* Hospital Economic Squeeze: When Business, Health, and Empathy Pull Each Other Together *
By: Wari Wicatman
In 2026, Indonesian hospitals will be squeezed by three pressures: rising operational costs, stalled BPJS claims, and healthcare workers’ workloads, triggering an empathy crisis.
*The harsh reality.* With more than 270 million BPJS participants, hospitals rely on a claims system that is still largely processed manually. As a result, claims are slow, cash flow is tight, and administrative staff work overtime daily. Meanwhile, INA-CBG rates often fail to cover real costs, especially in complex cases. Hospitals are forced to manage their budgets “carefully”: reduce patented drugs, delay new equipment, and limit procedures.
On the other hand, service costs are rising. Specialist doctor visits in 2026 will reach IDR 400,000–IDR 900,000 per visit. MRIs will cost IDR 3.5–6 million per procedure. Private hospital deposits will be 50%–80% of the estimated cost. Patients have become “cost per case” on a spreadsheet.
*The most affected: humans.* A 2025 study of 3,629 healthcare workers showed that 37.5% experienced burnout syndrome — 44.6% of medical personnel, 38.6% of hospital workers. 48.2% experienced emotional exhaustion, and 51.8% experienced depersonalization. Burnout causes healthcare workers to lose empathy, increasing the risk of medical errors.
*Empathy is lost through small things:* depositing first before acting, rushed communication, a patient’s family yelling at a healthcare worker who has been on duty for 12 hours. Everyone is tired, everyone feels like a victim.
*The solution must be structural, not advisory:*
1. *Revise INA-CBG rates* based on real costs and complex cases.
2. *Accelerate BPJS claims* with 100% real-time SIMRS bridging.
3. *Protect healthcare workers*: humane ratios, timely salaries, psychological support.
4. *Incentives for empathy*: Make healthcare worker ratios and zero violence accreditation KPIs.
Hospitals must be financially healthy. But if profit sacrifices humanity, we’re not saving the business — we’re burying the reason the hospital exists.
The economy can recover. Trust lost because patients feel treated like “claim numbers” is far more expensive to regain.**
Indonesia, April 18, 2026
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