General Background

Indonesia:

The Dutch East Indies were the previous name for Indonesia (or Netherlands East Indies).

Although Indonesia did not become the country's official name until independence, a German

geographer first used the term in 1884, and it is assumed to stem from the Greek words indos,

which means "India," and nesos, which means "island." In 1945, Indonesia proclaimed

independence from the Netherlands after a period of Japanese occupation (1942–45) during

World War II. Its independence fight, on the other hand, lasted until 1949, when the Dutch

officially acknowledged Indonesian sovereignty. The country took on its current shape in

1969, when the United Nations (UN) recognised the western portion of New Guinea as part

of Indonesia. In 1976, Indonesia absorbed the former Portuguese colony of East Timor

(Timor-Leste). East Timor, on the other hand, proclaimed independence and became fully

autonomous in 2002, following a UN-sponsored referendum in 1999.(James, 2021).

The Indonesian archipelago is one of the world's most peculiar places: it comprises a major

tectonic plate junction, spans two faunal kingdoms, and has acted as a nexus for people and

civilizations from Oceania and mainland Asia for millennia. These characteristics have

resulted in an environment and civilization that are often only linked by their vulnerability to

seismic and volcanic activity, closeness to the sea, and a humid, tropical climate. Despite this,

Indonesia has a sense of oneness because to a centralised government and a similar language.

In addition, the country participates in various international trade and security organisations,

including ASEAN, OPEC, and the UN, in line with its status as an economic and cultural

crossroads.

Indonesia is split into 30 propinsi, or provinces, plus the two daerah istimewa (special

districts) of Yogyakarta in central Java and Aceh in northern Sumatra, as well as the daerah
khusus ibukota (special capital district) of Jakarta Raya. On smaller islands, most

administrative areas were developed to match with traditional regions, whose boundaries

were generally dictated by natural physical characteristics; on bigger islands, administrative

boundaries were built to simplify complicated traditional and cultural divides. For example,

the province of Central Java (Jawa Tengah) encompasses not just the island of Java's centre,

but also the heart of Javanese culture. The semiautonomous special district of Yogyakarta and

the city of Surakarta (Solo), both ancient court centres with traditional rulers, are also located

within the province's limits (albeit without real political power). Similarly, in the western

portion of the island, the provinces of West Java (Jawa Barat) and Banten correspond to the

Sundanese people's physical, cultural, and linguistic landscape. Since the turn of the century,

the number of first-order political units has fluctuated. East Timor became independent in

1999 after being designated as a province in 1976. In addition, numerous new provinces were

established out of the old structure, mostly as a result of the movement to decentralise in the

early twenty-first century. The western point of West Java was divided into the province of

Banten (2000). The western end of Papua became West Papua (Papua Barat; 2006). East

Kalimantan was divided into North Kalimantan (Kalimantan Utara; 2012). Gorontalo (2000;

government created in 2001) on the northern peninsula and West Sulawesi (Sulawesi Barat;

2004) on the island's west-central coastal area were both new provinces in Celebes. The Riau

Islands (Kepulauan Riau; 2002; government in place since 2004) and Bangka Belitung (2000;

government in place since 2001) were formed from islands off Sumatra's eastern coast. The

country's volatile political past has shaped Indonesia's political process. In 1955, the first

election following independence was conducted. There were about 170 political groups and

factions competing, with four major parties receiving the majority of the votes. The election

went off without a hitch, but the subsequent administration was troubled by unanticipated

political issues. In 1959, Sukarno—first Indonesia's national figure and president—dissolved

the elected parliament, instituted the notion of Guided Democracy, and reinstated the 1945

constitution. The establishment of several ministries, the rise to political dominance of the

Indonesian Communist Party (Partai Komunis Indonesia; PKI), and the development of the

army as a key anticommunist political force highlighted the time of Guided Democracy. An

attempted coup d'état in 1965 brought the structure to a halt, resulting in Sukarno's demise.

Indonesia launched a new political period, officially known as the New Order, under Suharto,

Sukarno's successor.

International Association/Regional Block

In recent years, the Europe relationship with Indonesia has become stronger. Negotiations for

an Europe-Indonesia free trade agreement began on July 18, 2016, following successful

exploratory meetings in April 2016 to further enhance Europe-Indonesia trade and investment

cooperation. So, date nine complete rounds have been held. The Partnership and Cooperation

Agreement Document defines the entire relationship between the EU and Indonesia, and a

Free Trade Agreement (FTA) will develop a crucial component of that relationship. The

agreement becomes effective on May 1, 2014. Since 1995, Indonesia has been a member of

the World Trade Organization (WTO), and it benefits from trade privileges provided by the

EU's Generalized Scheme of Preferences (GSP), which allows around 30% of total imports

from Indonesia to be duty-free. The EC Cooperation Agreement with the Association of

Southeast Asian Nations (ASEAN), which was formalized in 1980, has structured ties for

many years. Economic and political conversations have been undertaken on this premise on a

regular basis. Senior Official Meetings between the EU and Indonesia have included periodic

discussions of political, economic, and cooperation concerns. On November 9, 2009, a

