IABC – MAKING IT HAPPEN “Universal Health System: Potential Business Opportunities” Sheraton Hotel, Surabaya (Monday, 6 November 2017) Erin Maree Lloyd Group Head Nursing, Quality and Risk RSDHC
INDEX 1. Ramsay Sime Darby Healthcare Group 2. Economic Trend: Indonesia/ Demographics/ Ease of business 3. Universal Health System 4. Potential Growth of Healthcare Market 5. Potential Services 6. Business Opportunities 1
1. RAMSAY SIME DARBY HEALTH CARE GROUP 3
2. RECENT ECONOMIC TRENDS IN INDONESIA • Indonesian economy struggling to maintain growth since 2012 • (lower commodity prices & slower global growth) • Despite slowdown GDP grown $560 in 2000 to $3,630 in 2014. (Source: http://amcham.or.id/images/amcham_updates/2016/Report%202016%20ES%20final%20sharable.pdf) 5
Indonesia at a glance ✓ Land area: 1,811,570 sq km ✓ Population 258.7 million (2016) ✓ Life expectancy: 72.7 years ✓ Male: 70.1 years & Female: 75.5 years World Bank Ranking : Ease of doing Indonesia ranks 91 out of 190 business countries↑15 places (Source: fact sheet – Australia, http://www.amcham.or.id/fe/5619-policy-package-16-postponed) 6
3. UNIVERSAL HEALTH SYSTEM Major Focus On Universal Health Improving The Health Of The System Nation 9
Universal Health Coverage (WHO) “All people and communities” Stimulate Economic Development Includes: ✓ Promotive ✓ preventive ✓ Curative ✓ Rehabilitative ✓ Palliative (Source: http://www.who.int/health_financing/universal_coverage_definition/en/) 10
Indonesia National Health System • Since 2014: Universal Healthcare Program JKN (Jaminan Kesehatan Nasional) • Deployment : via Healthcare and Social Security Agency BPJS (Badan Penyelenggara Jaminan Social) • I mprove : public access to health services • ( 2016) expanded to 67.6% population • Government → achieve 100% coverage by 2019 ( Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing ) 11
Universal Health Coverage Road Map ( Source: Presentation of Dr. Nafsiah Mboi, Sp.A, MPH, Minister of Health, Republic of Indonesia, title Moving Towards Universal Health Access In Indonesia) 12
4. POTENTIAL GROWTH FOR HEALTHCARE MARKET • Indonesia’s healthcare market is expected to triple from USD 7 billion in 2014 to USD 21 billion in 2019 • Large population & ↑ middle class • Relatively low healthcare market penetration • Under-served healthcare market • LOW hospital bed & doctor ratios (Physicians density 0.2 physicians/1,000 population (2012) • Indo : per capita healthcare expenditure ↑ achieve universal healthcare coverage • Government – ID poor infrastructure & insufficient medical staff ( Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing) & CIA World Factbook July 9, 2017 ) 14
Indonesia’s Government Budget Allocation For Healthcare Has Now Reached 5% Of Overall Spending ( Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing) 15
Supportive Government Policies Boost growth /Indonesia’s pharmaceutical market (largest ASEAN) 1) Govt roadmap: develop pharmaceutical raw materials 2) 10 th policy reform package, allows foreign investors to acquire 100% ownership of pharmaceutical companies 3) Presidential Instruction No.6/2016 instructed related-ministries measures to foster development of new pharmaceutical drugs and medical devices ( Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing ) 16
Medication Challenges , AMCHAM 2016 room for further penetration by US companies Cautions: Constrained by implementing regulations 2014 Halal Law - impact on pharmaceuticals Counterfeiting Medications and patients’ inadequate trust of the industry . Govt adopting measures to contain the spread ( Source: http://healthcareasiamagazine.com/sites/default/files/healthcareasiamagazine/print/HCAJuly2017_12-13.pdf http://amcham.or.id/images/amcham_updates/2016/Report%202016%20ES%20final%20sharable.pdf) 17
