RESPONSIBILITIES OF REGIONAL GOVERNMENT RELATED TO FULFILLMENT OF CITIZENSHIP RIGHTS IN HEALTH SERVICES

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1 International Journal of Civil Engineering and Technology (IJCIET) Volume 9, Issue 11, November 2018, pp , Article ID: IJCIET_09_11_275 Available online at ISSN Print: and ISSN Online: IAEME Publication Scopus Indexed RESPONSIBILITIES OF REGIONAL GOVERNMENT RELATED TO FULFILLMENT OF CITIZENSHIP RIGHTS IN HEALTH SERVICES A.A.A.N. Tini Rusmini Gorda, Ni Nyoman Juwita Arsawati, I Gusti Ayu Eviani Yuliantari Faculty of Law, Universitas Pendidikan Nasional (UNDIKNAS) Denpasar ABSTRACT The provision of Article 28H of the 1945 Constitution of the Republic of Indonesia which states that "every person has the right to live physically and mentally, live, and get a good and healthy environment and is entitled to health services". In the provisions of the Article, health services are part of the right of citizens to obtain prosperous life both physically and mentally. Health is an important element of human rights, as stated in the United Nations Declaration of Human Rights which states that everyone has the right to an adequate standard of living for the health and welfare of himself and his family. Thus, the State is obliged to respect, protect and fulfill these health rights, which is carried out by creating equal access to health services, carrying out legislative measures that can guarantee the protection of public health, as well as making policies related to public health. The Indonesian government has issued a public health insurance program, but the problem that often arises is that the implementation is still not evenly distributed in each region. Based on this, the author will discuss this paper using a law and regulation approach to explain the overlapping regulations related to health services and a comparative approach to discussing equitable access to health services in each region. Thus, it is expected that the role of the government in fulfilling citizenship rights to health services can be carried out evenly throughout the regions. Key words: role of government, basic rights of citizens, health services Cite this Article: A.A.A.N. Tini Rusmini Gorda, Ni Nyoman Juwita Arsawati, I Gusti Ayu Eviani Yuliantari, Responsibilities of Regional Government Related to Fulfillment of Citizenship Rights in Health Services, International Journal of Civil Engineering and Technology (IJCIET) 9(11), 2018, pp editor@iaeme.com

2 Responsibilities of Regional Government Related to Fulfillment of Citizenship Rights in Health Services 1. INTRODUCTION The 1945 Constitution of the Republic of Indonesia (hereinafter referred to as the 1945 Constitution) has constitutionally regulated the fulfillment of the right to health services, which is set forth in the provisions of Article 28H of the 1945 Constitution. Therefore the fulfillment of the right to health services is the responsibility of the government. Public health is the pillar of a nation's development. Health is one of the basic human needs. It is often said that health is everything, without health everything is meaningless. Therefore, every activity carried out by the government in relation to the role of the government in fulfilling the right of citizens to obtain health services should be carried out in an effort to improve the highest level of public health carried out with the principles of justice, protection and sustainability (Sujatmoko, 2016; Sasmi Ticoalu, 2013). The Indonesian government has now provided several forms of health services that reach all walks of life. One example is the Health Social Security Administering Body (BPJS Kesehatan). Initially BPJS Kesehatan was only given to civil servants, police and the army, but since January 1, 2014 the government issued a policy by issuing BPJS Kesehatan for all levels of society. However, it is unfortunate that in its implementation until now BPJS Kesehatan is still unable to fulfill fair and equitable health services. Communities in big cities can of course enjoy the health insurance, but people who live in small towns and even remote villages still don't enjoy it. Thus, it should be in addition to the Central Government, the Regional Government also has an important role in fulfilling the rights of citizens in health services. Therefore the paper raises the issue of the role of local governments in fulfilling citizenship rights to health services. 2. FORMULATION OF THE PROBLEM 1. How is the role of the Regional Government in fulfilling citizenship rights to health services viewed from the perspective of justice? 2. What is the form of responsibility of the local government related to the fulfillment of the right to health? 3. RESEARCH OBJECTIVES AND BENEFITS The purpose and benefits of this research are: To understand deeply the role of the government in fulfilling citizenship rights to health services from the perspective of justice. To understand in depth the form of responsibility of local governments related to the fulfillment of the right to health 4. RESEARCH METHODS This research is a normative legal research, because this research attempts to discuss or review legal norms in this case the norms of legislation to find out synchronization both vertically and horizontally. Synchronization of the norms referred to in this study is the synchronization between the 1945 Constitution of the Republic of Indonesia and other laws relating to the role of the government in fulfilling the rights of citizens in health services which in this case is the policy of the local government in fulfilling basic rights citizens in health services. In this study the author uses primary legal materials consisting of legislation relating to citizenship rights to health with the approach of legislation and comparative approaches supported by the implementation of policies from the region. Then the writer uses descriptive-qualitative analysis technique that is by describing or describing the legal provisions in the legal materials with the legal problem of research and reviewing and editor@iaeme.com

