Bridging the Gap: Uncovering Health Inequities and Moving Forward

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Yogyakarta, June 18, 2025 – Raboan Research and Perspective Sharing returned with a highly relevant and thought-provoking topic: “Ethics in the Distribution of Catastrophic Health Services under BPJS.”

This session featured expert speaker Prof. dr. Laksono Trisnantoro, M.Sc., Ph.D., Professor at the Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing (FMPHN), Universitas Gadjah Mada. The discussion was moderated by Mahmasoni Masdar, S.Kep., Ns., M.Kep from CBMH UGM. Together, they explored the pressing issue of inequality in access to healthcare services across Indonesia.

Drawing from BPJS data from 2015 to 2023, Prof. Laksono presented how advanced medical procedures such as cardiac catheterization (Cathlab) remain concentrated in Java and Bali. In contrast, eastern regions like Papua and Maluku are significantly underserved. This disparity raises an ethical concern, as all BPJS members—regardless of their backgrounds—deserve equal access to life-saving health services.

Prof. Laksono also introduced ethical frameworks based on Pareto efficiency and Rawlsian justice in public policy, prompting reflection with questions such as: Is it justifiable that only a portion of the population benefits from state-of-the-art healthcare, while others lack even basic referral access? Is it ethical to allow a system to continue operating without addressing deeply rooted structural inequalities? As stated in the Pareto principle:

“A policy is considered good if at least one group becomes better off, without making others worse off.”

Raboan session was highly interactive, with participants from various professional backgrounds calling for true implementation of equity and social solidarity within the National Health Insurance (JKN) system.

This theme strongly aligns with the Sustainable Development Goals (SDGs), especially SDG 3: Good Health and Well-Being and SDG 10: Reduced Inequalities. Equal access to catastrophic health services is not merely about equipment or budgets—it is a matter of dignity and justice for all Indonesian citizens.

This Raboan discussion reaffirmed that equitable access to healthcare is not merely a matter of infrastructure and funding, but a question of justice and human dignity. It is hoped that this forum will serve as a concrete impetus for policymakers to build a more just, inclusive, and people-centered health system for all Indonesians.

 

Etika dalam Pemerataan Pelayanan Kesehatan Katastropik BPJS

“Posted First, Fired Later?” Learning from Healthcare Workers’ Social Media Cases: Ethics, Reputation, and Hospital Marketing

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Yogyakarta, June 11, 2025 – The weekly Raboan Research and Perspective Sharing returned with a timely and relevant topic for the digital age: “Posted First, Fired Later? Learning from Healthcare Workers’ Social Media Cases: Ethics, Reputation, and Hospital Marketing.” The event was held online via Zoom, featuring dr. Jodi Visnu, MPH, a Health-Marketing Strategist, as the main speaker. The session was attended by a diverse audience, including healthcare workers, academics, hospital health promotion staff, and social media content creators. There was high engagement and active discussion, showing that this issue is a growing concern for both the healthcare world and the digital public.

Dr. Jodi explained how healthcare professionals today are not just caregivers, but also institutional influencers—meaning their social media posts can directly impact the reputation and public image of the hospitals they represent. Cases of viral content from medical staff leading to ethical controversies and even termination reveal a lack of proper digital communication policies in many health institutions.

He emphasized that while hospitals are encouraged to be more open and educational online, it’s important to differentiate between content that’s informative and helpful versus content made just to go viral. Ethics should not limit creativity—but guide it—ensuring responsible communication that respects others and doesn’t harm, especially patients. Dr. Jodi also highlighted the importance of instilling ethical awareness early in medical education and strengthening hospital policies to adapt to the digital era.

This session aligns with the spirit of the Sustainable Development Goals (SDGs), especially:

  • SDG 3 (Good Health and Well-Being): by promoting ethical and empathetic communication in healthcare to build trust, protect patients’ rights, and support a dignified, people-centered health system.
  • SDG 4 (Quality Education): by emphasizing the need for digital literacy and early ethics training for future health professionals.

This Raboan became a meaningful space for participants to critically reflect on the role of social media in shaping public perception. It reminded everyone that social platforms are not just tools for sharing content. They also carry real consequences for public trust, institutional reputation, and professional ethics in healthcare.

Reporter          : Alvira Rahmasari, S.H.G.

Editor              : Rafi Khairuna Wibisono, S.Kom.

Learning from Healthcare Workers’ Social Media Cases: Ethics, Reputation, and Hospital Marketing

Who Decides What Happens to Your Body? Raboan Talks About Family Roles in Medical Decisions During the Pandemic

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Yogyakarta, June 4, 2025 – The weekly Raboan Research and Perspective Sharing returned on Wednesday with a meaningful discussion on real-life issues during the pandemic. Nathan Agwin Khenda, Ftr., M. Bio.Et., was the speaker, sharing insights on the topic: “Healthcare Workers’ Views on Family Involvement in Medical Decisions During the COVID-19 Pandemic.”

Khenda explained that during the pandemic, many patients couldn’t make decisions about their medical treatment. Some were too sick, didn’t understand their condition, or needed urgent care. So, decisions were often made by family members, community leaders, or even doctors directly.

This shows how strong family and community culture is in Indonesia. Important decisions, especially in health, are often made together, not just by the patient alone. This is called “familial autonomy”, where families play a big part in choosing what happens in medical treatment.

Based on stories from two hospitals, Khenda shared how things like family relationships, cultural values, and emergency situations affect these decisions. In normal conditions, doctors will try to explain everything first to both patients and families. But in emergencies, they have to act fast to save lives.

“In crisis moments, doctors focus on doing what’s best for the patient (beneficence) and choosing actions with the least risk (minus mallum),” Khenda said.

This topic also connects to the Sustainable Development Goals (SDGs), especially Goal 3 (Good Health and Well-being) and Goal 16 (Justice and Strong Institutions). A good healthcare system should not only have good equipment or doctors, it should also respect people’s rights and cultural values.

This Raboan session left us with a big question to think about: in serious situations, who really makes the final call about our body—us, our family, or someone else?

Reporter          : Ardhini Nugrahaeni, M.K.M.

Editor              : Alvira Rahmasari, S.H.G.

 

Otonomi Kekerabatan dalam Pengambilan Keputusan Tindakan Medis saat Pandemi COVID-19