5. POTENTIAL SERVICES Basic to Advanced & Preventative and Treatment ❖ Maternal, Newborn & Child Health ❖ Infectious Disease Management • Tuberculosis • Food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever + Vector diseases dengue fever and malaria ❖ Economist (Aug 17) “2020: non communicable disease cardiovascular & diabetes will account 70% of deaths in developing countries” • Treatment of Cardiovascular Diseases (Hypertension, Stroke) • Management of Diabetes • Cancer (Lung) ❖ Ageing Population ❖ Mental Health ❖ World Bank – primary care (GP) front line form of medicine - 90% of problems 2015 Survey 102 developing countries: showed primary health had significant impact: life expectancy & lower infant mortality ( Source: CIA World Factbook July 9, 2017 World Health Organization 2017 Sustainable Development Goals) 19
6. BUSINESS OPPORTUNITIES *Jakarta Post Feb 2017: 2015: 175,000 claims believed to be fraudulent. ✓ BPJS 2017: 1 million [potentially fraudulent] ✓ Governance ✓ System Management ✓ Financing ✓ Service Provision & Access ✓ Service Delivery ✓ Workforce ✓ Consumables (Health Technologies, Medications) ✓ IT/Health Security ( Source: http://www.bpjsketenagakerjaan.go.id/) 22
Future Labour Market Indonesia Education Partnerships *Indo Education Expenditures 3.3% Of GDP (2014) Finding qualified human President: capacity : grow economically focus: • skilled positions • international skills & • middle management jobs professional development • RSD: E Learning U of I Degree : Sarjana Kedokteran & Bachelor of Medical Science (Joint degree) Partner University : The University of Melbourne, Monash University ( Source: http://amcham.or.id/images/amcham_updates/2016/Report%202016%20ES%20final%20sharable.pdf) 23
Electronic Commerce INDONESIAN PRESIDENTIAL REGULATION - NUMBER 74 OF 2017 ON ROADMAP FOR THE NATIONAL ELECTRONIC COMMERCE SYSTEM FOR 2017 • Funding • Taxation • Consumers protection • Education and human resources • Communication infrastructure • Logistics • Cyber security; and • Establishment of Implementing Management for Roadmap for National E- Commerce for 2017 – 2019 • E-Commerce system, start-ups, business development, and logistic acceleration 24
Electronic Apps & Health Care Google is also bringing its data-friendly YouTube Go app - Indonesia. 2016 report co-authored by Google projected that Southeast ASIA Internet economy - grow 6.5-fold to $197 billion by 2025 *Indonesia expected to represent around half, including key categories: e-commerce & ride-hailing ( Source: http://www.amcham.or.id/fe/5626-internet-for-all-Indonesians) 25
Health Care Data Explosion Digital Technology = Health Appts 165,000 Explosion Infor Technology : AI & Robotics provide medicine down to personal level Democratization of Access : AI tools embedded in Android & iOS – individuals access - own basic health information. Public Willingness : care anywhere anytime ( Source: PwC Global 2017 & Journal of Public Health Research 2013 (Technology ) 26
Assist Integration Of Service With Government • • MyHealth Record Patient flow, demand & operation management • Clinical Analaysis of Patient • data Medical training & simulation • • Medical Imaging Clinical Programs: • Prescribing – e prescription o Cancer CareZone: • o CareZone GI Hepatitis Telehealth, Telemedicine & remote delivery of health o CareZone Mental Health solution • Management systems ( Source: Source: Digitial Health Austrade Feb 2016 ) 27
Royal Flying Doctor Service ▪ Waiting room 7.69 million sq. Km ▪ 24-hour aeromedical emergency services ▪ Combined with telehealth consultations, fly-in fly-out GP and Nurse clinics, mobile dental services, patient transfers ….. 28
Cyber Security Consideration ▪ NHS cyber attack ▪ Security standards ▪ Assessment of threats ( Source: PwC Global 2017 ) 29
Australian RSD Services ✓ HICMR ✓ Riskman ✓ Mercury E Credentialing 30
RSDHC Indonesian Success Stories Joint Commission International Accreditation AON Best Employers Award Bintaro (Jan 2017) (Oct 2017)
IN CONCLUSION: “Indonesia's total median age is 28.2 years (2011 estimate). This indicates that one half of the population is older than 28.2 years, while the other half is younger than this number ” ( Source: https://en.wikipedia.org/wiki/Demographics_of_Indonesia ) 31
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