Democratic Decentralisation and Pro-poor Policy Reform in Indonesia: The Politics of Health Insurance for the Poor in Jembrana and Tabanan

in Asian Journal of Social Science
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Abstract

This paper explores the conditions under which democratic decentralisation has contributed to pro-poor policy reform in Indonesia by examining the politics of health insurance for the poor in two Indonesian districts, Jembrana and Tabanan, both located in Bali. Governments in these districts have responded quite differently to the issue of health insurance for the poor since they gained primary responsibility for health policy as a result of Indonesia’s implementation of decentralisation in 2001. We argue that this variation has reflected differences in the nature of district heads’ political strategies — particularly the extent to which they have sought to develop a popular base among the poor — and that these in turn have reflected differences in their personal networks, alliances and constituencies. Comparative research suggests that pro-poor outcomes have only occurred in developing countries following democratic decentralisation when social-democratic political parties have secured power at the local level. In the Indonesian case, we suggest, political parties are not well defined in ideological and programmatic terms and tend to act as electoral vehicles for hire and mechanisms for the distribution of patronage, while local-level politics is increasingly dominated by the executive arm of government. Hence the pathway to pro-poor policy reform has been different — namely, via the emergence of local executives who pursue their interests and those of allies and backers via populist strategies with or without the support of parties.

Democratic Decentralisation and Pro-poor Policy Reform in Indonesia: The Politics of Health Insurance for the Poor in Jembrana and Tabanan

in Asian Journal of Social Science

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References

AchmadJ. Hollow Development: The Politics of Health in Soeharto’s Indonesia 1999 Canberra Australian National University

Antara News “Tjahjo Kumolo: Pilkada Jembrana Pertarungan Wibawa PDIP” 2010 accessed on 4 April 2012 8 Novem-ber. Available at: http://bali.antaranews.com/berita/8147/tjahjo-kumolo-pilkada-jembrana-pertarungan-wibawa-pdip.

AntlovH. AspinallE.FealyG. “Not Enough Politics! Power, Participation and the New Democratic Polity in Indonesia” Local Power and Politics in Indonesia Decentralisation & Democratisation 2003 Singapore Institute of Southeast Asian Studies 72 86

ArifiantoA.MariantiR.BudiyatiS.TanE. “Making Services Work for the Poor in Indonesia: A Report on Health Financing mechanisms in Kabupaten Tabanan, Bali” 2005 East Asian Bureau of Economic Research Finance Working Paper Series 2005.9

Bali Post “Tabanan Targetkan 50 Persen Penduduk Miliki Askes Mandiri” 2006a September 13

Bali Post “Lahan RSI Tabanan Terbengkalai” 2006b July 3

Bali Post “BRSU Nunggak Askeskin Rp4M” 2007 September 27

Bali Post “Pemprov Bali Gagal Rayu Jembrana” 2010 January 8 2

BuehlerM. AspinallE.MietznerM. “Decentralisation and Local Democracy in Indonesia: The Marginalisation of the Public Sphere” Problems of Democratization in Indonesia: Elections Institutions and Society 2009 Singapore ISEAS 267 285

BunnellT.MillerM. “Jakarta in Post-Suharto Indonesia: Decentralization, Neo-liberalism and Global City Aspiration” Space and Polity 2011 15 1 35 48

ChoiN. “Democracy and Patrimonial Politics in Local Indonesia” Indonesia 2009 October 88 131 164

CrookR.SverrissonA. HoutzagerP.MooreM. “Does Decentralization Contribute to Poverty Reduction?; Surveying Evidence” Changing Paths: International Development and the New Politics of Inclusion 2003 Ann Arbor University of Michigan Press 233 259

DjaniL.WilsonI.MasdukiT. “Governing Favors: An investigation of accountability mechanisms in local government budget allocation in Indonesia” 2009 AIGRP Policy Brief No. 8 Australian National University Canberra.

GaduhA.LeisherS.NachukS. “Making Services Work for the Poor: A Synthesis of Nine Case Studies from Indonesia” 2006 Jakarta World Bank

HadizV. “Reorganising Political Power in Indonesia: A Reconsideration of So-called ‘Democratic Transitions’” Pacific Review 2003 16 4 591 611

HadizV. “Decentralisation and Democracy in Indonesia: A Critique of Neo-Institutionalist Perspectives” Development and Change 2004 35 4 697 718

HadizV. Localising Power in Post-Authoritarian Indonesia: A Southeast Asia Perspective 2010 Stanford Stanford University Press

HarrissJ. HoutzagerP.MooreM. “Do Political Regimes Matter? Poverty Reduction and Regime Difference Across India” Changing Paths: International Development and the New Politics of Inclusion 2003 Ann Arbor University of Michigan Press 204 232

HasanN. “Calon Gubernur dari Golkar Terkaya” Tempo Interaktif 2008 accessed on 13 June 2012 2 July. Available at: http://www.tempointeractive.com/hg/nusa/jawamadura/2008/07/02/brk20080702–127314id.html.

