Man: If it keeps going like this, when will there be any progress?

Exhaust reads “Mischievous hospital claims”, signs stuck to ambulance read “Drug crisis”, “State Budget Cigarette Tax”, wheel reads “Low premiums”, front of ambulance reads “5.05 trillion rupiah deficit”, road sign reads “Healthy Indonesia”.

The Indonesian Medical Association has recommended a medical audit as an option to solve a perpetual deficit in the national health insurance scheme which is expected to reach over Rp 10 trillion this year.

The association criticised the state health insurer Health Care and Social Security Agency (BPJS Healthcare) for its poor management of insurance saying it is already having a detrimental effect on public services.

It also noted that the deficit could also affect doctors or medical workers because BPJS Healthcare had been holding payments to providers due to a large amount of bills.

The government has also been criticised for reneging on a planned increase of the cigarette excise by around 10 percent next year, which was earmarked to help cover costs, saying the health cost triggered by smoking was far higher than the revenue collected from the tax.

Some health experts – who have called for a more drastic increase in the cigarette excise – estimate that 30 percent of BPJS Healthcare spending goes on treating tobacco-related diseases.