Framework Agreement on Comprehensive Partnership and Cooperation was signed, and it

went into effect on May 1, 2014. The agreement lays the groundwork for frequent political

communication and sectoral collaboration, as well as elevating bilateral ties. The Agreement
establishes a legal framework for engagement and cooperation in a variety of policy areas,

including human rights, political debate, and commerce. Negotiations for an Europe-

Indonesia Free Trade Agreement (FTA) began on July 18, 2016, following successful

exploratory discussions to further enhance Europe-Indonesia trade and investment

cooperation. The goal is to reach an agreement on a free trade agreement that facilitates trade

and investments while also addressing a wide range of issues such as tariffs, non-tariff trade

barriers, trade in services and investment, trade aspects of public procurement, competition

rules, intellectual property rights, and sustainable development. In 2018, a Sustainability

Impact Assessment (SIA) was initiated in support of Europe-Indonesia FTA discussions. The

SIA aims to determine how the proposed FTA's trade and trade-related measures could affect

economic, social, human rights, and environmental factors in each trading partner and other

relevant nations. Indonesia is one of the ten ASEAN nations, with the largest economy in the

area (35 percent GDP) and the EU's fifth largest commercial partner in the region. It's also

one of Southeast Asia's fastest-growing economies (average GDP growth of approximately 6

percent in the past 10 years).

The ASEAN area is a vibrant market with 640 million consumers and the world's sixth

largest economy. After the United States and China, these countries constitute the Europe

third largest trading partner outside of Europe. Indonesia is the largest market in ASEAN,

with a population of more than 264 million people. A priority for the Europe is to improve

access for EU exporters to the vibrant ASEAN market. Negotiations between the Europe and

ASEAN for a region-to-region trade and investment pact began in 2007 and were suspended

by mutual agreement in 2009 to make room for a bilateral format of negotiations. These

bilateral trade and investment agreements were envisioned as steppingstones to a future

regional accord. After Singapore (2010), Malaysia (2010), Vietnam (2012), Thailand (2013),

and the Philippines (2013), Indonesia is the sixth country in the region to begin bilateral FTA
talks with the Europe (2015). So far, the Europe has completed bilateral negotiations with

two of them: Singapore (2014) and Vietnam (2015). (2015). Bilateral Free Trade Agreements

between the Europe and ASEAN countries will act as steppingstones to a future Europe-

ASEAN deal, which is the Europe ultimate goal (Commision, 2021).

Singapore:

Singapore is a city-state on the Malay Peninsula's southern tip, roughly 85 miles (137

kilometres) north of the Equator. It is made up of the diamond-shaped Singapore Island and

around 60 minor islets; the main island takes up all but roughly 18 square miles of the total

area. Johor Strait, a small waterway traversed by a road and rail causeway more than half a

mile long, separates the main island from Peninsular Malaysia to the north. The state's

southern boundaries span via Singapore Strait, where outliers of Indonesia's Riau-Lingga

Archipelago reach to within 10 miles of the main island. Singapore is one of the busiest ports

in the world and is the largest port in Southeast Asia. Its expansion and wealth are due to its

strategic location at the southernmost tip of the Malay Peninsula, where it commands the

Strait of Malacca, which links the Indian and South China Seas. Singapore, a former British

colony that is now a Commonwealth member, joined the Federation of Malaysia in 1963

when it was formed, but seceded on August 9, 1965 to become an independent state.

Since 1960, Singapore, one of the British empire's key commercial ports, has witnessed

unprecedented economic expansion and diversity. It has established strong financial and

industrial sectors in addition to strengthening its position as a global trading hub. Singapore's

economy is the most advanced in Southeast Asia, and it is frequently discussed with other

fast industrializing Asian countries such as South Korea and Taiwan. Singapore's economy

has never been largely based on the manufacture and export of commodities, as have the

economies of the other Southeast Asian countries. Singapore's economic development has
been strictly monitored by the government, and it has been heavily reliant on foreign

multinational firms for investment money. The government owns around three-quarters of all

land and is the primary source of surplus capital, which comes mostly through payments to

the CPF social-security savings programmed. In addition, in order to attract investment and

raise export competitiveness, the government has endeavored to increase the value and

productivity of labor. This has been followed by a strong commitment to health and

education. Labor shortages and rising salaries have fueled calls for the economy to be

restructured even further toward higher-value-added industry. The case for strong

government involvement in economic growth has become less compelling. Market forces,

privatization of government enterprises, and increased backing for domestic private

entrepreneurs are all part of official policy. As centralized union organizations have been

supplanted by smaller industry- and enterprise-based unions, union membership has dropped

(Kennard, 2022). Local labor-management talks have become more important. Singapore has

been able to highlight its comparative advantage in knowledge-intensive businesses that are

less reliant on foreign investment, such as communications and information and financial

services. Schemes that grant investment credits and allowances stimulate higher productivity

and research and development. Investing local capital overseas while also exporting

managerial skills has shown to be a successful economic approach. Singapore has been

looking for qualified workers, mainly Chinese from the US and China (notably Hong Kong).

