Tuesday, 27 October 2026
MEDAN | INDATANEWS.COM - Medan City Council (DPRD) is preparing a new municipal regulation on the city's healthcare system. The proposed regulation aims to strengthen patient protection, expand universal healthcare coverage through the Universal Health Coverage (UHC) programme, improve working conditions and pay for healthcare workers, and raise the quality of hospital services.
The new regulation has become increasingly important as Medan's healthcare sector continues to evolve. According to the city council, the existing regulation no longer adequately addresses current needs and challenges. The council wants to ensure that the city administration has a stronger legal framework to guarantee all residents appropriate, affordable and non-discriminatory access to healthcare.Afif Abdillah, who initiated the draft regulation on Medan's healthcare system, said more than 50 per cent of its provisions would differ from those in the existing regulation. Following consultations with Indonesia's Ministry of Law and Human Rights, the council was advised to draw up a new regulation rather than simply revise the current one.
"More than 50 per cent of the content will change. We consulted the Ministry of Law and Human Rights and were advised to draft a new regulation based on Law No. 17 of 2023 on Health, rather than revise the existing one," Afif told journalists on Monday, 26 October 2026. He was speaking after reading the initiators' response to the draft healthcare regulation, which had been submitted as a legislative initiative of the city council.The chairman of the NasDem Party faction on Medan City Council explained that evolving policy objectives, changing requirements for healthcare development and substantial amendments to numerous articles were the main reasons for drafting a new regulation. When the city administration implemented the previous regulation, the UHC programme and healthcare cooperation arrangements through Indonesia's Health Social Security Agency, BPJS Kesehatan, had not developed to the extent they have today.
The city council therefore intends not merely to update existing provisions but also to establish clear responsibilities for the city administration, healthcare providers and hospitals in safeguarding the public's rights.According to Afif, current UHC funding does not yet cover every patient need. The Medan city administration has allocated around Rp300 billion for public healthcare. Nevertheless, some medical services and patient requirements remain inadequately covered by the existing funding model.

The city council is therefore proposing provisions that would allow the city administration to finance healthcare services not currently covered by UHC through the municipal budget (APBD), provided this is consistent with the applicable regulations."We want the city administration to allocate funding from the municipal budget so that the public continues to receive protection," Afif said.
In his view, the city administration must ensure that funding constraints do not prevent residents from obtaining the medical care they need. The new regulation is expected to define the relevant safeguards more clearly while strengthening the city administration's responsibility for organising healthcare services.The city council also wants to establish more precise provisions governing the cooperation agreement, or memorandum of understanding (MoU), between the Medan city administration and BPJS Kesehatan. These provisions would cover the rights and obligations of both parties, as well as the service standards they must meet.
Clearer requirements would enable the city administration to monitor the implementation of the partnership against mutually agreed standards. They would also help ensure that residents receive tangible benefits from public funds allocated to support the UHC programme.Afif cited reports that some healthcare workers earn only between Rp800,000 and Rp900,000. The city council considers this situation concerning because healthcare workers bear significant responsibility for treating patients, and their work is directly linked to protecting human life.
In his view, the government and healthcare providers must ensure that the demands of delivering high-quality services are matched by appropriate remuneration. Hospitals are unlikely to maintain service quality over the long term if doctors, nurses and other healthcare staff are not paid fairly."It is impossible to build good healthcare services on the basis of poor pay. Healthcare workers who are responsible for human lives must be paid appropriately. Many nurses are now saying that they no longer want to send their children to nursing school. If this trend continues, we will face a shortage of nurses," he said.
His remarks highlight how low salaries are not only an economic concern for healthcare workers but could also threaten the long-term availability of qualified staff. If nursing becomes less attractive because of inadequate earning opportunities, the healthcare system could struggle to recruit enough nurses in the future.Afif, who also chairs the NasDem Party's regional executive board in Medan, called for healthcare workers' pay to be taken into account when reviewing cooperation agreements between hospitals and BPJS Kesehatan.
The city council also sees a need to address outstanding reimbursement payments owed by BPJS Kesehatan to hospitals. Delays or problems in processing these claims could place financial pressure on healthcare facilities and disrupt the smooth delivery of medical services.Addressing these issues requires consideration of the rights and obligations of all parties involved. Hospitals must maintain service quality and respect their employees' rights. At the same time, funding and reimbursement procedures must operate properly to enable healthcare facilities to fulfil their responsibilities sustainably.
Through the new regulation, the city council hopes to provide the city administration with a clearer legal basis for assessing these issues and enforcing agreed healthcare service requirements.The city council proposes that the Medan city administration reward hospitals that deliver particularly good services, as demonstrated by public feedback and measurable performance criteria. Suggested incentives include tax or fee reductions where permitted by applicable regulations, grants, and financial assistance for facility development and improvements in service quality.
Conversely, the council supports stricter sanctions against hospitals that repeatedly fail to meet service standards despite having received warnings. One proposal is to recommend the withdrawal of their status as UHC service providers, where this is possible under the applicable procedures and within the powers of the relevant authorities."Hospitals that repeatedly fail to meet service standards despite previous warnings should be subject to stricter sanctions. This could include a recommendation to revoke their status as UHC service providers, in accordance with the applicable procedures and the authorities' respective powers," Afif stressed.
The city council believes the city administration needs clear mechanisms for evaluating its partner hospitals. This is particularly important because substantial public funds are being allocated to help residents access healthcare."If a hospital fails to provide adequate services to the public even though the city administration has already paid for UHC, we must have the right to review that partnership," Afif said.
The proposal makes the quality of medical services a key criterion for continuing cooperation between the city administration and hospitals. Through transparent assessments, healthcare facilities would be encouraged to improve their services continuously while fulfilling their obligations to patients.By drafting a new regulation, Medan City Council aims to bring patient protection, healthcare financing, the financial welfare of healthcare workers and hospital accountability together within a single regulatory framework. Further deliberations are expected to produce clear, practical provisions that comply with existing laws and regulations.
The healthcare regulatory reform is therefore intended to go beyond administrative matters and cooperation between institutions. Its central objective is to address the public's need for safe, appropriate, affordable and consistently available healthcare services. (IDNC)REPORTER: Teguh Panjaitan | EDITOR: Fik Sagala
