Abstract:
Today, over 3-10 percent of healthcare costs in Indonesia are ravaged by fraud, waste, and abuse, with an estimated one-third of all these costs frivolously spent in such ways. Not until the mid of 2017, governments realized that there are no optimal efforts to prevent fraud by various stakeholders. In 2018, the Corruption Eradication Commission (KPK) has found that fraud prevention, detection, and resolution could help the governments in dealing with the financial deficit in National Health Insurance program (JKN). As a response to this, the Inspectorate General of the Ministry of Health initiated a collaboration along with KPK, BPJS Health, Health Facilities, and Healthcare Practitioners, and Non-Governmental Organizations (NGOs). It first lays out the justification of the need for collaborative governance, particularly in fraud prevention. Hence, this study examines whether the model of collaborative governance conducted in dealing with a financial deficit promotes shared understandings among stakeholders. Moreover, this study aims to identify the tendencies of collaborative governance model in practical through theoretical-based analysis and semi-structural interviews. This study is conducted through post-positivistic approach and qualitative methods by examining the tendencies of collaboration with two collaborative governance model as analysis tools, which are: (a) the collaborative governance model by Ansell & Gash (2007) and (b) the collaborative governance model by Emerson & Nabatchi (2015). This research found that the absence of policy legal frameworks or clear ground rules has most contribute to the use of these two theories. It then boils down the analysis on existing regulations and guidelines, a government-run fraud prevention scheme, and to what extent this scheme serves the needs of non-government stakeholders to participate in this collaboration. The findings suggest that several factors such as networks connectedness, access to participation, and politicization of the health care system are responsible for incorporating the shared understanding among stakeholders.
