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IS INDONESIAN LOCAL GOVERNMENT ACCOUNTABLE TO THE POOR? EVIDENCE FROM HEALTH POLICY IMPLEMENTATION

Published online by Cambridge University Press:  18 August 2016

Diego Fossati
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Abstract

Since decentralization in 2001, Indonesian local governments have acquired a key role in poverty alleviation and social service delivery. The extent to which they have been able to meet this challenge is subject to debate, however, and systematic analysis of policy outcomes remains scarce. This paper contributes to the literature with a study of the district-level implementation of Jamkesmas, Indonesia's free healthcare program for the poor. Using original data on policy implementation, I show that local government is to some extent responsive to the needs of the most vulnerable. In years when local elections (pilkada) are implemented, low-income households are targeted more accurately, suggesting that electoral incentives for local elites may increase access to social services among the poor. However, I also show that the positive effect of local direct elections is limited to districts with electorally competitive politics.

Keywords

Indonesian politicsdemocratic accountabilityhealth policypoverty alleviationdecentralizationpilkada
Type
Articles
Information
Journal of East Asian Studies , Volume 16 , Issue 3 , November 2016 , pp. 307 - 330
Copyright
Copyright © East Asia Institute 2016 

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References

REFERENCES

Achmad, Januar. 1999. Hollow Development : The Politics of Health in Soeharto's Indonesia. Canberra: Australian National University.Google Scholar
Alatas, Vivi, Banerjee, Abhijit, Hanna, Rema, Olken, Benjamin A, and Tobias, Julia. 2012. “Targeting the poor: evidence from a field experiment in Indonesia.” American Economic Review 102 (4): 1206–1240.CrossRefGoogle ScholarPubMed
Alatas, Vivi, Banerjee, Abhijit, Hanna, Rema, Olken, Benjamin A, Purnamasari, Ririn, and Wai-Poi, Matthew. 2013. Does elite capture matter? Local elites and targeted welfare programs in Indonesia. In Working Paper No. 18798: National Bureau of Economic Research.CrossRefGoogle Scholar
Antlov, Hans. 1994. Village Leaders and the New Order: Richmond, UK: Curzon Press Ltd.Google Scholar
Aspinall, Edward. 2013. “Popular Agency and Interests in Indonesia's Democratic Transition and Consolidation.” Indonesia 96 (1): 101–121.Google Scholar
Aspinall, Edward. 2014. “Health Care and Democratization in Indonesia.” Democratization 21 (5): 803–823.CrossRefGoogle Scholar
Aspinall, Edward and Berger, Mark T.. 2001. “The break-up of Indonesia? Nationalisms after decolonisation and the limits of the nation-state in post-Cold War Southeast Asia.” Third World Quarterly 22 (6): 1003–1024.CrossRefGoogle Scholar
Aspinall, Edward and Warburton, Eve. 2013. “A Healthcare Revolution in the Regions.” Inside Indonesia 111. Accessed July 13, 2016. www.insideindonesia.org/a-healthcare-revolution-in-the-regions-2.Google Scholar
BBC Indonesia . 2014. “BPJS: Banyak keluhan di bulan pertama JKN.” Februrary 7. Accessed July 27, 2015. www.bbc.com/indonesia/berita_indonesia/2014/02/140207_evaluasi_bpjs.Google Scholar
Besley, Timothy and Kudamatsu, Masayuki. 2006. “Health and Democracy.” The American Economic Review 96 (2): 313–318.Google Scholar
