KIS : Sebuah Janji Yang Terlupakan (Dilupakan) ?

Sampai detik ini masih saja terngiang sebuah janji dari seorang capres yang kini telah menjadi presiden. Ucapan itu disampaikan bersamaan dengan menunjukkan sebuah kartu yang disebut dengan Kartu Indonesia Sehat (KIS). Seketika itu langsung bertanya-tanya dalam hati, apakah KIS itu ? Jika KIS merupakan sebuah program jaminan kesehatan berskala nasional, bukankah sudah ad JKN yang diselenggarakan oleh BPJS Kesehatan yang sudah dilegalkan dalam konstitusi negara ?

Banyak pertanyaan yang timbul saat itu, namun satu hal yang bisa saya simpulkan adalah bahwasanya beliau bercita-cita me-Nasional-kan Kartu Jakarta Sehat (KJS). Seperti yang kita ketahui bahwa program KJS adalah jaminan kesehatan khusus untuk penduduk Propinsi DKI Jakarta yang bersifat Universal Covergae. Saat itupun masih menjadi pemikiran saya jikalau beliau memang ditakdirkan Allah menjadi presiden, apakah memang benar-benar KIS ini akan dijalankan ? Apa tidak berbenturan dengan sistem dan program yang sudah ada dan legal karena diamanatkan dalam Undang-Undang. Jujur saja saya saat ini sangat meragukan.

Namun ternyata sejarah berbicara laiin dari perkiraan saya, baru seminggu diangkat menjadi Menko PKM tiba-tiba saja sudah disampaikan dengan tegas oleh bu Menko yang masih “kinyis-kinyis” ini bahwa KIS akan dijalankan sebagai program jaminan kesehatan nasional. Lha ??? Belum cukup sampai disitu, seorang vokalis DPR pendukung presiden terpilih mengatakan dengan gagah (meskipun Aleg ini wanita) bahwa KIS akan menjadi program jaminan yang LEBIH BAIK daripada BPJS Kesehatan. Nah lho…Kok iso ?

Saya masih ingat, saat membaca berita online tentang itu saya yang sudah gatel ingin komentar langsung berkomentar bahwa “KIS itu tidak perlu karena saat ini sudah ada program JKN yang dilaksanakan oleh BPJS Kesehatan, akan lebih baik jika memperbaiki dan menambal kekurangan serta kelemahan JKN”. Ternyata hari berikutnya ada penjelasan lain dari Menko yang sama tapi malah makin membingungkan, beliau mengatakan bahwa KIS itu akan lebih luas dari JKN karena melindungi gelandangan, psikotik jalanan dan tuna wisma lainnya. Langsung saya komentari lagi “JKN pun sebenarnya ada program itu, program perlindungan bagi masyarakat Penyandang Masalah Kesejahteraan Sosial (PMKS) namanya. Program ini merupakan program lanjutan dari Program Keluarga Harapan (PKH) dan menjadi salah satu elemen perlindungan program JAMKESMAS sebelum ber-integrasi kedalam JKN pada 1 Januari 2014”. Program PMKS sudah direncanakan dengan matang oleh Kemenkes, namun saat pengajuan anggaran ke Kemenkeu ditolak dengan alasan yang saya tidak tahu. Nah lho…lagi-lagi terbantahkan urgensi daripada KIS ini.

Waktu berjalan dan terus bergerak, isu KIS ini tertutupi oleh gegap gempita nya negeri ini dengan masalah-masalah lain. Namun ternyata program KIS ini tetap dilanjutkan, berawal dari instruksi dari presiden agar BPJSK mencetak kartu KIS ini, padahal payung hukum dan landasan konstitusi nya pun belum ada. Aturan hukum yang ada tetap menyatakan bahwa sistemnya bernama SJSN, programnya bernama JKN dan penyelenggaranya adalah BPJS Kesehatan. Dalam benak saya hanya berfikir bahwa apakah tidak merupakan pemborosan anggaran saja ketika harus mengganti seluruh kartu kepesertaan BPJSK menjadi kartu KIS. Belum lagi masih simpang siurnya KIS ini, sebenarnya apakah hanya merupakan suplement tambahan PBI dari kelompok masyarakat dengan PMKS ini atau apakah merupakan substitusi total dari seluruh peserta BPJS Kesehatan ? Pertanyaan itupun sampai detik ini belum terjawab.

Dari sebuah sumber di internal BPJS Kesehatan saya mendapatkan informasi bahwasanya pada akhirnya direksi BPJS Kesehatan “mengalah” dengan intruksi presiden ini karena kondisi BPJS Kesehatan saat ini cukup membuat deg-deg an dan sangat memerlukan kehadiran sosok pemimpin tertinggi pemerintahan sebagai pelindung program JKN ini. Aksi “mengalah” nya direksi BPJS Kesehatan ini dilakukan dengan meng-akomodir keinginan presiden menjadikan KIS sebagai kartu identitas kepesertaan menggantikan kartu peserta JKN yang sudah beredar di masyarakat. Tentu saja hal ini lebih cenderung ingin mengambil hati seorang pesiden dan diharapkan presiden akan tampil dan memperjuangkan kelangsungan program JKN serta memperbaiki kelemahan dan kekurangan program ini.