Singapore's economy is becoming increasingly reliant on tourism. Massive developments in

hotels and retail malls have complemented Singapore's strategic location in Southeast Asia

and superb air-transport infrastructure. Among the main attractions are duty-free shopping

and a range of leisure activities, as well as a restored beachfront. Singapore's financial

services are sophisticated and offered by a diverse range of institutions. A burgeoning venture

capital sector provides seed cash to companies developing or introducing innovative

technology. Except for currency issuance, the Singapore government's Monetary Authority

conducts all of the tasks of a central bank. The Asian Dollar Market, which is basically an

international money and capital market where currencies other than the Singapore dollar are

exchanged, has been a focal point of Singapore's emergence as an international financial

centre. In terms of assets, Singapore's Development Bank is the country's largest bank.

Singapore's Stock Exchange is a vital part of the region's financial landscape.

Singapore continues to serve as a financial middleman, transporting raw resources such as

rubber, wood, and spices from Southeast Asia in exchange for completed goods from both

inside and outside the area. Machines and transport equipment, as well as crude petroleum,

are key imports, whereas machinery and refined petroleum products are major exports.

Singapore's major commercial partners include China, the United States, Indonesia,

Malaysia, and Japan. About one-third of Singapore's export commerce is made up of entrepôt

operations, in which commodities are transhipped and occasionally processed or

manufactured in the nearby vicinity. The oil-refining business has been particularly notable in

this regard. Singapore has become a joint-venture partner in a number of projects with

Malaysia and Indonesia in order to promote more commerce. In this regard, investments in

the neighbouring Indonesian island of Batam have been critical. Singapore is a Westminster-

inspired unitary parliamentary democracy. The president is the head of state; until 1991, the

primarily ceremonial position of president was filled by legislative election, but the

constitution was altered in that year to allow for direct popular election of the president and

the expansion of presidential powers. The unicameral Parliament has 94 members, 84 of

whom are elected and 10 of whom are appointed to five-year terms. The prime minister, who

is also the head of government, and the cabinet are chosen by the parliamentary majority,

who then form the government. A Citizens' Consultative Committee is established in each

constituency to connect local people with the ruling party.

The political and administrative branches of government keep in close contact. The many

ministries and statutory boards make up the administrative framework. These are manned by

public workers who are overseen by the Public Service Commission, which is an independent

body.

International Association/Regional Block

Singapore's broad free trade agreements (FTA) have been credited with hastening the

country's transition to a first-world economy, together with a clear legal system and educated

workforce. Some of the largest combined trade agreements in the ASEAN-China, ASEAN-

India, and ASEAN-Hong Kong trade blocs are among Singapore's 13 bilateral and 11

regional FTAs, which provide Singapore-based businesses with preferential markets, free or

reduced import tariffs, and improved intellectual property regulations. Despite the fact that

regional players have powerful FTA networks, they are not as large as Singapore's. Because

of these reasons, the country will remain the preferred site for companies looking to grow

into Southeast Asia and nearby countries.

On October 19, 2018, the Europe and Singapore inked trade and investment agreements. On

the 13th of February 2019, the European Parliament approved the accords. On November 8,

2019, EU member states ratified the trade pact. On November 21, 2019, it went into effect.

After all Europe Member States have accepted it according to their respective national laws,

the investment protection agreement will enter into force. In 2020, Singapore will be the

Europe 16th largest trade partner in terms of products and its second largest trading partner in

the Association of Southeast Asian Nations (ASEAN). With Singapore, the Europe enjoys a

sizable positive trade balance in both products and services. Singapore is the third largest

Asian investor in the Europe and a popular destination for European investments in Asia

(after Japan and Hong Kong). The bilateral foreign direct investment stock between the
Europe and Singapore reached at €348 billion in 2020, after substantially increasing in the

previous years.

Singapore is one of ASEAN's ten members. It is the Europe largest business partner in

ASEAN, accounting for little less than one-third of Europe-ASEAN goods and services trade

and nearly two-thirds of ASEAN investment. Singapore is home to over 10,000 Europe

enterprises that utilize it as a hub to service the whole South Pacific. ASEAN is the Europe

third largest commercial partner outside of Europe when taken as a whole (after the US and

China). The Europe top aim is to improve access for Europe exporters to the vibrant ASEAN

market. Discussions between the Europe and ASEAN for a region-to-region trade and

investment pact began in 2007 and were suspended by mutual agreement in 2009 to make

room for bilateral negotiations. These bilateral trade and investment agreements were

designed to serve as steppingstones toward a future regional agreement(Singapore - Trade -

European Commission, 2021).

