Sustainability Evaluation of Tobacco Excise Tax Policy to Finance Universal Health Coverage in Indonesia

Abstract

Universal Health Coverage (UHC) is a public health funding scheme promoted by the World Health Organization (WHO) to achieve equity in healthcare services, including promotive, preventive, curative, and rehabilitation care at an affordable cost. In 2014, Indonesia started the UHC program through its national program Jaringan Kesehatan Nasional (JKN). So far, JKN has faced many issues, with the most never-ending problem is a fund deficit. To counter this issue, the Indonesian government opted to use an earmarking fund from tobacco excise to support JKN. This research aims to provide a structural insight that earmarked funds from tobacco excise are not sustainable in the long run in Indonesia's case using system dynamics. The adverse effects of tobacco use on health, which increases public health expenditure and its socioeconomic impact, are the primary cause of this unsustainability.