3 A.A.A.N. Tini Rusmini Gorda, Ni Nyoman Juwita Arsawati, I Gusti Ayu Eviani Yuliantari analyzing the policies issued by the regional head with regard to health services to provide equitable justice for the community The Role of Local Governments in Fulfilling Citizensgip Rights to Health Services Viewed from a Justice Perspective The idea of human rights is built on the principle of equality. This principle emphasizes that humans are equal in position regarding their dignity. Various differences inherent in human beings do not cause human positions to be unequal. The equality is intended so that the fulfillment of the basic rights of citizens can be given as fairly as possible. Equality implies fairness, namely equal or equal treatment throughout the community. Equality is very important in creating to create harmony, harmony and balance for the fulfillment of a sense of justice for everyone. Justice as fairness uses the idea of pure procedural justice to deal with problems in certain circumstances (Rawls, 2011; Susilowati, 2018). The social system is designed so that the distribution produced is fair, whatever happens. To achieve this goal, it is important to put the socio-economic processes around the appropriate political and legal institutions. The government in fulfilling the right of citizens to get health services must be given equally and fairly for all people (Arif, 2018; Prayogo, 2018). The steps made by the government to prosper the community in the health sector are by procuring health facilities, making it easier for the poor to access health services. But currently in Indonesia the fulfillment of citizenship rights to health services is still not optimal. There are still many areas in remote areas or villages in Indonesia that still do not get adequate health facilities in contrast to people in big cities who have enjoyed health facilities. The purpose of a country is to prosper the people, as well as Indonesia. One role of the government that aims to prosper the people is to provide health insurance because health is a human right that must be realized in accordance with the mandate of Pancasila and the Constitution of the Republic of Indonesia. The government has an obligation to fulfill the rights of citizens, especially in the health sector. This is stated in the provisions of Article 28H of the 1945 Constitution. In the provisions of the Article, health services are part of the right of citizens to obtain a life of physical and spiritual prosperity. Therefore the fulfillment of the right to health services is the responsibility of the government. In the provisions of Article 12 of Law No. 23 of 2014 concerning Regional Government Health is part of compulsory government affairs relating to basic services. This is a guideline for local governments to carry out the roles and responsibilities of local governments in providing health services for the community. The fulfillment of the right to health is realized by the State by providing health care facilities and ensuring that each individual can access it according to their individual needs (Lisdiyono & Assalmani, 2017). Health care facilities provided by the State must be safe, quality and affordable. The Indonesian government has organized National Health Insurance where health insurance applies to all people in Indonesia. Equity in the fulfillment of citizenship rights to health services must be carried out in accordance with the principles of justice. Unfortunately, in Indonesia, there are still many people in remote villages who still do not enjoy health insurance, even if they have enjoyed the equipment and the facilities are not the same as those in big cities. Even though in accordance with the principle of justice, the provision of health insurance must be the same and evenly distributed in all regions of Indonesia. Here is the importance of the role of the regional government as an extension of the central government to provide good health services to each region. Each region must provide health services based on the theory of justice, it is intended to ensure equal distribution of health services for each region in Indonesia. Equity as an important aspect of editor@iaeme.com

