Health Economics: Challenges, Evidence, and Policy in Indonesia

Suroso Suroso (), Aeda Ernawati Ernawati () and Arieyanti Dwi Astuti ()

Revista Galega de Economía, 2026, vol. 35, issue 2, 1-24

Abstract: Indonesia has made substantial progress toward universal health coverage (UHC) through the National Health Insurance (JKN) programme, yet evidence on financing, equity, efficiency, and governance remains fragmented. Previous reviews have largely examined individual aspects of JKN or health financing, limiting understanding of broader health system challenges. This systematic review synthesizes evidence from 27 studies using an integrated framework encompassing financing, equity, efficiency, and governance. The findings show that while JKN has expanded coverage and reduced some financial barriers, major challenges persist, including catastrophic health expenditure, regional disparities in access, inefficient provider payment systems, and governance fragmentation under decentralization. Preventive interventions consistently demonstrate favourable cost-effectiveness and long-term economic benefits. Immediate policy priorities include strengthening strategic purchasing and provider payment reforms, while long-term reforms should focus on hybrid financing, fiscal equalization, and preventive health investment. Indonesia’s experience offers lessons for other emerging economies pursuing sustainable and equitable UHC.

Keywords: Health economics; Health financing; Health equity; Fiscal sustainability; Universal health coverage (search for similar items in EconPapers)
JEL-codes: E62 H51 I14 I18 (search for similar items in EconPapers)
Date: 2026
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