Jurnal Manajemen Pelayanan Kesehatan
Vol 13, No 02 (2010)


Siswanto, Siswanto (Unknown)

Article Info

Publish Date
11 Dec 2013


The impact of regional autonomy Act has resulted in healthservices system reform in Indonesia by central, province aswell as district/municipalities. The article is to analyze the “tradeof f” of Indonesian health services reform after theimplementation of regional autonomy Act by the use of normativegoals of health system, i.e equity, quality, and efficiency, asassessment parameters. The analysis revealed that: (i) theimplication of regional autonomy Act has resulted in Indonesianhealth services system reform which is partial and scattered,(ii) part of health services system reformation has moved tosocialism, another part of the reformation has moved toliberalism, with the implication of trade-off between equity,quality and efficiency, (iii) the whole Indonesian health servicessystem remains in the position of liberalism (market system),(iv) the choice toward socialism or liberalism is inherent withthe trade-off of advantages and disadvantages, so theintervention of its negative impacts are important. The articlerecommended that it is of importance to set in advance the endgoal of Indonesian health services system by all stakeholders,whether choosing liberal (market) system or social system,then setting up a clear road map completed with feasibleincremental programs to achieve the predetermined end goal.Keywords: regional autonomy, liberalism, socialism, trade-off

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