4 Responsibilities of Regional Government Related to Fulfillment of Citizenship Rights in Health Services justice is very important to implement because with the existence of equity in each region it will provide welfare for the community to obtain health services as a form of actualization of basic rights as part of the human rights of each individual (Wicaksono, 2018; Mulyawan, 2018) Forms of Responsibility of Local Governments Regarding Fulfillment of the Right to Health The obligation/responsibility of the state to fulfill the right to health, the government formulated the National Health System policy on March 2, 2004 through Kep.Men.Kes. RI No. 131/Men.Kes/SK/II/2004 concerning National Health System. The national health system (SKN) reflects the efforts of the Indonesian people to improve the ability, willingness and awareness to achieve the highest level of health as the realization of public welfare as referred to in the Preamble of the 1945 Constitution. human beings, namely: (a) provide guarantees to everyone to get basic health care that is in accordance with their needs, quality, sustainable and affordable both physically and financially; (b) controlling health costs and providing efficient and effective health services; and (c) enhance cooperation between government and private efforts in creating a form of health care for the community; organized in an efficient, effective and quality and affordable manner. The role, duties and responsibilities of the government are more focused on fostering, regulating and supervising the creation of equitable health services and achieving harmonious and balanced conditions between health efforts carried out by the government and the public, including the private sector (Wirawan, 2018). In particular the government's responsibility in implementing health insurance is regulated in Article 20 of the Health Law which states that: The government is responsible for the implementation of public health insurance through the national social security system for individual health efforts. The implementation of the social security system as referred to in paragraph (1) is carried out in accordance with the provisions of the legislation. The government is obliged to fulfill the right of the community to obtain the highest degree of health, which is fulfilled the right to live physically and mentally healthy and fulfill their basic needs. Previously every government affair which was the authority of the President and carried out by the regional government was regulated in PP No. 38 of 2007 concerning the Government, Provincial Government and Regency/City Government. Now everything related to government affairs or regional administration is regulated in Law No. 23 of 2014 concerning Regional Government. Article 9 paragraph (3) Law No. 23 of 2014 concerning Regional Government states that Concurrent Government Affairs are governmental affairs that are divided between the Central Government and the provincial and district/city Regions. Concurrent government affairs submitted to the regions form the basis for implementing Regional Autonomy. The health sector is a compulsory concurrent government affair which relates to the basic services that are the regional authority. In the Attachment to the Distribution of Concurrent Government Affairs between the Central Government and the Provincial and District/City Regions Act No. 23 of 2014 concerning Regional Government in the Health Sector is detailed in terms of government authority in regulating public health. The task of the Government or Local Government is not in the implementation as is now the case with Jamkesmas or Jamkesda. The organization will be managed by an agency outside the government. The government's task is only to pay contributions and supervision. Fheriyal Sri Isriawaty (2015) stated that synchrony and harmony is what will become the final form of a National Health Insurance System editor@iaeme.com

5 A.A.A.N. Tini Rusmini Gorda, Ni Nyoman Juwita Arsawati, I Gusti Ayu Eviani Yuliantari Law Number 36 of 2009 concerning Health, regulating the responsibilities of the state, including the Government, Provincial Government and Regency/City Government that must be carried out, includes: Planning, regulating, organizing, fostering and supervising the implementation of health efforts that are equitable and affordable by the community; Availability of environment, order, physical and social health facilities for the community to achieve the highest level of health; The availability of resources in the field of health that is fair and equitable for all communities to obtain the highest level of health; Availability of access to information, education and health service facilities; Empower and encourage the active role of the community in all forms of health efforts; Availability of all forms of quality, safe, efficient and affordable health efforts; Implementation of public health insurance through the national social security system for individual health efforts The provisions of this article explain that the fulfillment of citizenship rights to health services is not only the responsibility of the central government, but also the responsibility of the regional government based on the principle of regional autonomy. The regional government has the rights, obligations and authority to regulate and manage all of its own government affairs in accordance with the potential of each region. One form of health service is with BPJS Kesehatan and that applies in all regions in Indonesia. In Badung Regency, Bali health BPJS officially synergizes with the Badung regency government in providing a guarantee of equitable and quality health services to the bustling population within the Badung district government. The Regional Health Insurance, called the Badung Sehat Card (KBS), is now officially a National Health Card-Indonesia Healthy participant. The policy issued by the Badung Regent in collaboration with BPJS Kesehatan is used for the entire Badung district community. For underprivileged people (poor people) BPJS Kesehatan is obtained without any doubt because it is the responsibility of the government to pay its contributions, while for people who are able to pay their own contributions every month according to their class. Unlike the case with KBS which does not collect fees for its implementation. This is because the potential of Badung Regency is very large related to the regional own-source revenue. When linked to the theory of justice, the policies made by Badung regency have been able to provide a sense of justice for the entire community so that the fulfillment of citizenship rights to health services can be carried out equitably. The policy issued by the regional head is very good if applied by all regions in Indonesia, moreover it is a collaboration with national health insurance under the auspices of BPJS Kesehatan. This will make it easier for the public to get good health services and can also make the community prosperous by fulfilling the basic rights of citizens in fair and equitable health services in all levels of Indonesian society. 5. CONCLUSIONS The Government has carried out its role in fulfilling the citizenship rights to health by creating a national health insurance program. The national health insurance in question is a program to facilitate public access to health services. It's just that the reality is that the program is still not perfect. This can be seen from the overlapping health services in big cities with remote villages in Indonesia, namely in the field of medical facilities and equipment. Seen based on the principle of justice, the government should make policies that provide a sense of justice for the whole community, namely by providing the same facilities for the entire community. It editor@iaeme.com