Booth, Anne. 2003. “Decentralisation and Poverty Alleviation in Indonesia.” Environment and Planning C: Government and Policy 21 (2): 181–202.CrossRefGoogle Scholar
Brender, Adi and Drazen, Allan. 2005. “Political Budget Cycles in New Versus Established Democracies.” Journal of Monetary Economics 52 (7): 1271–1295.CrossRefGoogle Scholar
Brown, David S. and Hunter, Wendy. 1999. “Democracy and Social Spending in Latin America, 1980–92.” American Political Science Review 93 (4): 779–790.CrossRefGoogle Scholar
Buehler, Michael. 2008. “The Rise of Shari'a By-Laws in Indonesian Districts: An Indication for Changing Patterns of Power Accumulation and Political Corruption.” South East Asia Research 16 (2): 255–285.Google Scholar
Buehler, Michael. 2013. “Married with Children.” Inside Indonesia 112. Accessed July 13, 2016. www.insideindonesia.org/married-with-children.Google Scholar
Buehler, Michael and Tan, Paige. 2007. “Party–Candidate Relationships in Indonesian Local Politics: A Case Study of the 2005 Regional Elections in Gowa, South Sulawesi Province.” Indonesia 84: 41–69.Google Scholar
Burgess, Robin, Hansen, Matthew, Olken, Benjamin A, Potapov, Peter, and Sieber, Stefanie. 2011. The political economy of deforestation in the tropics. NBER Working Paper No. 17417. National Bureau of Economic Research, Cambridge, MA.CrossRefGoogle Scholar
Caraway, Teri, and Ford, Michele. 2014. “Balancing Business.” Inside Indonesia 117. Accessed July 13, 2016. www.insideindonesia.org/balancing-business-4.Google Scholar
Davidson, Jamie S. 2007. “Politics-As-Usual on Trial: Regional Anti-Corruption Campaigns in Indonesia.” The Pacific Review 20 (1): 75–99.CrossRefGoogle Scholar
De Haan, Jakob and Klomp, Jeroen. 2013. “Conditional Political Budget Cycles: A Review of Recent Evidence.” Public Choice 157 (3–4): 387–410.Google Scholar
Departemen Kesehatan R. I. 2013. Profil kesehatan Indonesia 2012. Jakarta: Departemen Kesehatan RI.Google Scholar
Diamond, Larry Jay and Morlino, Leonardo. 2005. “Introduction.” In Assessing the Quality of Democracy, edited by Diamond, Larry Jay and Morlino, Leonardo. Baltimore: John Hopkins University Press.Google Scholar
Drazen, Allan and Eslava, Marcela. 2010. “Electoral Manipulation via Voter-Friendly Spending: Theory and Evidence.” Journal of Development Economics 92 (1): 39–52.Google Scholar
Dwicaksono, Adenantera, Nurman, Ari, and Prasetya, Panji Yudha. 2012. Jamkesmas and District Health Care Insurance Schemes: Assessment Resports from 8 Districts/Municipalities and 2 Provinces. Bandung, Indonesia: Perkumpulan INISIATIF.Google Scholar
Dwicaksono, Adenantera, Nurman, Ari, Muluk, Saeful, Wulandari, , and Ramdan., Dadan 2010. Analisis pembiayaan jaminan kesehatan di daerah: Panduan praktis untuk elemen masyarakat sipil, pemerintah daerah, & DPRD. Bandung, Indonesia: Perkumpulan INISIATIF.Google Scholar
Erb, Maribeth and Sulistiyanto, Priyambudi, eds. 2009. Deepening Democracy in Indonesia? Direct Elections for Local Leaders (Pilkada). Singapore: ISEAS.Google Scholar
Faizal, Elly Burhaini. 2013. “Jamkesmas in 2013 expanded with 10 million more entitled.” Jakarta Post, January 21. Accessed March 29, 2015. www.thejakartapost.com/news/2013/01/21/jamkesmas-2013-expanded-with-10-million-more-entitled.html.Google Scholar