Health Policy and System

Health policy is described as "decisions, policies, and activities done within a society to attain

certain healthcare goals." An explicit health policy, according to the World Health

Organization, may accomplish multiple goals: it creates a future vision, it identifies

objectives and expected duties of various groups, and it develops agreement and informs

people. Global health policies, public health policies, mental health policies, health care

services policies, insurance policies, personal healthcare policies, pharmaceutical policies,

and public health policies such as vaccination policies, tobacco control policies, and

breastfeeding promotion policies are just a few of the many types of health policies. They

might address issues such as healthcare finance and delivery, access to care, care quality, and

health inequalities (Health Policy, 2021).

Human rights are included into many nations' and jurisdictions' healthcare policies.

According to the World Health Organization, every nation in the world is a signatory to at

least one human rights treaty addressing health-related rights, such as the right to health and

other rights relating to health-related situations. Medical care is a human right, according to

the United Nations' Universal Declaration of Human Rights (UDHR):

"Everyone has the right to a standard of living adequate for the health and well-being of

himself and his family, including food, clothing, housing, medical care, and necessary social

services, as well as the right to security in the event of unemployment, illness, disability,

widowhood, old age, or other lack of livelihood in circumstances beyond his control,"

according to Article 25 of the Universal Declaration of Human Rights.

The perceived duty molded by religious beliefs to care for individuals in less fortunate

situations, particularly the sick, influences health policy in various countries and among

diverse faith-based groups. Other governments and non-governmental groups use humanism's

concepts to define their health program claiming the same sense of duty and constitutional

right to health. Amnesty International has focused on health as a human right in recent years,

tackling issues such as limited access to HIV medications and women's sexual and

reproductive rights, as well as vast discrepancies in maternal mortality within and between

nations. The Lancet, the world's premier medical magazine, has applauded the growing

recognition of health as a basic human right. There is still a lot of debate over who should pay

for everyone's medical treatment and when. Government expenditure on healthcare, for

example, is frequently used as a proxy for a government's dedication to its citizens' health. On

the other hand, one school of thought in the United States rejects the idea of taxpayer-funded

health care as incompatible with the (considered no less important) right of the physician's
professional judgement, as well as the related concerns that government involvement in

overseeing the health of its citizens might erode the right to privacy between doctors and

patients. Individual patients' freedom to dispose of their own income is also denied under

national health insurance, according to the argument.

Governments' employment of law to limit competition among private medical insurance

providers against national social insurance programs, such as in Canada's national health

insurance program, is another point of contention in the rights argument. Supporters of

laissez-faire say that this reduces the health system's cost-effectiveness by diverting resources

from the public system to those who can afford private treatment. The question is whether

investor-owned medical insurance firms or health maintenance organizations are more

equipped to work in their customers' best interests than government regulation and

monitoring. Another argument in the United States is that over-regulation of the healthcare

and insurance businesses by the government has effectively put a stop to charitable home

visits by physicians to the poor and elderly.

Singapore Health Policy

Singapore's fast changing economic and social developments have aided in the country's

healthcare growth reaching new heights. The Singapore government commissioned a special

committee on specialization in 1970 to investigate the growth of specialist health care and

postgraduate specialist training. Since then, the expansion of our healthcare industry and the

improvement of medical specializations have been a constant priority. Singapore's health

system has risen to parity with that of other developed countries as a result of this.

Globally, healthcare institutions invest trillions of dollars each year to address the industry's

mounting issues. Epidemiological shifts in mortality rates (from maternal, neonatal, and
infectious illnesses to coronary heart disease and malignancies) and an ageing with longer life

expectancies are among these concerns.

Lifestyle habits, which are mostly the product of technology improvements, have resulted in

people having an increasing number of risks, which has resulted in a rise in the incidence of

many chronic diseases.

In recent years, many chronic illnesses have become more prevalent among young adults.

Such developments will increase the nation's and individual's financial expenditures, and our

existing healthcare may not be sustained if we continue investing in and expand what has

worked successfully for us over the last five decades. 'More of the same' does not seem to be

the answer. Because of the complexities of the healthcare environment, a rise in health care

costs does not automatically imply greater outcomes. What will likely provide superior value

or accomplishment per unit expense in the next years is the primary issue that should be

posed. The future healthcare payment model should be outcome- or worth for a population,

rather than episodic, fee-for-service. The desired outcome or worth should be patient-

centered, with each member of the medical system meeting all of a patient's demands in their

entirety.

The term "stakeholders" in the medical system should be phased out. This word is no longer

in use, although it was once popular when we were constructing and developing our

healthcare system piecemeal. Healthcare organizations and services would be more

appropriately referred to as 'providers' as we evolve towards a patient-centric healthcare

system because they function as providers for a patient's healthcare requirements. The public,

patients, payers (government, employers, or other third-party payers), policymakers, and the

healthcare system should all be referred to as "various stakeholder groups" (the regional
health system and their partners). Healthcare integration, primary care strengthening, and

community-based cooperation are three major areas where we may improve value. In the

following paragraph, these ideas are expanded upon. The goal of healthcare integration is to

provide interfaces that allow each provider in the medical system to meet the requirements of

the patient itself. (10-12) Any system's capacity to properly execute an integration is

contingent on careful preparation and high-level cooperation across suppliers. This

necessitates a completely different strategy than providing world-class specialty care. The