6 Responsibilities of Regional Government Related to Fulfillment of Citizenship Rights in Health Services is currently being developed by the Badung regency government by making policies in the field of health services in the form of a Badung Health Card to provide services in the health sector without burdening the community for payment of contributions in order to ensure equal distribution of health services for every level of society. Health is one of the rights of citizens who become concurrent government affairs based on the principle of decentralization submitted by the central government to regional governments in accordance with the mandate of the 1945 Constitution. Therefore the regional government has responsibility in fulfilling the rights of citizens in health services by giving health insurance for the community in the area. In addition, local governments can also form regulations and policies related to health services. Because it is based on the principle of decentralization, all forms of responsibility are in the hands of regional governments, which means that the regions are fully responsible for the health services of their respective regions. With the principle of decentralization, the Badung regency government succeeded in issuing a policy in terms of providing health services for all levels of society in Badung regency in a fair and equitable manner as a form of human rights actualization of each individual. 6. SUGGESTIONS It is expected that the regional government to optimize more in terms of health services in the form of health insurance in order to reflect equitable justice for each individual. Moreover, local governments from each region in Indonesia must be able to carry out their role in providing health services to the community based on the principle of decentralization as the implementer of health insurance programs in the region in order to make policies in the health sector that can be enjoyed by the community in the village remote village. REFERENCES [1] Act of the Unitary State of the Republic of Indonesia in [2] Ali, Zainuddin, Metode Penelitian Hukum, Jakarta: Sinar Grafika, [3] Arif, A. (2018). Comparative Study of Law of Impeachment in Various Countries. Asian Journal of Law and Jurisprudence 1(1). [4] Arif, F., & Prayogo, G. (2018). The arrangements and mechanisms of impeachment to the president and vice president on the ground of betrayal of state from the good governance framework: A study of post amendment Indonesian constitution. International Journal of Civil Engineering and Technology 9(4), [5] Isriawaty, F. S. (2015). Tanggung Jawab Negara Dalam Pemenuhan Hak Atas Kesehatan Masyarakat Berdasarkan Undang Undang Dasar Negara Republik Indonesia Tahun 1945, Jurnal ilmu hukum legal opinion 2(3). [6] International Convention on Civil and Political Right (Covenant on Civil and Political Rights). [7] Law of the Republic of Indonesia Number 23 of 2014 concerning Regional Government (State Gazette of the Republic of Indonesia of 2014 Number 244, Supplement to the State Gazette of the Republic of Indonesia Number 5587). [8] Law of the Republic of Indonesia Number 36 of 2009 concerning Health (State Gazette of the Republic of Indonesia of 2009 Number 144, Supplement to the State Gazette of the Republic of Indonesia Number 5063). [9] Law of the Republic of Indonesia Number 39 of 1999 concerning Human Rights (State Gazette of the Republic of Indonesia of 1999 Number 165, Supplement to the State Gazette of the Republic of Indonesia Number 3886) editor@iaeme.com

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