What will you do after you graduate from MBA?
I always work for my aspiration, to make breakthroughs, to help people have equal opportunity to get better live. So in the future I have decided that I want to contribute to help the government to improve the implementation of Universal National Healthcare which now is run by BPJS Kesehatan which works together with the Ministry of Health.
Before we move to the solution that I would like to propose, I want to explain why I choose to contribute in National Healthcare Insurance (JKN, Jaminan Kesehatan Nasional) implementation, instead of other major challenges that are faced by Indonesia, such as lack of telecommunication infrastructure.
First, the challenges that are faced by BPJS Kesehatan are both unique and complex. It’s unique because the only one who can run JKN is the government, who operate it through BPJS Kesehatan. Complex because despite that JKN organizer has to cover all Indonesian people, it also has to concern about its cash flow, about its revenue growth and cost reduction.
As organizer of JKN, BPJS Kesehatan truly is a financial institution, or to be more specific it is an insurance institution. However, it is different from insurance company. While insurance companies orient on the profit making, so screening assessment before they approved their customer application is a must, JKN organizer aren’t allowed to filter their customer. It has to cover all Indonesian people regardless their medical history. Insurance companies are also able to set claim limit. In the other hand, JKN implementation should cover all claims without limit. That’s why implementation of JKN can only be done by the government (through BPJS Kesehatan).
Secondly, National Healthcare or Jaminan Kesehatan Nasional (JKN) is both strategic and important issue. In philosophical point of view, JKN implementation is one of the practices of Fifth Sila of Pancasila “Keadilan bagi seluruh rakyat Indonesia”. In term of economical point of view, JKN will directly influence Indonesian’s people productivity. It is a common knowledge that if one person gets serious illness it will make minimum two people aren’t able to work. The first will be the patient and the other will be patient’s family who has to take care the patient during rehabilitation in hospital or in home. Can you imagine that if there are 20 million people get seriously sick, it means that actually there are 40 million people who can’t work? And JKN will be more important in the next decade while Indonesia will have demographic bonus, whereas productive population will reach 70% of total population. BPJS Kesehatan will take part to make sure that majority of that productive population to be healthy and keep productive.
In addition, JKN (Jaminan Kesehatan Nasional) is one of the main programs of current government regime. Eventhough if the regime is changed (considering the next president election), the next regime will continue the program because it is politically sexy, very sexy. So whoever the election winner, the regime will support the program. That’s why this is the right time for us to contribute to the implementation of JKN. The one who could run JKN (the government) already support this program.
As a part of the community, I observe some problems in the implementation of BPJS Kesehatan, there are the financial health of BPJS Kesehatan, the quality of the service/customer satisfaction, and the reach expansion of the membership.
Firstly, I want to explain about the financial health. As I mentioned before, BPJS Kesehatan truly is a financial institution. It rise fund from the community (and the government) and spend expense to pay medical claim. So we can see that its financial health will be influence by income growth and expense reduction. In the domain of income growth, there are still 80 million people who haven’t been member of BPJS yet. This illustrate that there is a potential income minimum Rp 2 trillion/month. On the other hand, BPJS Kesehatan’s income is dominated by subsidy from government (from APBN or APBD). Total number of people who get subsidy is 109 million people or 61% of the total BPJS members.
http://bpjs-kesehatan.go.id/bpjs/index.php/jumlahPeserta
https://finance.detik.com/moneter/3501209/bpjs-kesehatan-incar-pendapatan-iuran-rp-80-t
For now, BPJS Kesehatan’s income is still dominantly covered by the government. But if better strategies of income growth will not implemented soon, the sustainability of the financial health is at risk.
The second problem in financial health is expense reduction. This means that the numbers of people who are suffering from illness and claimed their bill are high. In the other hand, there are not enough significant efforts to prevent illness, specially the expensive claimed diseases such as heart and kidney failure. This year BPJS Kesehatan cash flow has been deficit for 9 trilliun because of those reasons.
The second big problem is the quality of the service/satisfaction of the member. I divided it into two parts; customer satisfaction and service quality and relationship between BPJS and the health care provider. I spotted the problem in customer satisfaction is lack of customer engagement (such as customers don’t understand their rights and responsibility toward JKN, customers think that they don’t get benefit unless they get sick [promotif and preventive effort to prevent deceases]). The other problem is the flexibility of the administration process.
The second part is service quality factors, such as; accessibility of the medical facility, patient handling issue (response time, accuracy, hospitality), and accountability of the medical facility (the lack of competitive environment to drive them to deliver better services).
The third big problem is Membership Reach (Jangkauan Kepesertaan). We can divide this problem into smaller part. The first one is Indonesia’s geography (1.9 mill km2, more thant 17,000 islands, lack of transportation, electricity, and telecommunication infrastructure). The second part is Indonesian Population. We have 260 million people and will have bonus demography in 2020. We will have more people to be covered by JKN. In the other hand, there is still high number of BPJS member who hasn’t actively payed their premium fee. It means BPSJ has kept lost some revenue.
To tackle all of those problems, I have a strategy that I believe can help to improve the implementation of JKN strategically. I adopt this strategy from the success example of private sector insurance company & micro banking (the industry of my customer in Indosat), and combine them with current trend in fintech companies. The strategy is utilizing freelance agent as the first bridge to connect BPJS Kesehatan and its customers.
