Abstract：
The National Health Protection (NHP) of Indonesia is a pro-poor social health insurance as the government pays the monthly premium for the poor. A waste picker is classified as an urban poor group needing affordable or free access to health care. This study explores the extent to which the NHP protects the health of waste pickers and provides them with quality health care. For this mixed-method study, 342 waste pickers completed the survey, 40 engaged in interviews, and 15 participated in Natural Group Discussions. The study found that 20% of waste pickers were not enrolled in NHP due to issues such as incorrect validation of poverty, discrimination, illegal fees, nepotism, unaffordable premiums, and lack of interest in purchasing the health plan. Among those who were enrolled, waste pickers expressed satisfaction with the health care they received and the behavior of the staff. However, they did criticize certain aspects such as waiting times, service gaps between full-paying and subsidized patients, suspicion of the quality of medicines, complicated medical administration procedures, and inflexibility of the capitation system. The study concludes that despite the NHP, poor groups remain vulnerable to accessing free health care.
摘要：
印度尼西亚的国家健康保护（NHP）是一种有利于穷人的社会健康保险，因为政府每月为穷人支付保费。拾荒者被归类为城市贫困群体，需要负担得起或免费获得医疗保健。这项研究探讨了NHP在多大程度上保护了拾荒者的健康，并为他们提供了优质的医疗保健。对于这项混合方法研究，342名拾荒者完成了调查，40人参加面试，15人参加了自然小组讨论。研究发现，由于对贫困的不正确确认等问题，20%的拾荒者没有加入NHP，歧视,非法收费,裙带关系,负担不起的保费，对购买健康计划缺乏兴趣。在那些被录取的人中，拾荒者对他们获得的医疗保健和工作人员的行为表示满意。然而,他们确实批评了某些方面，例如等待时间，全额付费和补贴患者之间的服务差距，怀疑药品的质量，复杂的医疗管理程序，和人头制度的不灵活性。研究得出的结论是，尽管有NHP，贫困群体仍然容易获得免费医疗服务。
