Indonesian Health Law: Constitutional Mandates, Regulatory Architecture, and Contemporary Governance Challenges

Wiet Sidharta; Hargianti Dini Iswandari

doi:10.59890/ijla.v4i3.304

Authors

Wiet Sidharta Universitas Ngudi Waluyo
Hargianti Dini Iswandari Universitas Ngudi Waluyo

DOI:

https://doi.org/10.59890/ijla.v4i3.304

Keywords:

Indonesian Health Law, Constitutional Rights, Health Governance, Regulatory Framework, Legal Certainty

Abstract

Indonesian health law must reconcile constitutional guarantees, welfare-state obligations, regulatory complexity, and contemporary governance pressures. This study aims to analyze the coherence between constitutional mandates, regulatory architecture, and health governance implementation in Indonesia. A normative juridical approach was employed through a review of constitutional provisions, statutes, regulations, and policy instruments; no respondents or informants were involved. The materials were examined using doctrinal and qualitative legal analysis. The findings show that legislative consolidation has strengthened the formal health-law framework, yet implementation remains constrained by decentralization, institutional fragmentation, weak accountability, legal uncertainty, digital-health risks, and unequal access to services. The study concludes that stronger regulatory coherence, interinstitutional coordination, and rights-based enforcement are essential to improve equitable and sustainable health governance.

References

Abimbola, S. (2020). Health system governance: A triangle of rules. BMJ Global Health, 5(8), Article e003598. https://doi.org/10.1136/bmjgh-2020-003598.

Alexandra, S., Handayani, P. W., & Azzahro, F. (2021). Indonesian hospital telemedicine acceptance model: The influence of user behavior and technological dimensions. Heliyon, 7(12), Article e08599. https://doi.org/10.1016/j.heliyon.2021.e08599.

Amiati, M., Halim, H., & Hassim, J. Z. (2024). Navigating ambiguity: Critiques of Indonesia’s health law and its impact on legal redress for medical malpractice victims. Hasanuddin Law Review, 10(1), 94–107. https://doi.org/10.20956/halrev.v10i1.5346.

Anindya, K., Lee, J. T., McPake, B., Wilopo, S. A., Millett, C., & Carvalho, N. (2020). Impact of Indonesia’s national health insurance scheme on inequality in access to maternal health services: A propensity score matched analysis. Journal of Global Health, 10(1), Article 010429. https://doi.org/10.7189/jogh.10.010429.

Asante, A., Cheng, Q., Susilo, D., Satrya, A., Man, N., Fattah, R. A., Haemmerli, M., Kosen, S., Novitasari, D., Puteri, G. C., Adawiyah, E., Hayen, A., Mills, A., Tangcharoensathien, V., Jan, S., Thabrany, H., & Wiseman, V. (2023). The benefits and burden of health financing in Indonesia: Analyses of nationally representative cross-sectional data. The Lancet Global Health, 11(5), e770–e780. https://doi.org/10.1016/S2214-109X(23)00064-5.

Bhat, P. I. (2020). Idea and methods of legal research. Oxford University Press. https://doi.org/10.1093/oso/9780199493098.001.0001.

Djalante, R., Lassa, J., Setiamarga, D., Sudjatma, A., Indrawan, M., Haryanto, B., Mahfud, C., Sinapoy, M. S., Djalante, S., Rafliana, I., Gunawan, L. A., Surtiari, G. A. K., & Warsilah, H. (2020). Review and analysis of current responses to coronavirus disease 2019 in Indonesia: Period of January to March 2020. Progress in Disaster Science, 6, Article 100091. https://doi.org/10.1016/j.pdisas.2020.100091.

Ferraz, O. L. M. (2020). Health as a human right: The politics and judicialisation of health in Brazil. Cambridge University Press. https://doi.org/10.1017/9781108678605.

Gamalliel, N., & Fuady, A. (2024). Indonesia’s new health law: Lessons for democratic health governance and legislation. The Lancet Regional Health—Southeast Asia, 23, Article 100390. https://doi.org/10.1016/j.lansea.2024.100390.

Global Burden of Disease 2019 Indonesia Subnational Collaborators. (2022). The state of health in Indonesia’s provinces, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Global Health, 10(11), e1632–e1645. https://doi.org/10.1016/S2214-109X(22)00371-0.

Kickbusch, I., Piselli, D., Agrawal, A., Balicer, R., Banner, O., Adelhardt, M., Capobianco, E., Fabian, C., Gill, A. S., Lupton, D., Medhora, R. P., Ndili, N., Ryś, A., Sambuli, N., Settle, D., Swaminathan, S., Vega Morales, J., Wolpert, M., Wyckoff, A. W., & Xue, L. (2021). The Lancet and Financial Times Commission on governing health futures 2030: Growing up in a digital world. The Lancet, 398(10312), 1727–1776. https://doi.org/10.1016/S0140-6736(21)01824-9.

Kraft, M. E., & Furlong, S. R. (2024). Public policy: Politics, analysis, and alternatives (8th ed.). CQ Press.

Kuckartz, U., & Rädiker, S. (2023). Qualitative content analysis: Methods, practice and software (2nd ed.). SAGE Publications.