Health Management Unit and Transitional Care department of Eastern Health Alliance are in-

house examples of integrated care. Alliances with the Agency of Integrated Care and Saint

Andrew's Community Hospital to establish home - based care, as well as with Salvation

Army Peacehaven Nursing Facility to established Grace Corner that can provide concentrated

and relatively low rehabilitation programs for patients requiring a longer rehabilitation

period, are some of the ways our local health system is crimping the healthcare channel to

treat patients for Singaporeans residing in the East. Other integration programmes for the

community in the central portion of Singapore include Post Acute Care @ Home (PACH),

Project Care – Advanced Care Planning (ACP), and Virtual Hospital by the National

Healthcare Group, which includes Tan Tock Seng Hospital (How & Fock, 2014).

Problems With Healthcare in Singapore

The healthcare system in Singapore is mainly reliant on institutions. In the past, the most

successful means of addressing healthcare concerns was through institutions. This was

because treating patients with acute illnesses like smallpox and TB required centralized care.

However, the diseases we are now fighting are chronic diseases like diabetic, hypertension,

liver failure, and so on. Institutions are failing to adequately address our chronic health

issues. The lack of significant care choices, manpower challenges, hospital bed shortages, and

high-cost long-term care are all examples of the consequences. In May 2019, the
granddaughter of a deceased lady published an expressive Facebook post accused Changi

General Hospital (CGH) of providing poor palliative care and failing to treat her dying

grandma with the same respect and care as other patients. CGH replied by asserting that the

treatment provided was adequate but admitting that they might have done a better job of

including family members.

i) Alternatives to Long-Term Aging are few

It's no surprise that as we become older, we'll really have to spend much more time on

healthcare. The facilities, whether they be clinics or hospitals, are usually the primary

point of contact for healthcare. Patients' options for long-term care are also restricted to

institutions such as a local hospital or a care home. Even so, prices and the poor

conditions in these facilities would be a concern. How many of us want to spend our

senior years in a sterilized hospital or retirement home?

ii) Hospitals have long lines and long wait times

We quickly think of going to the A&E (Accident and Emergency) Unit when we see that

our loved one's health is worsening at an ungodly hour. There's a risk thing won't go as

planned, and you'll have to wait for a doctor's appointment and then for a hospital room.

Worst of all, when all the waiting might have been avoided. According to studies, many

visit the A&E department with mild ailments that might have been handled at home by a

GP (General Practitioner)(Jaga, 2021).

Indonesia Health Policy

In 2019, Indonesia has 2,813 hospitals, with 63.5 percent of them being administered by

private organizations. As per data from Indonesia's Ministry of Health, there have been 2,454

hospitals in the country in 2012, with a capacity of 305,242 rooms, or 0.9 beds per 1,000

people. Most hospitals are located in cities. According to World Bank data from 2012,
Indonesia has 0.2 physicians per 1,000 inhabitants and 1.2 nurses and midwives per 1,000

people. As of 2015, only 20 of Indonesia's 2,454 hospitals were authorized by Joint

Commission International (JCI). In addition, the Ministry of Health of Indonesia lists 9,718

government funded Puskesmas (Health Community Centers) that provide comprehensive

healthcare including immunization to the people at the sub-district level. Traditional as well

as contemporary health techniques are used. The Community Health Centre (Puskesmas) is at

the top of the chart, supported through Health Sub-Centers on the second level, and Village-

Level Integrated Posts on the third level in Indonesia's community health system. In 2010, an

estimated 56 percent of Indonesians had health insurance, mostly state workers, low-income

workers, as well as those with private coverage. Following the adoption of an universal

healthcare system social health care insurance in 2014, the percentage was predicted to reach

100 percent by 2019. The system was anticipated to cover 83 percent of people (223 million

people) by 2020. The goal was to make all hospitalizations in ordinary (class 3) hospital beds

free of charge. In Indonesia, healthcare has typically been divided, with private insurance

available to those who can afford it, universal public coverage for the poorest members of

society, and NGOs operating in specialized areas offering services to people who are not

protected by public or private systems. The government announced Jaminan Kesehatan

Nasional (JKN), a plan to provide universal health care, in January 2014. Spending on

healthcare was predicted to rise by 12% per year to US$46 billion by 2019.