Firman, Tommy. 2013. “Territorial Splits (pemekaran daerah) in Decentralising Indonesia, 2000–2012: Local Development Drivers or Hindrance?” Space and Polity 17 (2): 180–196.CrossRefGoogle Scholar
Gabrillin, Abba. 2014. “Survei LSI: Masyarakat masih menginginkan pilkada langsung.” Kompas, 17 December. Accessed March 24, 2015. http://nasional.kompas.com/read/2014/12/17/12521451/Survei.LSI.Masyarakat.Masih.Menginginkan.Pilkada.Langsung.Google Scholar
Gani, Ascobat, Thabrany, Hasbullah, Pujianto, , Yanuar, Ferry, Tachman, Tata, Siregar, Adiatma, Wahyu, Hudi K., Soerachmad, Susilo, Widyastuti, , Yulherina, , Nurbaiti, , and Dunlop, David W.. 2008. Report on assessment of health financing system in selected districts and municipalities. Depok, Indonesia: Center for Health Economics and Policy Studies, School of Public Health, University of Indonesia.Google Scholar
Golkar, . 1992. Orde Baru dalam angka, 1969–1991 : Hasil-hasil pembangunan jangka panjang tahap pertama. Jakarta: Golongan Karya, Dewan Pimpinan Pusat, Sekretariat Jenderal.Google Scholar
Hadiz, Vedi R. 2010. Localising Power in Post-Authoritarian Indonesia: A Southeast Asia Perspective. Stanford, CA: Stanford University Press.Google Scholar
Hadiz, Vedi R. and Robison, Richard. 2005. “Neo-Liberal Reforms and illiberal Consolidations: The Indonesian Paradox.” Journal of Development Studies 41 (2): 220–241.Google Scholar
Hadiz, Vedi R.. 2013. “The Political Economy of Oligarchy and the Reorganization of Power in Indonesia.” Indonesia 96 (1): 35–57.CrossRefGoogle Scholar
Haggard, Stephan and Kaufman, Robert R. 2008. Development, Democracy, and Welfare States: Latin America, East Asia, and Eastern Europe. Princeton, NJ: Princeton University Press.Google Scholar
Harding, Robin and Stasavage, David. 2014. “What Democracy Does (and doesn't Do) for Basic Services: School Fees, School Inputs, and African Elections.” The Journal of Politics 76 (1): 229–245.CrossRefGoogle Scholar
Harimurti, Pandu, Pambudi, Eko, Pigazzini, Anna, and Tandon, Ajay. 2013. “The Nuts and Bolts of Jamkesmas, Indonesia's Government-Financed Health Coverage Program for the Poor and Near-Poor.” Universal Health Coverage (UNICO) studies series, no. 8. Washington, DC: The World Bank.Google Scholar
Jakarta Post . 2010. “Jamkesmas: Dubious Scheme Prone to Abuses.” Accessed March 29, 2015. www.thejakartapost.com/news/2010/02/28/jamkesmas-dubious-scheme-prone-abuses.html.Google Scholar
Kristiansen, Stein, Dwiyanto, Agus, Pramusinto, Agus, and Putranto, Erwan Agus. 2009. “Public Sector Reforms and Financial Transparency: Experiences from Indonesian Districts.” Contemporary Southeast Asia: A Journal of International and Strategic Affairs 31 (1): 64–87.Google Scholar
Kristiansen, Stein and Santoso, Purwo. 2006. “Surviving Decentralisation?: Impacts of Regional Autonomy on Health Service Provision in Indonesia.” Health Policy 77 (3): 247–259.Google Scholar
Kudamatsu, Masayuki. 2012. “Has Democratization Reduced Infant Mortality in Sub-Saharan Africa? Evidence from Micro Data.” Journal of the European Economic Association 10 (6): 1294–1317.CrossRefGoogle Scholar
Kurasawa, Aiko. 2009. “Swaying Between State And Community: The role of RT/RW in Post-Suharto Indonesia.” In Local Organizations and Urban Governance in East and Southeast Asia: Straddling State and Society , edited by Read, Benjamin L. and Pekkanen, Robert, 58–83. London: Routledge.Google Scholar