Who are the most suitable to the agents:
- Independent business owner (small shop/toko kelontong), self-employee, house wife, or any other people who could allocate their free time to be an agent
Why they want to be the agents:
- They will get incentives. Current sales channel (such as Indomaret/Alfamart) get their incentives from the administration fee (Rp 2.500). The mechanism could be duplicated in agent.
What the agents do and what problem they tackle:
- Agents can reach and tap the most remote community because they are part of the community itself. It will help to speed up BPJS Kesehatan target to cover all of Indonesian people.
- Actively approach community member to register and pay BPJS premium through them. This effort will secure BPJS’s recurring income from individual member.
- As the most front-line channel to inform/socialize any preventive and promotif event. Agents could build relationship with the nearest medical facility (and vice versa) to get the most updated preventive and promotif event. It will be one of the agent’s added values that he/she offer to get customer loyalty from BPJS customer. In addition, medical facilities will be helped to reduce their medical cost through this socialization.
- As the first “BPJS customer care” that could help BPJS customer to tackle daily problem such as counseling about administration process, gather feedback or complain, educate the customers about their right and responsibility. And in the end, the customer could get benefit from BPJS even though they aren’t sick.
BPJS Kesehatan could launch their agents by themselves like what micro banking due or they can’t collaborate with other financial institutions such as banks or fintech. Currently, banks already have microbanking or LAKU PANDAI agent. In addition, fintech companies such as bukalapak has their own agent (usually independent business owner) who help people that doesn’t have access to the internet to buy goods from bukalapak.
If BPJS Kesehatan launch agent by themselves, in simple logic they could get more margin but they have to invest more in development of platform. Meanwhile, if BPJS choose to collaborate with other financial institutions, BPJS could utilize their partner platforms (less investment) but BPJS may get less margin. This calculation is one of some points that I want to exercise in the college.
However there are still problems that can’t be tackled by the agent such as accessibility of medical facility (medical facility is too far) and quality and capability of the medical facilities (limited equipment etch). These problems should be tackled together with Ministry of Health who coordinate all the medical facilities in Indonesia.
After I graduate from Imperial College, I plan to go back to Indonesia and contribute directly to the improvement of implementation of JKN. With knowledge, skill, and experience I get from my university, I believe that I could contribute as expert staff or assistant one of the directors, especially Director of Finance and Investment (Kemal Imam Santoso) or Director of Customer Expansion and Service (Andayani Budi Lestari).
However if there is no direct opportunity to join BPJS Kesehatan yet, my second plan is to join management consulting firm in Indonesia and I will bring my expertise in healthcare management into the company. By joining one of them, I could expose myself to real issues that are faced by the clients, get access to the firm’s huge knowledge management system that have been acquired from previous projects from all over the world, exercise my analytical skill, and develop strategic suggestion for the clients. That’s how I will build my portfolio in healthcare management. In addition, working in management consulting will enable me to tap to network of high profile individuals (C level positions, high level state officials) in effort to be able to get access to contribute directly to the implementation of JKN.
Why I choose Imperial College of London?
Why MBA
- From have gain some important skill from my education and jobs experience such identifying problem, problem solving, ideas implementation, project management, corporate sales and marketing. I also serve customer from financial institutions such as insurance and banking.
- However, understand that I still need to master or sharpen some of my skill and understanding.
- I need to learn about corporate finance, risk management, healthcare management, human resource management, retail marketing, and customer behavior.
- Sharpen my problem solving skill, enrich my experience in running ideas, handling business, project, and organization, and broaden my professional network
- I also want to challenge my solution plan, getting feedback from fellow cohort that are come from various professional industry/area, and off course from the experienced expert in the business school.
- Different from other business/management related master degree that focus on specific skill such as finance and risk management, MBA offer the most complete skill to prepare its student so they can be the leader in their business/organization.
Why Imperial?
- As a university, Imperial It is one of the best colleges in the world. It consistently rank as top 10 best university based on QS World University Ranking.
- Its MBA program is among 1% of MBA programs in the world that receive triple accreditation (Association to Advance College School of Business-AACSB, Association of MBA-AMBA, European Quality Improvement System-EQUIS)
- Its MBA program offer flexibility in choosing courses, so I can tailor my experience based on my own objectives, combining aspiration and vision which is contributing to the improvement of implementation of JKN in Indonesia.
- Imperial is located in London, the center of the world financial business, where many high profile business leader and company are settled. Location in London gives me the opportunity to interact and learn directly from them to improve my capability.
- UK has been successfully implementing its Universal National Healthcare that provides free medical care for all of its citizens. This gives me opportunity to learn more about how national healthcare is effectively managed by The National Healthcare Service.
- Imperial has Launch Pad, start-up ecosystem in London that offer access
- Student-Led Conference: CEO Series and Future by Imperial Series (academisi), and Leadership in Action (leader in social movement)
- Elective Modules:
- Management Challenges in Healthcare
- Leading Social Innovation
- Advanced Corporate Finance
- Consumer Behaviour
- Group Project & Internship: I will utilize both of them as testing ground for my ideas and use them to enrich my experience in managing idea, people, and projects.
- Group Project : Inovasi dan Pengelolaan Jaminan Kesehatan Semesta pada Negara Berkembang
- Internship : The National Health Service
Agung Firmansyah 