July 12, 2023
JAKARTA – Unfazed by health workers’ threat to strike, lawmakers passed the omnibus health bill into law on Tuesday, bringing sweeping and divisive changes to the health sector.
The new Health Law supplants 11 existing laws governing public health. Its provisions allow foreign doctors to open practices in the country, eliminate mandatory health spending and transfer the authority to issue medical competency certificates from medical associations to the government, among hundreds of other changes.
At the House of Representatives plenary session where the bill was passed, lawmakers said the new law would help fast-track health reform after the devastating coronavirus pandemic, address the country’s severe shortage of doctors and improve the quality of health services.
“The omnibus Health Law is a comprehensive and important revision to our current [system], and we hope it can help address the country’s various health problems and improve public health,” said Emanuel Melkiades Laka Lena, the deputy chairman of House Commission IX overseeing health and manpower.
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Representing the executive branch at the session was Health Minister Budi Gunadi Sadikin, who said the law would “provide a foundation for us to create a stronger healthcare system, not only in big cities but also in remote areas”.
Led by the Indonesian Medical Association (IDI), doctors, nurses, dentists and other medical workers had threatened to strike if the bill was passed into law. They opposed the bill from the beginning of deliberations, demanding it be brought back to the drawing board.
Just hours before the Tuesday House plenary session, hundreds of doctors and nurses staged a last-ditch demonstration in front of the House complex to pressure lawmakers into delaying the enactment of the law.
At the core of their dispute was the role of medical associations. At least one version of the bill contained provisions that allowed multiple associations to represent the same medical specialty, potentially undermining the central role of the IDI, which is currently the only medical association in the country.
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The IDI also opposes the revocation of its authority to issue competency certificates required to obtain medical licenses. Proponents of the law say moving that authority to the government will end the IDI’s monopoly over the licensing process.
Some civil society groups oppose the law as well, contending that there was little meaningful public participation in its deliberation and decrying the removal of a health spending minimum in the state budget.
The seven pro-government parties in the House voted to enact the law. Two opposition parties – the Democratic Party and the Prosperous Justice Party (PKS) – voted against it, citing its rushed deliberation and the removal of mandatory health spending.