Political battle in increasing tobacco tax to support Universal Health Coverage in Indonesia
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Center for Health Economics and Policy Studies University of Indonesia, Indonesia
National Commission on Tobacco Control Indonesia, Indonesia
Center for Indonesia's Strategic Development Initiatives, Indonesia
School of Public Health, University of Indonesia, Indonesia
The National Social Security Council, Indonesia
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A683
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Background and challenges to implementation:
Indonesia has been the champion of smokers and the heaven for cigarette industries. Indonesia has not sign/access FCTC. In 2014, Indonesia implemented the National Health Insurance program, to achieve Universal Health Coverage (UHC) by 2019. The UHC program is built by social health insurance principle. In the last four year, the program faced billions of dollars deficit. The government and the members/people face the increasing needs to finance its UHC. Experience from from other countries, like Phillipines, shows that tobacco tax can support UHC financing. Studies in Indonesia also show that people perception leads to desired result for public health, and revenue gain for the economy. However, policy making for tobacco control and tax is highly political. Indonesia is a country with one of the highest Tobacco Industry Interference Index. In contrast, Indonesia is having pressures from the Congress/Parliament to pass a Tobacco Bill, that protect the tobacco farmers and the cigarette industries.

Intervention or response:
The authors have been studying to understand the political battles in increasing tobacco tax to expand fiscal space to finance the UHC. In-depth interviews and multi-sectoral focus group discussions among policy makers were conducted.

Results and lessons learnt:
Several Ministries and including, Ministry of Health, Ministry of Finance and the National Health Insurance Agency see increasing tobacco tax will benefit public health and the economy. However, the political challenges from the Congress and some Ministries, particularly Ministry of Industry and Ministry of Labour have been blocked the people supports to raise tobacco tax.

Conclusions and key recommendations:
Despite President statement about the important of tobacco control in reducing unnecessary spending among the poor, there is no movement in increasing high tobacco tax in support UHC. The proposed presentation will also include the high smoking prevalence, the rampant of cigarette advertising, and the political battles on tobacco control in Indonesia.