Through JKN, all Indonesians would be covered for a variety of treatments through public

and private health-care providers that have chosen to participate in the system. The officially

worked pay a premium of 5% of their wage, with the employee paying 1% and the employer

paying 4%. Informal laborers and self-employed people pay a monthly surcharge ranging

from 25,500 to 59,500 IDR (£1.34-£3.12). The initiative, however, has already been

criticized for just being overly ambitious, lacking administrative expertise, and failing to
acknowledge the need for improved healthcare facilities in rural regions. According to an

official with the program's administrated institution, the social insurance agency Badan

Penyelenggara Jaminan Sosial Kesehatan (BPJS), JKN surpassed its enrollment target in its

first year (registering 133.4 million members versus a target of 121.6 million) and that,

according to an independent survey, customer satisfaction was 81 percent, JKN awareness

was 95 percent, and complaints were resolved within one and a half years. JKN is intended to

be phased in over time. When the first stages of the programs began in January 2014, it

covered 48 percent of the country's population. The plan had 195 million participants as of

April 2018. (75 percent of the population). In 2019, the full population is projected to be

covered. The BPJS programs has a deficit of almost IDR six trillion in 2016. However, in

only three years, the deficit grew to 32 trillion dollars. As a result, the government has

implemented a policy that raises the monthly access fee by 80 to 100 percent. Some people

perceived the move as a tax on low- and middle-income people.

Problems With Healthcare in Indonesia

Despite being one of the wealthiest countries in South Asia, the Indonesian islands continue

to have severe difficulties with their healthcare systems, making it difficult for natives and

expats to receive the treatment they require.

i) Corruption in Medical

The healthcare system in Indonesia is plagued by significant levels of corruption across

the country's public sector. Doctors' priorities are often determined by the money on offer

rather than the amount of urgency. Even though healthcare is part of a universal system,

there is still a disparity in care between both the affluent and the poor in Indonesia. The

low pay that doctors get in Indonesia contribute to corruption in public healthcare system.

There is almost no corruption in the private healthcare sector, and earnings are often
substantially higher. When residing in Indonesia, it is recommended that foreigners seek

private treatment, but be aware of the increased prices.

ii) Poor quality of public health services

Despite the government's efforts to enhance the quality of public health care, the majority

are still rated poor. Despite their attempts, the lack of quality in Indonesia's healthcare

system has made it among the worst of the South Asia.

Doctors

Even if Indonesian physicians hold medical degrees, this does not necessarily imply that

they are fit to deal with patients or even have the necessary credentials. High levels of

corruption are also a problem in the educational system, where medical school spots can

be purchased: the worse your grades, greater you paid to get into the medical school. The

needed admission qualifications for those studying medicine have been reduced as a

result of this. Furthermore, health colleges do not always adhere to worldwide accrediting

requirements, which reveals why their certificate is not accepted outside of the nation.

Many expatriates from wealthy nations believe doctors have poor professional and

clinical abilities, thus it's crucial to choose your doctor carefully. It's a good idea to start

by asking for suggestions in expat groups.

Facilities

Many of Indonesia's health-care facilities are likewise of poor quality. Only 16 of

Indonesia's 1,800 hospitals are globally certified, and most of them are privately operated.

This means that most of them do not adhere to international health standards. Even
 though 'good' public hospitals may be found in major cities, they often lack the medical

equipment required for some procedures, as well as stable energy and clean water. To

escape these inadequate standards, most expats opt for group practice medical clinics,

which are specifically geared to serve foreigners. These clinics are more costly, as they're

more in line with the standards of other nations' institutions and provide a broader range

of treatments. Because they are used to seeing foreigners come in, you will have a better

chance of locating an English-speaking doctor. Only a few healthcare clinics and

hospitals take credit cards, so bring plenty of cash with you.

Contingency Plan: Comparison of Health Policies in Managing COVID-19 in Singapore

and Indonesia

According to the most recent data, there were 115,967,664 confirmed cases of COVID-19,

with a mortality toll of 2,579,775 persons globally. Because this pandemic poses a global

hazard; health regulations must be developed to create a safety catastrophe mitigation system

to deal with COVID-19. Because health is a deciding factor for social welfare, health policy

may be considered as an essential part of social policy. Apart from South Korea and Taiwan,

Singapore is indeed one of the three nations that has become a reference point for dealing

with COVID-19. Singapore has a smaller territory than Indonesia, but because of the

significant movement of people, products, and services in Singapore, COVID-19 has spread

more widely. Based on this information, Indonesia may learn how Singapore decreased

COVID-19 proliferation and use Singapore as a model for implementing COVID-19 handling

policies. Singapore is now undergoing a severe economic downturn as a result of COVID-

19's impact on industry and transit ports. Singapore is extremely reliant on other countries.

Currently, Singapore's policy stresses public health and safety, as well as the Singaporean

community's economy. Indonesia has been experiencing delays in responding to the COVID-
19 pandemic since the beginning, resulting in the first and second instances on two citizens of

Depok, as declared by President Joko Widodo on March 2, 2019. As a result, Indonesia was

found to be unprepared to handle COVID-19. According to the most recent statistics, there

were 1,373,836 COVID-19 cases in Indonesia, with a total fatality of 37,154 persons.