Lake, David A. and Baum, Matthew A. 2001. “The Invisible Hand of democracy Political Control and the Provision of Public Services.” Comparative Political Studies 34 (6): 587–621.Google Scholar
Medina, Luis Fernando and Stokes, Susan. 2002. “Clientelism as Political Monopoly.” Paper presented at the Annual Meeting of the American Political Science Association. Boston. August 26–September 1.Google Scholar
Mietzner, Marcus. 2007. “Local elections and autonomy in Papua and Aceh: Mitigating or Fueling Secessionism?” Indonesia 84: 1–39.Google Scholar
Mietzner, Marcus. 2008. “Soldiers, Parties and Bureaucrats: Illicit Fund-Raising in Contemporary Indonesia.” South East Asia Research 16 (2): 225–254.Google Scholar
Mietzner, Marcus. 2013a. “Fighting the Hellhounds: Pro-Democracy Activists and Party Politics in Post-Suharto Indonesia.” Journal of Contemporary Asia 43 (1): 28–50.CrossRefGoogle Scholar
Mietzner, Marcus. 2013b. Money, Power, and Ideology: Political Parties in Post-Authoritarian Indonesia. Honolulu: Asian Studies Association of Australia.Google Scholar
Nurman, Ari and Martiani, Ana Westy. 2008. Merumuskan skema penyediaan jaminan pelayanan kesehatan yang sesuai untuk daerah. Bandung, Indonesia: Perkumpulan INISIATIF.Google Scholar
Papke, Leslie E. and Wooldridge, Jeffrey M.. 1996. “Econometric Methods for Fractional Response Variables with an Application to 401 (k) Plan Participation Rates.” Journal of Applied Econometrics 11 (6): 619–632.Google Scholar
Pepinsky, Thomas B. and Wihardja, Maria M.. 2011. “Decentralization and Economic Performance in Indonesia.” Journal of East Asian Studies 11 (3): 337–371.CrossRefGoogle Scholar
Pierskalla, Jan. 2012. “Splitting the Difference? Institutional Capacity, Elite Competition and District Creation in Indonesia.” Working paper.Google Scholar
Przeworski, Adam, Alvarez, Michael, Cheibub, Jose, and Limongi, Fernando. 2000. Democracy and Development: Political Institutions and Well-Being in the World, 1950–1990. New York: Cambridge University Press.CrossRefGoogle Scholar
Ross, Michael. 2006. “Is Democracy Good for the Poor?” American Journal of Political Science 50 (4): 860–874.Google Scholar
Rosser, Andrew. 2012. “Realising Free Health Care for the Poor in Indonesia: The Politics of Illegal Fees.” Journal of Contemporary Asia 42 (2): 255–275.CrossRefGoogle Scholar
Rosser, Andrew. 2015. “Contesting Tobacco-Control Policy in Indonesia.” Critical Asian Studies 47 (1): 69–93.CrossRefGoogle Scholar
Rosser, Andrew and Wilson, Ian. 2012. “Democratic Decentralisation and Pro-poor Policy Reform in Indonesia: The Politics of Health Insurance for the Poor in Jembrana and Tabanan.” Asian Journal of Social Science 40 (5–6): 608–634.Google Scholar
Sandi, Ayu Prima. 2013. “BPK temukan empat masalah pengelolaan Jamkesmas.” Tempo, March 19. Accessed March 29, 2015. www.tempo.co/read/news/2013/03/19/090467936/BPK-Temukan-Empat-Masalah-Pengelolaan-Jamkesmas.Google Scholar
Sen, Amartya. 2001. Development as Freedom. Oxford: Oxford University Press.Google Scholar
Seymour, Richard and Turner, Sarah. 2002. “Otonomi Daerah: Indonesia's Decentralisation Experiment.” New Zealand Journal of Asian Studies 4 (2): 33–51.Google Scholar
Shi, Min and Svensson, Jakob. 2006. “Political Budget Cycles: Do They Differ Across Countries and Why?” Journal of Public Economics 90 (8): 1367–1389.Google Scholar