Tapi bagaimana caranya men-sosialisasikan kepada masyarakat ? Akhirnya diambillah jalan tengah dengan tujuan “win win solution” sehingga mulai dikampanyekan oleh Kemenkes dan BPJS Kesehatan bahwa nama sistemnya adalah Sistem Jaminan Sosial Nasional (SJSN), nama programnya adalah Program Jaminan Kesehatan Nasional (JKN), penyelenggaranya adalah Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS Kesehatan) dan nama kartu identitas pesertanya adalah Kartu Indonesia Sehat (KIS). Ini merupakan solusi yang penuh harapan semua akan senang dan semua akan tersenyum tanpa ada yang dipermalukan. Program nya tetap berjalan, penyelenggaranya tidak berubah dan janji tentang sebuah nama yaitu KIS juga ter-akomodir. Saya pun ikut berpartisipasi dengan men-sosialisasikan ini dalam forum-forum diskusi di medsos (Group FB BPJS Kesehatan).

Aksi lanjutannya adalah dengan melakukan sosialisasi kepada masyarakat bahwa terhitung sejak 1 Maret 2015 secara bertahap kartu identitas peserta BPJS Kesehatan akan DIGANTI dengan Kartu Indonesia Sehat (KIS) dan mulai dibagikan oleh pemerintah. Seremonial penyerahan KIS perdana yang dilakukan oleh presiden pun diliput secara totalitas oleh media cetak dan elektronik.

Jarum jam terus bergerak, sejarah mencari jalannya sendiri dan sampai detik ini kita pun sama sekali tidak mengetahui sampai dimana kemajuan pembagian dan penggantian kartu peserta tersebut menjadi kartu KIS. Hari ini pada tanggal 30 Agustus 2015 jika dihitung mundur pada 1 Maret 2015 maka sudah hampir 6 bulan namun kita tidak pernah tahu sudah berapa persen peserta BPJS Kesehatan yang kartu identitas pesertanya diganti menjadi kartu KIS.

Dalam hari-hari terakhir ini, dimana BPJS Kesehatan menuai banyak persoalan dan kendala disertai dengan aroma “jaga jarak” antara sang regulator (Kemenkes) dengan Operator lapangan (BPJS Kesehatan) seperti persoalan tarif kapitasi, tarif CBGs, rasio klaim yang over budgeting, norma kapitasi dan sebagainya maka sesungguhnya kehadiran presiden sebagai kepala negara dan kepala pemerintahan sangat diperlukan. Ketika para pihak dalam sistem JKN mengalami kemacetan “komunikasi” maka sudah seharusnya sang “orang tua” menjadi penengah dan memberikan solusi.

Setidaknya, kehadiran beliau dalam memberikan solusi atas masalah-masalah ini akan menjadi sedikit penebus “ke-khilafan” beliau yang terkesan agak melupakan KIS. Padahal sudah jamak lah bahwa isu kesehatan dan pendidikan selalu menjadi dagangan utama saat kampanye dari mulai level ter-rendah (PILKADA) sampai pada PILPRES. Mohon maaf yang sebesar-besarnya kepada bapak presiden yang terhormat, KIS ini dulu adalah janji bapak saat kampanye dan debat Capres. Saya menangkap bahwa program KIS saat itu menjadi program andalan bapak, namun mengapa disaat-saat seperti ini yang begitu membutuhkan kehadiran bapak tapi bapak terkesan acuh dan memandang sebelah mata terhadap program JKN ini ? Saya sangat paham bahwa saat ini presiden fokus kepada pembenahan dan pembangunan infrastrukur negara, sebagian besar belanja negara dihabiskan untuk sektor fisik meskipun saya sangat berterimakasih bahwa dalam pidato tentang nota keuangan RAPBN 2016, presiden akan menambah porsi anggaran kesehatan.

Namun saya pribadi tetap menginginkan “kehadiran” presiden dalam masalah JKN ini. Minimal statement dari pemimpin yang berarti adalah “titah” tentang keberlangsungan program JKN ini. Saya miris dan sedih mendengar selentingan kabar burung bahwa kondisi seperti ini memang “sengaja” diciptakan untuk mengesankan bahwa BPJS Kesehatan GAGAL dalam menjalankan program ini sehingga ada sebuah skenario memindahkan penyelenggara nya. Kalaupun memang presiden ingin merubah nama program, ingin merubah badan penyelenggaranya, bukankah itu hal yang tidak sulit ? JKN dan BPJS Kesehatan ditetapkan dalam UU dan Perpres. Adalah kewenangan presiden untuk mengajukan perubahan (amandemen) terhadap UU kepada legislatif atau jika kondisinya memang memenuhi syarat maka bapak bisa menerbitkan Peraturan Pemerintah Pengganti Undang-Undang (Perpu). Peraturan Presiden tentang pelaksanaan program JKN pun bisa bapak rubah kapan saja karena memang konstitusi negara memberikan kewenangan kepada presiden untuk melakukan hal tersebut.

Mohon maaf beribu maaf….jika saya katakan bahwa KIS ini sampai dengan saat ini masih tidak jelas dan abu-abu. Kami sudah mencoba memahami bahwa kartu peserta BPJS Kesehatan akan diganti dengan kartu KIS, namun sampai detik inipun saya sendiri belum menerima kartu tersebut. Jadi sebenarnya apakah KIS ini ? Rasanya tidak berlebihan jika saya menyebutkan bahwa KIS adalah SEBUAH JANJI YANG TERLUPAKAN atau memang sengaja DILUPAKAN….

Wasalam.

Tri Muhammad Hani
RSUD Bayu Asih Purwakarta
Jl. Veteran No. 39 Kabupaten Purwakarta – Jawa Barat

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