HellerP. “Moving the State: The Politics of Democratic Decentralization in Kerala, South Africa and Porto Alegre” Politics and Society 2001 29 91 131 163

HicksJ. “The Missing Link: Explaining the Political Mobilization of Islam in Indonesia” Journal of Contemporary Asia 2012 42 1 39 66

Ida BagusM. “From Isolation to Invisibility: West Bali, East Java and the Bugis Diaspora” 2008 accessed on 4 April 2012 Paper presented at the 17t Biennial Conference of the Asian Studies Association of Australia Melbourne 1–3 July. Available at: http://arts.monash.edu.au/mai/asaa/maryidabagus.pdf.

JanuragaP.SuryawatiC.ArsoS. “Persepsi Stakeholders Terhadap Latar Belakang Subsidi Premi, Sistem Kapitasi dan Pembayaran Premi Program Jaminan Kesehatan Jembrana” Jurnal Manajemen Pelayanan Kesehatan 2009 12 1 33 40

KosackS. “Realising Education for All: Defining and Using the Political Will to Invest in Primary Education” Comparative Education 2009 45 4 495 523

KurniawatiD. “Bali Town Yearns for the Leader Who Made Things Work” Jakarta Globe 2012 accessed on 1 April 2012 17 March. Available at: http://www.thejakartaglobe.com/editorschoice/bali-town-yearns-for-the-leader-who-made-things-work/505303.

LeisherS.NachukS. Making Services Work for the Poor: A Synthesis of Nine Case Studies from Indonesia 2006 Jakarta World Bank

MacIntyreA.RamageD. Seeing Indonesia as a Normal Country: Implications for Australia 2008 Canberra Australian Strategic Policy Institute

MalleyM. AspinallE.FealyG. “New Rules, Old Structures and the Limits of Democratic Decentralisation” Local Power and Politics in Indonesia: Decentralisation and Democratisation 2003 Singapore Institute of Southeast Asian Studies 102 118

ManorJ. Perspectives on Decentralization 2011 Swedish International Centre for Local Democracy Working Paper 3.

MietznerM. “Local Democracy: Old Elites are Still in Power, But Direct Elections Now Give Voters a Choice” Inside Indonesia 2006 85 17 18

MujaniS.LiddleR. “Indonesia: Personalities, Parties and Voters” Journal of Democracy 2010 21 92 35 49

NugraheniR. “Raih Suara Terbanyak, Bupati Jembrana Masuk MURI” TempoInteraktif 2006 accessed on 4 April 2012 6 February. Available at: http://www.tempointeraktif.com/share/?act=TmV3cw==&type=UHJpbnQ=&media=bmV3cw==&y=JEdMT0JBTFNbeV0=&m=JEdMT0JBTFNbbV0=&d=JEdMT0JBTFNbZF0=&id=NzM0OTY=.

ParksT.ColeW. Political Settlements: Implications for International Development Policy and Practice 2010 Bangkok Asia Foundation Occassional Paper No. 2

PatunruA.McCullochN.Von LuebkeC. A Tale of Two Cities: The Political Economy of Local Investment Climate in Solo and Manado Indonesia 2009 Brighton Institute of Development Studies IDS Working Paper 338.

PitanaI. G. RubinsteinRaechelleConnorLinda “Status struggles and the priesthood in contemporary Bali” Staying Local in the Global Village: Bali in the Twentieth Century 1999 Honolulu University of Hawai’i Press 181 201

RayD.GoodpasterG. KingsburyD.AvelingH. “Indonesian Decentralization” Autonomy and Disintegration in Indonesia 2003 London RoutledgeCurzon 75 95

RobinsonM. “Introduction: Decentralising Service Delivery? Evidence and Policy Implications” IDS Bulletin 2007 38 1 1 6

RosserA. “Realising Free Health Care for the Poor in Indonesia: The Politics of Illegal Fees” Journal of Contemporary Asia 2012 42 2 255 275