Sirowy, Larry and Inkeles, Alex. 1990. “The Effects of Democracy on Economic Growth and Inequality: A Review.” Studies in Comparative International Development 25 (1): 126–157.Google Scholar
Soendoro, Emir. 2009. Jaminan sosial solusi bangsa Indonesia berdikari. Jakarta: PT DInov ProGRESS Indonesia.Google Scholar
Sparrow, Robert. 2008. “Targeting the Poor in Times of Crisis: The Indonesian Health Card.” Health Policy and Planning 23 (3): 188–199.CrossRefGoogle ScholarPubMed
Sparrow, Robert., Suryahadi, Asep, and Widyanti, Wenefrida. 2013. “Social Health Insurance for the Poor: Targeting and Impact of Indonesia's Askeskin Programme.” Social Science & Medicine 96: 264–271.CrossRefGoogle ScholarPubMed
Sri Lestari, Rahayu and Subardi, Evi. 2012. Bantuan sosial di Indonesia sekarang dan ke depan: BOS, jamkesmas, PNPM mandiri, PKH: Bantuan Operasional Sekolah (BOS), Program Jaminan Kesehatan Masyarakat, Program Nasional Pemberdayaan Masyarakat (PNPM)-Mandiri, Program Keluarga Harapan. Bandung, Indonesia: Fokusmedia.Google Scholar
Stasavage, David. 2005. “Democracy and Education Spending in Africa.” American Journal of Political Science 49 (2): 343–358.Google Scholar
Sularto, St and Koekerits, T. Jakob. 1999. Federalisme untuk Indonesia. Jakarta: PT Kompas Media Nusantara.Google Scholar
Sulastomo, . 2011. Sistem Jaminan Sosial Nasional: Mewujudkan amanat konstitusi. Jakarta: Kompas Penerbit Buku.Google Scholar
Sumarto, Sudarno, Suryahadi, Asep, and Widyanti, Wenefrida. 2002. “Designs and Implementation of the Indonesian Social Safety Net Programs.” The Developing Economies 40 (1): 3–31.CrossRefGoogle Scholar
Suryahadi, Asep, Febriany, Vita, and Yumna, Athia. 2014. “Expanding Social Security in Indonesia: The Processes and Challenges.” Social Policy and Development Paper No. 14. Geneva: UNRISD.Google Scholar
Thabrany, Hasbullah, Sari, Kurnia, Tilden, Robert, Dunlop, David W., and Hajaraeni, Yuniar. 2015. Supporting Indonesia's DJSN to develop national guidelines for implementing a national social health insurance program by 2014. Depok, Indonesia: Center for Health Economics and Policy Studies, School of Public Health, University of Indonesia.Google Scholar
TNP2K. 2014. Laporan studi integrasi Jamkesda ke JKN. Jakarta: TNP2K-GIZ.Google Scholar
Vidyattama, Yogi, Miranti, Riyana, and Resosudarmo, Budy P.. 2014. “The Role of Health Insurance Membership in Health Service Utilisation in Indonesia.” Bulletin of Indonesian Economic Studies 50 (3): 393–413.Google Scholar
Weitz-Shapiro, Rebecca. 2012. “What Wins Votes: Why Some Politicians Opt Out of Clientelism.” American Journal of Political Science 56 (3): 568–583.CrossRefGoogle Scholar
Winters, Jeffrey A. 2011. Oligarchy. New York: Cambridge University Press.Google Scholar
Winters, Jeffrey A. 2013. “Oligarchy and Democracy in Indonesia.” Indonesia 96 (1): 11–33.CrossRefGoogle Scholar
Wisnu, Dinna. 2012. Politik sistem jaminan sosial menciptakan rasa aman dalam ekonomi pasar. Jakarta: PT Gramedia Pustaka Utama.Google Scholar
Wong, Joseph. 2004. Healthy Democracies: Welfare Politics in Taiwan and South Korea. Ithaca, NY: Cornell University Press.Google Scholar
World Bank. 2012. Jamkesmas health service fee waiver: Social assistance program and public expenditure review 4. Jakarta: The World Bank, Indonesia Office.Google Scholar