | Diskusi 4.2 | Diskusi 4.3 |
Comments
Terkait hal ini, harus ada perbaikan berbagai kebijakan di JKN. Berdasarkan konsep pembiayaan kesehatan, diharapkan ada kebijakan yang memperhatikan berbagai titik kritis di dalam sistem, diantaranya:
(1) Perlu peningkatan dana untuk program kesehatan dari APBN dan APBD serta masyarakat. Peningkatan dana ini berwujud anggaran investasi dari pemerintah pusat dan pemerintah daerah yang mampu untuk memperluas akses terhadap pelayanan kesehatan dan pemenuhan kecukupan tenaga kesehatan khususnya di daerah sulit.
(2) Perlu kebijakan yang lebih mengaplikasikan prinsip asuransi kesehatan sosial dalam BPJS; Bagi masyarakat yang menggunakan kelas I dan VIP sebaiknya menggunakan asuransi komersial tanpa ada hubungan dengan dana BPJS; perlu kebijakan untuk mencegah adverse selection, khususnya bagi masyarakat yang mampu; kemudian perlu kebijakan untuk memisahkan dana yang berasal dari PBI dan non PBI sehingga dapat dilakukan transparansi dan akuntabilitas yang lebih baik. Dengan demikian, di dalam BPJS akan ada kompartemen-kompartemen berdasarkan sumber dana dan pengeluarannya. Lalu, diharapkan ada pemisahan yang tegas sehingga mencegah terjadinya dana yang masuk dari PBI di BPJS dipergunakan untuk pengeluaran kesehatan bagi masyarakat yang non-PBI mandiri; serta perlu mengaktifkan kebijakan dana kompensasi untuk daerah-daerah yang belum mempunyai sumber daya kesehatan yang cukup.
(3) Perlu ada kebijakan pembatasan Benefit Package (Paket Manfaat) dan/atau menggunakan iur biaya untuk berbagai pelayanan yang besar biayanya; perlu ada kebijakan untuk memperbaiki aspek pemberi pelayanan (supply) kesehatan terlebih dahulu sebelum menggunakan klaim; perlu adanya sistem verifikator dan investigator yang lebih baik di pelayanan primer dan rujukan untuk mencegah fraud dan pemborosan dana yang tidak perlu. Untuk mengurangi biaya sumber daya manusia dan pemerataan pelayanan, residen perlu dijadikan pekerja medis dalam pelayanan kesehatan yang didanai oleh BPJS.
Dalam jangka pendek, diharapkan ada kebijakan pengiriman tenaga medis keberbagai rumah sakit dan puskesmas yang kekurangan SDM. Di samping itu perlu ada kebijakan sistem pencegahan dan penindakan fraud dalam jaminan kesehatan.
(www.ardadinata.com).
Principle-Agency Relationship dalam hubungan antara BPJS dengan pemerintah dan masyarakat saya sependapat dengam Mbak Ranni bahwa ada hubungannya,yang walaupun implementasi kebijakannya yang kurang optimal. Dimana para pembuat keputusan (principals) dalam hal ini pemerintah harus mendelagasikan tanggung jawab implementasi kebijakan kepada agen - agen lainnya seperti manager,dokter,perawat dan sektor kesehatan dan sektor sektor swasta lainnya. Dan output dari pengambilan kebijakan ini adalah agar masyarakat mendapatkan kesejahteraan dan keadilan. Yang walaupun dalam penerapannya belum maksimal sehingga evaluasi sangat sangat diperlukan untuk melihan sejauh mana kebijakan ini implementasinya membawa perbaikan signifikan atau tidak..
1. bagaimana hubungan pemerintah (principal) dengan BPJS (agent)
BPJS berperan sebagai agen bagi pemerintah yang merupakan pelaku utama. Pemerintah harus berperan untuk memastikan prioritas dalam kesehatan masyarakat dikaitkan dengan alokasi sumber daya dan keputusan dalam pembelian.
BPJS Kesehatan tidak se-fleksibel organisasi swasta dalam menerapkan prinsipal agent relationship karena selain sebagai prinsipal bagi provider BPJS juga sebagai agent dibawah pemerintah, dan tidak memiliki wewenang dalam membuat aturan yang tidak selaras dengan kebijakan diatasnya (undang-undang/permenkes)
2. bagaimana hubungan BPJS (prinsipal) dan Provider (agent)
ini ditentukan dengan suatu kerjasama yang legal dimana kontrak dibuat antara BPJS dan provider (Puskesmas, RS,dll) untuk menggambarkan tujuan BPJS dalam pemenuhan kebutuhan atau benefit pelayanan alat kuncinya adalah hak masing-masing baik prinsipal maupun provider dalam bentuk kerjasama.
3. bagaimana hubungan BPJS (agent) dengan masyarakat (prinsipal).
hubungan prinsipal-agen antara masyarakat dan purchaser, dimana purchaser bertindak sebagai agen bagi masyarakat dalam pembelian layanan keehatan. Pertanyaan kunci dalam hubungan ini adalah mengenai sejauh mana BPJS dapat mewakili kebutuhan, pilihan dan prioritas masyarakat (penduduk) dalam menentukan hal-hal yang berhubungan dengan layanan; dan system monitor yang menjamin kualitas, keadilan dan penyediaan layanan kesehatan yang sesuai
Dalam hubungannya BPJS Kesehatan dengan Pemerintah dan Masyarakat, ada situasi Principle-Agency Relationship yang terjadi. Pemerintah sebagai eksekutif/pelaksana kebijakan mendelegasikan tugas atau kewenangannya kepada BPJS kesehatan. Kemudian masyarakat sebagai peserta JKN memberikan mandat kepada BPJS Kesehatan untuk melakukan tugasnya menjamin dalam hal pembiayaan apabila peserta mengalami sakit. Prinsip utama teori ini menyatakan adanya hubungan antara pihak yang memberi wewenang (prinsipal) yakni pemerintah dan masyarakat dengan pihak yang menerima wewenang (agensi) yakni BPJS Kesehatan.
Terima kasih.
Dalam krbijakan JKN ini idealnya ada hubungan antara BPJS, dan pemerintah dan masyarakat tetapi kondisi sebenarnya yang terjadi masing masing pihak seolah olah masih kebingungan untuk mrnjalankannnya, trtapi masih berusaha untuk saling bekerja sama. Jadi perlu untuk disrmpurnakan lagi dalam kebijakan dan prlaksanaannya.
Terimakasih
Dalam sistem JKN menerapkan principal-agency relationship. Principal dalam hal ini sebgai penyandang dana atau pemegang saham sedangkan yang bertindak sebagai agen adalah provider lembaga. Jadi dalam sistem JKN yang sebagai principle adalah pemerintah dan agen adalah BPJS, dan masyarakat sebagai pengguna dari layanan tersebut. Pendekatan ini digunakan untuk menjelaskan bagaimana principle mengatasi dua masalah yang dapat timbul dalam agency relationship khususnya masalah kerugian seleksi dan moral hazard.
Terima kasih
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