Lee, J. T., McPake, B., Putri, L. P., Anindya, K., Puspandari, D. A., & Marthias, T. (2023). The effect of health insurance and socioeconomic status on women’s choice in birth attendant and place of delivery across regions in Indonesia: A multinomial logit analysis. BMJ Global Health, 8(1), Article e007758. https://doi.org/10.1136/bmjgh-2021-007758.

Majeed, N., Hilal, A., & Khan, A. N. (2023). Doctrinal research in law: Meaning, scope and methodology. Bulletin of Business and Economics, 12(4), 559–563. https://doi.org/10.61506/01.00167.

Meilianti, S., Smith, F., Kristianto, F., Himawan, R., Ernawati, D. K., Naya, R., & Bates, I. (2022). A national analysis of the pharmacy workforce in Indonesia. Human Resources for Health, 20, Article 71. https://doi.org/10.1186/s12960-022-00767-4.

Mitchell, M. (2023). Analyzing the law qualitatively. Qualitative Research Journal, 23(1), 102–113. https://doi.org/10.1108/QRJ-04-2022-0061.

Muharram, F. R., Sulistya, H. A., Swannjo, J. B., Firmansyah, F. F., Rizal, M. M., Izza, A., Isfandiari, M. A., Ariningtyas, N. D., & Romdhoni, A. C. (2024). Adequacy and distribution of the health workforce in Indonesia. World Health Organization South-East Asia Journal of Public Health, 13(2), 45–55. https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_28_24.

Mulyanto, J., Wibowo, Y., Ernawati, D. A., Lestari, D. W. D., & Kringos, D. S. (2023). Exploring inequalities in the use, quality, and outcome of the diabetes management program of Indonesian National Health Insurance. Health Equity, 7(1), 644–652. https://doi.org/10.1089/heq.2023.0025.

Nugroho, S. T., Ahsan, A., Kusuma, D., Adani, N., Irawaty, D. K., Amalia, N., & Hati, S. R. H. (2023). Income disparity and healthcare utilization: Lessons from Indonesia’s National Health Insurance claim data. Asian Pacific Journal of Cancer Prevention, 24(10), 3397–3402. https://doi.org/10.31557/APJCP.2023.24.10.3397.

O’Connor, C., & Joffe, H. (2020). Intercoder reliability in qualitative research: Debates and practical guidelines. International Journal of Qualitative Methods, 19, 1–13. https://doi.org/10.1177/1609406919899220.

Pratiwi, A. B., Setiyaningsih, H., Kok, M. O., Hoekstra, T., Mukti, A. G., & Pisani, E. (2021). Is Indonesia achieving universal health coverage? Secondary analysis of national data on insurance coverage, health spending and service availability. BMJ Open, 11(10), Article e050565. https://doi.org/10.1136/bmjopen-2021-050565.

Republic of Indonesia. (1945). The Constitution of the Republic of Indonesia of 1945. Constitutional Court of the Republic of Indonesia.

Republic of Indonesia. (2023). Law of the Republic of Indonesia Number 17 of 2023 on Health (State Gazette of the Republic of Indonesia of 2023 Number 105, Supplement to the State Gazette of the Republic of Indonesia Number 6887).

Republic of Indonesia. (2024). Government Regulation of the Republic of Indonesia Number 28 of 2024 concerning the implementation of Law Number 17 of 2023 on Health (State Gazette of the Republic of Indonesia of 2024 Number 135, Supplement to the State Gazette of the Republic of Indonesia Number 6952).

Rose, J., & Johnson, C. W. (2020). Contextualizing reliability and validity in qualitative research: Toward more rigorous and trustworthy qualitative social science in leisure research. Journal of Leisure Research, 51(4), 432–451. https://doi.org/10.1080/00222216.2020.1722042.

Saheb, T., & Saheb, T. (2024). Digital health policy decoded: Mapping national strategies using Donabedian’s model. Health Policy, 147, Article 105134. https://doi.org/10.1016/j.healthpol.2024.105134.

Sambodo, N. P., Van Doorslaer, E., Pradhan, M., & Sparrow, R. (2021). Does geographic spending variation exacerbate healthcare benefit inequality? A benefit incidence analysis for Indonesia. Health Policy and Planning, 36(7), 1129–1139. https://doi.org/10.1093/heapol/czab015.

Sapkota, S., Dhakal, A., Rushton, S., van Teijlingen, E., Marahatta, S. B., Balen, J., & Lee, A. C. K. (2023). The impact of decentralisation on health systems: A systematic review of reviews. BMJ Global Health, 8(12), Article e013317. https://doi.org/10.1136/bmjgh-2023-013317.

Siems, M. (2022). Comparative law (3rd ed.). Cambridge University Press. https://doi.org/10.1017/9781108892766.

Wiratraman, H. P. (2020). Does Indonesian coronavirus disease 2019 emergency law secure rule of law and human rights? Journal of Southeast Asian Human Rights, 4(1), 306–334. https://doi.org/10.19184/jseahr.v4i1.18244.

World Health Organization. (2024). Indonesia’s success in achieving 90 percent coverage and minimizing out-of-pocket expenses through national health insurance expansion.