Aceh healthcare cuts draw criticism as politician urges bureaucratic reform

A plan by the Aceh provincial government to restrict access to its regional healthcare scheme has drawn criticism, with a politician saying cost-cutting efforts should focus on bureaucracy rather than public services.

Masady Manggeng.

JAKARTA — Masady Manggeng, a member of the Indonesian Democratic Party of Struggle (PDI-P), questioned the rationale behind limiting the Aceh Health Insurance (JKA) programme, warning the policy risks undermining basic public welfare.

“Why should JKA be the one to give way? Why not seriously evaluate bureaucratic spending?” Masady said.

The criticism comes as authorities cite fiscal constraints as the main reason for tightening access to the healthcare scheme, which has long served as a social safety net in the province.

“If fiscal pressures are real, the government should instead carry out performance-based evaluations and restructure spending,” he said.

“Efficiency must start from the top. Assess performance, measure productivity and adjust spending accordingly.”

He said operational spending, which dominates the Aceh regional budget, offers the largest room for savings. Based on the 2026 budget, such spending accounts for roughly 77% of total expenditure, with personnel costs alone exceeding 4 trillion rupiah.

“With figures like these, it is inappropriate to cut back on essential services such as healthcare,” he added.

Masady said plans to limit eligibility based on income classifications risk diluting the programme’s role as an inclusive safety net.

He also urged Aceh Governor Muzakir Manaf, known as Mualem, not to rely solely on bureaucratic considerations.

“Major decisions like this must side with the people, not just follow administrative formulas,” he said.

He questioned arguments that the scheme should align more closely with Indonesia’s national health insurance system, warning this could undermine Aceh’s special autonomy status.

“If everything must be standardised with the national system, then what is the point of Aceh’s special status?” he said.

Masady called on the government to prioritise healthcare, education and job creation, saying these are the areas where citizens most directly feel the presence of the state.

“People do not need an oversized bureaucracy. They need access to healthcare, proper education and jobs,” he said.

He urged the provincial government to review spending priorities and safeguard the sustainability of the JKA programme through stronger fiscal management and accountability.