SaviraniA. “Dilema Para Politisi di Tingkat Lokal: Antara Mimpi Inovasi dan Demokrasi (Kajian Tentang Dilema Politisi Eksekutif di Kabupaten Bantul dan Jembrana)” Jurnal Ilmu Sosial dan Ilmu Politik 2007 11 1 93 118

SchillerJ. ErbM.SulistiyantoP. “Electing District Heads in Indonesia: Democratic Deepening or Elite Entrenchment” Deepening Democracy in Indonesia? Direct Elections for Local Leaders (Pilkada) 2009 Singapore Institute of Southeast Asian Studies 147 173

Schulte NordholtH. Bali An Open Fortress: Regional Autonomy Electoral Democracy and Entrenched Identities 2007 Singapore NUS Press

SherlockS. The 2004 Indonesian Elections: How the System Works and What the Parties Stand For: A Report on Political Parties 2004 Canberra Centre for Democratic Institutions

Suaramandiri.com “Bupati Jembrana Prof. I Gede Winasa Resmi ‘Dirangkeng’” 2011 accessed on 13 June 2012 Available at: http://www.suaramandiri.com/index.php?option=com_content&view=article&id=165:bupati-jembrana-prof-i-gede-winasa-resmi-dikrangkeng&catid=153:bali&Itemid=111.

SudaarsanaI. M. “Jaminan Kesehatan Jembrana ( JKJ): Satu Reformasi Kesehatan” 2006 accessed on January 2011 National Institute of Health Research & Development Seminar paper. Available at: http://www.litbang.depkes.go.id/download/seminar/desentralisasi6-80606/MakalahMade.pdf.

SulistiyantoP.ErbM. ErbM.SulistiyantoP. “Indonesia and the Quest for ‘Democracy’” Deepening Democracy in Indonesia? Direct Elections for Local Leaders (Pilkada) 2009 Singapore Institute of Southeast Asian Studies 1 37

TansR. “Mafias, Machines and Mobilization: The Sources of Local Power in Three Districts in North Sumatra, Indonesia” 2011 National University of Singapore Unpublished MA thesis

TIFA “Semua Bisa Seperti Jembrana: Kisah Sukses Sebuah Kabupaten Meningkatkan Kesejahteraan Rakyatnya” 2005 Menteng Dalam Yayasan Tifa

TurnerM.PodgerO.SumardjonoM. M.TirthayasaW. Decentralisation in Indonesia: Redesigning the State 2003 Canberra Asia Pacific Press

UfenA. “From Aliran to Dealignment: Political Parties in post-Suharto Indonesia” South East Asia Research 2008 16 1 5 41

VedeldT. “Democratic Decentralization and Poverty Reduction: Exploring the Linkages” Forum for Development Studies 2003 30 2 159 203

von LuebkeC. “The Political Economy of Local Governance: Findings from an Indonesian Field Study” Bulletin of Indonesian Economic Studies 2009 45 2 201 230

WinasaI. G. Jejak Langkah: Sebuah Catatan Kehidupan 2009 Negara Kommunitas Kertas Budaya

World Bank Health Strategy in a Post-Crisis Decentralizing Indonesia 2000 Washington, D.C. World Bank

World Bank Investing in Indonesia’s Health: Challenges and Opportunities for Future Public Spending 2008 Jakarta and Washington, D.C. World Bank

World Bank Health Financing in Indonesia: A Reform Road Map 2009 Washington, D.C. World Bank

World Bank “Indonesia School Operational Assistance—Knowledge Improvement for Transparency and Accountability (BOS-KITA): First World Bank Review and Implementation Support Mission ( July 27-August 18, 2009): Aide Memoire” 2009b Unpublished World Bank document.

ZulkifliA.HasanR.AnomA.WiremmerH. “PDI-P Berontak di Jembrana” Tempo 2000 September 4

8

In 2003the Jembrana administration paid an average of Rp. 12500 (A$1.56) per resident totalling Rp. 3 billion (A$375000). In 2004 the total cost of the programme was 4.5 billion (TIFA 2005).

11

See Winasa (2009) for a personal account of his life before politics.

18

Schulte Nordholt (2007) pg. 50.

19

Interview with Gede Winasa 10 February 2010.

21

By 2008when Winasa ran for Governor of Bali he was reported to be worth Rp. 14.3 billion (US$1.5 million) making him the second richest candidate for this position. See Hasan (2008).

34

On this point see Parks and Cole (2010).

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