Pelayanan Kesehatan

Yang Berkeadilan

Rais Reskiawan

Of all the forms of inequality, injustice in health care is the
most shocking and inhumane
Martin Luther King Jr

Pendahuluan
 Konstitusi menetapkan kesehatan merupakan
hak fundamental bagi setiap penduduk dan
negara bertanggung jawab untuk memenuhi hak
hidup sehat bagi seluruh penduduk terutama
bagi masyarakat miskin dan tidak mampu.

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or in access to medical care. furniture or boats” Tobin 1970 .Why equity in health care? “ The social conscience is more offended by severe inequality in nutrition and basic shelter. books. than by the inequality in automobiles.

Equity  Equity adalah keadilan dalam distribusi barang dan pelayanan di dalam masyarakat (Friedman)  Equity dalam kesehatan menunjukkan bahwa idealnya setiap orang memiliki kesempatan yang adil untuk memperoleh kesehatan yang sebaik-baiknya dan tidak dirugikan dalam memperoleh pelayanan kesehatan. .

Prisip Keadilan Keadilan Horizontal Keadilan Vertikal Perlakuan yang sama Perlakuan yang terhadap kondisi yang berbeda terhadap sama kondisi yang berbeda .

Keadilan Horizontal  Sumber daya/pengeluaran yang sama untuk kebutuhan yang sama  Penggunaan/penerimaan yang sama untuk kebutuhan yang sama  Akses yang sama untuk kebutuhan yang sama  Tingkat kesehatan yang sama .

Keadilan vertikal  Perlakuan tidak sama untuk kebutuhan yang berbeda  Based on ability to pay .

Berkeadilan di Pembiayaan Berkeadilan utk mengakses Infrastruktur Berkeadilan utk mengakses tenaga kesehatan Berkeadilan pada Faktor lain yg mempengaruhi .

Berkadilan dalam pembiayaan Penggunaan anggaran PBI Non PBI .

. pooled. and allocated to achieve desired health system objectives such as UHC. Health financing is not only about how much money is expended by the health sector but also about how efficiently and equitably resources are raised.

Berkadilan dalam infrastruktur .

Berkadilan utk mengakses tenaga kesehatan .

Berkeadilan pada Faktor lain yg mempengaruhi .

Schulz & Leith Mullings. & Health: Intersectional Approaches. Edit by Amy J. In Gender. Health Disparities: What do we know? What do we need to know? What should we do?. .Health Status: Major Determinants •Providers •Toxins •Institutions •Safety •Systems Healthcare •Neighborhood •Policies •Racism Environment •Discrimination Social Biology •Occupation Genetics Physical Health Lifestyle Education Choices Beliefs SES Income Wealth H. Jack Geiger. San Francisco. Race. Jossey-Bass. 2006.

p. . Health Disparities: What do we know? What do we need to know? What should we do?. 2006. Race. & Health: Intersectional Approaches. Edit by Amy J. Jossey-Bass. San Francisco. 265.Influence on Excess Mortality: Poor & Minorities Lifestyle 30% Healthcare 10% All others 60% H. In Gender. Schulz & Leith Mullings. Jack Geiger.

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preventive. or universal health coverage (UHC). . while also ensuring that the use of these services does not expose the user to financial hardship. Universal coverage (UC).those who need the services should get them. and  financial-risk protection . curative. is defined as ensuring that all people can use the promotive. rehabilitative and palliative health services they need.  quality of health services is good enough to improve the health of those receiving services.ensuring that the cost of using care does not put people at risk of financial hardship. of sufficient quality to be effective.  This definition of UC embodies three related objectives:  equity in access to health services . not only those who can pay for them.

Penghambat Ekuitas  Politik  Korupsi  Proteksi terhadap faktor yang mempengaruhi kesehatan .

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Focusing on the most disadvantaged groups: This targets the worst off or poorest groups and aims to improve their health through specific measures. 3. 2. This approach can improve the health of those who are worst off. Reducing the social gradient :Tackling the . even if the health gap between rich and poor is unchanged.Approaches and Principles 1. This usually involves target setting to reduce the disparity in health outcomes between the most advantaged and most disadvantaged groups. Narrowing health gaps :This aims to improve the health of those who are poorest or most disadvantaged by raising their health outcomes closer to those who are most advantaged.

Kofi Annan . “It is my aspiration that health will finally be seen not as a blessing to be wished for. but as a human right to be fought for.” Former United Nations Secretary General.

Kofi Annan .” United Nations Secretary General. “It is my aspiration that health will finally be seen not as a blessing to be wished for. but as a human right to be fought for.

37  (2012) ke 0. Koefisien Gini meningkat dari 0.41 (2013) .

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Health Inequalities “Race” – Ethnicity - Socioeconomic Status - Gender .Sexual Orientation .Other Social Healthcare Determinants .

rehabilitation and palliative care. quality health services should be covered including health promotion. Definisi UHC  Universal health coverage (UHC) means that all people receive the health services they need without suffering financial hardship when paying for them. The full spectrum of essential. . prevention and treatment.