Indonesia was now in fourth place in Asia with the largest number of positive COVID-19

cases, and second in the world, resulting in a negative reputation and a nightmare for

Indonesians. The Indonesian government is now attempting to contain the epidemic in a

variety of methods, ranging from persuasion through counselling, education on COVID-19,

and mask distribution to harsh steps such as social punishments and fines for breaking health

norms. Indonesian society, which had a low degree of discipline and awareness, was

impacted by social and environmental forces. Indonesian society nowadays is increasingly

concerned with its economic concerns. As a result, while establishing a policy, the

government must also consider the social and environmental factors. The Indonesian

government could take a page from Singapore's book, in which the economic and wellness go

hand - in - hand during pandemics. The rising number of cases and fatalities caused by

COVID-19 in Indonesia's various vital sectors has necessitated the creation of regulatory

requirements that can save Indonesia while also limiting the spread of COVID-19. The

legitimacy of bureaucrats, as evaluated by responsiveness and transparency, aids in the

pandemic's rapid response. Comparing Singapore and Indonesian legislation can serve as a

model for Indonesia in developing regulations that are both accurate and beneficial to

Indonesian society. There were several similarities between the two countries, including their

geographical location and shared Southeast Asia region. Singapore and Indonesia, on the

other hand, have significant contrasts in terms of government, with Singapore having a

parliamentary system and Indonesia having a presidential one. This mismatch leads to a
discrepancy in the measures taken by the government to choose which rule to employ, as well

as several other issues stated in Figure 1 (Andrew, 2022).

Indonesia Singapore

Area 728 km² 1,905 million km²

Population 5.6 million 270,2 million

Gross Domestic Product 364,2 billion USD (2018) 1,042 trillion USD (2018)

State Economic Resources Industry, tourism, financial Minerals, tourism, economy,

services, and the port sector agriculture, animal
husbandry, creative
economy and small and
medium business traders

Figure 1: Singapore and Indonesia: Brief Country Profiles

Source: Center for Strategic & International Studies

Singapore

Singapore was one of the nations judged to have an effective approach for detecting every

incidence of the coronavirus based on past studies. The official website of the Singapore

Ministry of Health provided frequent updates on the progress of each new and healed corona

case. Singapore was also active in educating the public through awareness programs. They

disseminate a lot of information to the public about easy but efficient techniques to stop the

virus from spreading. SINGAPORESingapore has done a fantastic job of planning for this

epidemic. This readiness was bolstered by Singapore's past epidemic experience, strong
health-care standards, a well-connected network of hospitals and health centers throughout

the country, and the prompt creation of a task group to handle with COVID-19. Singapore

has been struck by SARS and MERS epidemics before the Covid 19 pandemic. SARS struck

Singapore in 2003, and the country was devastated. Singapore had gained adequate expertise

in dealing with epidemics as a result of these two outbreaks. The Singaporean government

has responded promptly by constructing an Emergency Hospital and Laboratory under the

Ministry of Health. The Singaporean government was concentrating on improving ICU

capacity in order to expect an increase in COVID-19 patients. The Singaporean government

aggressively connected with the people via social media in a variety of ways. The official

website for informing the number of positive instances, as well as comprehensive data

presentation spanning from diagrams, graphs, visual graphics, and maps of the COVID-19

spread location, was https://co.vid19.sg/singapore/clusters. Singapore is a country with a

strong sense of order. The citizens who broke the rules were severely reprimanded by the

Singaporean government. Citizens who left their houses during the isolation period were

charged with a criminal offence. Foreigners were also subjected to this consequence, with

their right to remain in Singapore being revoked. As a result of the sentence, there was a high

degree of community compliance.

Indonesia

From the start, Indonesia's preparations were behind schedule. Since the first verified case in

China, certain nations, such as Singapore, have taken proactive measures to prepare for

COVID-19 epidemics. Indonesia has continued to open its doors to international visitors,

resulting in a delay in expecting the COVID-19 epidemic from the outset. Previously, when

MERS and SARS invaded Indonesia, the Ministry of Health of the Republic of Indonesia was

solely responsible for the anticipation. At airports and international ports, surveillance was

conducted out. There was also supervision of Indonesian laborer who had recently returned to
the country. When Indonesian and international visitors visited tourist places or travelled,

their body temperatures were always taken, and they were handed a Health Alert Card. The

control of MERS and SARS in Indonesia at the time was well-supervised, as evidenced by

Minister of Health Decree 424 / MENKES / SK / 2003. On April 3, 2003, a decree was

issued stating that SARS is a disease that might produce an outbreak, as well as rules for

dealing with it. This policy served as a solid framework for implementing effective measures

to stop the outbreak from spreading. Given the experience with MERS and SARS outbreaks,

as well as other pandemic illnesses, current health policy should place a greater emphasis on

rapid and well-coordinated monitoring. Indonesia was prepared for a pandemic and knew

what to do in the event of an emergency. From the national level to the district level,

Indonesia has COVID-19 Clustered Units. This unit consists of government officials, BNPB,

TNI, POLRI, and members of the community who are involved in the COVID-19 reaction.

Due to the size of Indonesia's geography, the Ministry of Health of the Republic of Indonesia

is currently unable to be honest in characterizing the number of COVID-19 cases. COVID-19

patients must be tracked with the help of the relevant Local Government, which involves the

smallest level on the neighborhood (RT), and other variables exacerbated the difficulty.

Furthermore, the question of patient privacy and data distribution slows down the Covid-19

monitoring process. 14 Indonesia has an app called Peduli Lindungi, which was created by

the Ministry of Communication and Information Technology to track and monitor places in

the community. Positive instances and the range of coverage of COVID-19 patients can be

notified using the application by identifying each safe region. Although this program has a

strong impact, it has received little public notice. Through this application, the government

plays a vital role in promoting and educating the community. 16 To stop the spread of

COVID-19, Indonesia has employed PSBB, Regional Quarantine, disinfectant spraying, and

mask use. The steps made by Indonesian officials, on the other hand, have yet to have a
deterring impact. In many circumstances, the infringement of the regulation will wind up on a

piece of paper with a stamp duty attached to it and will be repeated. Social consequences, on

the other hand, will have a very positive influence on society, as breaching health standards

may be humiliating and harmful to oneself. COVID-19 HOAX news must be dealt with in

order to stop it from spreading.

Economic Factors Influencing Policy

In terms of economics, these two countries are during a similar crisis. Singapore's dilemma

was exacerbated by the fact that the economy's driving force was the port transit linking

services. This was aggravated by the suspension of many economic activity, resulting in

severe economic slump. Singapore, on the other hand, has been constant in servicing and

sustaining the health of civil society and immigration throughout the economic crisis.

Singapore stimulates five industries through its services, three of which are listed below

(Households, Entrepreneurs and Fresh graduate, and small and medium business traders).

Singapore also provides subsidies for required finances, as well as business support and

financial help. Public Services and Taxes and Credits raised the funding for health, tourism,

and public transit, as well as increasing health worker incentives. Tax payments and tax

subsidies for foreign employees are handled by the tax and credit sector. Singapore's

economy has been in decline. Aside from the costs of a pandemic, the Singapore government

took a risky but sensible decision. This may be seen in the action of Singapore's President,

Halim Yacob, who voluntarily reduced his pay to offer incentives to health professionals and

other public sector personnel, who are on the front lines in dealing with COVID-19. In

Indonesia, the government has attempted to safeguard the community's economy through

economic policies such as Pre-Work Cards, Community Business Fund Assistance, and a

variety of other measures. Existing restrictions, on the other hand, have not generated the best

results, and certain of them may even be harmful to the government. The Pre-Work Card
Program, for example, was not doing well in terms of achieving the core goal. The program's

primary focus was on layoff victims and small and medium-sized business players, who bore

the brunt of the damage. The findings of the BPS verified this, revealing that 66.5 percent of

pre-employment card users are employees, 22.2 percent are jobless, and 11.3 percent are not

in the labor force. 19 The program's goal inaccuracy demonstrated a lack of communication

between the community and government authorities, as well as a low degree of concern and

community compliance. Although they are extremely capable, some community

organizations believe they require the benefits of this program. Others, on either hand, who

were in desperate need, were not able to take advantage of the program. As a result, the

Indonesian government must direct its initiatives on productive sectors such as small and

medium-sized businesses. When Indonesia was confronted by an economic crisis a few years

ago, small and medium enterprises actors were the saviors of the Indonesian economy.

Furthermore, enhanced incentives for health workers, who are on the front lines of the

Covid19 epidemic, are required.

Environmental and Social Factors

Singaporeans used to live in a structured society in which they followed the law. The

discipline of Singapore society did not emerge overnight. Previously, Singaporeans, like

Indonesians, found it difficult to follow the rules. The Singapore government, on the other

hand, has a strong plan and laws in place to ensure that individuals follow the rules. The

following are some of the variables that determine a successful policy:

1) Public legal awareness of certain events does not match that of legal officials;

2) Public behavior patterns, particularly in terms of legal certainty and public order, do not

match that of written legal provisions; and

3) Legal awareness of officials does not match that of written legal provisions.
The Indonesian population still has a poor level of knowledge and discipline when it comes

to following policies. This is due to a burdened feeling caused by the restrictions, even

though the regulations were created for the benefit of everybody. Some members of the

Indonesian communities are still considering the relevant economic issues in order to rescue

themselves. Some of them continued to doubt that the government intended for a brighter

future and a larger society. Several aspects of the Indonesian government's implementation of

a disciplined and law-abiding society can be emulated. Singapore's success may be attributed

to a few reasons, including persistent law enforcement, key technological roles, public

awareness, and life values.

Conclusion

The three factors that contributed to Singapore's success in dealing with Covid-19 were:

1) a responsive and efficient health disaster mitigation system, efficient and affordable

health services, and the use of big data and artificial intelligence in case tracing,

2) government legitimacy, and

3) previous pandemic experience.

Transparency, strong communication between the community and the government,

prioritizing the benefit of the community and the safety of civil society, and developing a

mentality of obedience and awareness of COVID-19 prevention, as well as foster a spirit

of national defense, are all things that Singapore can be emulated for in dealing with

COVID-19.