IABC – MAKING IT HAPPEN

“Universal Health System: Potential

Business Opportunities”

Sheraton Hotel, Surabaya (Monday, 6 November 2017)

Erin Maree Lloyd

Group Head Nursing, Quality and Risk RSDHC

INDEX

1. Ramsay Sime Darby Healthcare Group

2. Economic Trend: Indonesia/ Demographics/ Ease of business

3. Universal Health System

4. Potential Growth of Healthcare Market

5. Potential Services

6. Business Opportunities

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1. RAMSAY SIME DARBY HEALTH CARE GROUP

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2. RECENT ECONOMIC TRENDS IN INDONESIA

• Indonesian economy struggling to maintain growth since 2012

• (lower commodity prices & slower global growth)

• Despite slowdown GDP grown $560 in 2000 to $3,630 in 2014.

(Source: http://amcham.or.id/images/amcham_updates/2016/Report%202016%20ES%20final%20sharable.pdf) 5

Indonesia at a glance

✓ Land area: 1,811,570 sq km

✓ Population 258.7 million (2016)

✓ Life expectancy: 72.7 years

✓ Male: 70.1 years & Female: 75.5 years

6(Source: fact sheet – Australia, http://www.amcham.or.id/fe/5619-policy-package-16-postponed)

Indonesia ranks 91 out of 190 countries↑15 places

World Bank Ranking : Ease of doing business

3. UNIVERSAL HEALTH SYSTEM

Major Focus On Improving The Health Of The

Nation

Universal Health System

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Universal Health Coverage (WHO)

Includes:

✓ Promotive

✓ preventive

✓ Curative

✓ Rehabilitative

✓ Palliative

Stimulate Economic Development

(Source: http://www.who.int/health_financing/universal_coverage_definition/en/)10

“All people and communities”

(Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing)

• Since 2014: Universal Healthcare Program JKN (Jaminan Kesehatan Nasional)

• Deployment: via Healthcare and Social Security Agency BPJS (Badan Penyelenggara Jaminan Social)

• Improve: public access to health services

• (2016) expanded to 67.6% population

• Government → achieve 100% coverage by 2019

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Indonesia National Health System

(Source: Presentation of Dr. Nafsiah Mboi, Sp.A, MPH, Minister of Health, Republic of Indonesia, title Moving Towards Universal Health Access In Indonesia) 12

Universal Health Coverage Road Map

4. POTENTIAL GROWTH FOR HEALTHCARE MARKET

• Indonesia’s healthcare market is expected to triple from USD 7 billion in 2014 to USD 21 billion in 2019

• Large population & ↑ middle class

• Relatively low healthcare market penetration

• Under-served healthcare market

• LOW hospital bed & doctor ratios (Physicians density 0.2 physicians/1,000 population (2012)

• Indo: per capita healthcare expenditure ↑achieve universal healthcare coverage

• Government – ID poor infrastructure & insufficient medical staff

(Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing) & CIA World Factbook July 9, 2017) 14

Indonesia’s Government Budget Allocation For Healthcare Has Now Reached 5% Of Overall Spending

(Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing)

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Supportive Government Policies

Boost growth /Indonesia’s pharmaceutical market (largest ASEAN)

1) Govt roadmap: develop pharmaceutical raw materials

2) 10th policy reform package, allows foreign investors to acquire 100% ownership of pharmaceutical companies

3) Presidential Instruction No.6/2016 instructed related-ministries measures to foster development of new pharmaceutical drugs and medical devices

(Source: Indonesiahttps://investors-corner.bnpparibas-am.com/investment-themes/indonesia-healthcare-fast-growing)

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Medication Challenges

AMCHAM 2016 room for further penetration by US companies

Cautions:Constrained by implementing regulations 2014 Halal Law -impact on pharmaceuticals

Counterfeiting Medications and patients’ inadequate trust of the industry. Govt adopting measures to contain the spread

(Source: http://healthcareasiamagazine.com/sites/default/files/healthcareasiamagazine/print/HCAJuly2017_12-13.pdf http://amcham.or.id/images/amcham_updates/2016/Report%202016%20ES%20final%20sharable.pdf)

,

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5. POTENTIAL SERVICES

Basic to Advanced & Preventative and Treatment❖ Maternal, Newborn & Child Health

❖ Infectious Disease Management • Tuberculosis • Food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever + Vector

diseases dengue fever and malaria

❖ Economist (Aug 17) “2020: non communicable disease cardiovascular & diabetes will account 70% of deaths in developing countries”

• Treatment of Cardiovascular Diseases (Hypertension, Stroke)• Management of Diabetes• Cancer (Lung)

❖ Ageing Population

❖ Mental Health

❖ World Bank – primary care (GP) front line form of medicine - 90% of problems2015 Survey 102 developing countries: showed primary health had significant impact: life expectancy & lower infant mortality

(Source: CIA World Factbook July 9, 2017 World Health Organization 2017 Sustainable Development Goals)

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6. BUSINESS OPPORTUNITIES

✓ BPJS

✓ Governance

✓ System Management

✓ Financing

✓ Service Provision & Access

✓ Service Delivery

✓ Workforce

✓ Consumables (Health Technologies, Medications)

✓ IT/Health Security

(Source: http://www.bpjsketenagakerjaan.go.id/) 22

*Jakarta Post Feb 2017:2015: 175,000 claims believed to be fraudulent. 2017: 1 million [potentially fraudulent]

Future Labour Market Indonesia Education Partnerships*Indo Education Expenditures 3.3% Of GDP (2014)

Finding qualified human capacity :

• skilled positions • middle management jobs

(Source: http://amcham.or.id/images/amcham_updates/2016/Report%202016%20ES%20final%20sharable.pdf)

U of I Degree : Sarjana Kedokteran & Bachelor ofMedical Science (Joint degree)Partner University : The University of Melbourne, Monash University

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President:grow economically focus:

• international skills & professional development

• RSD: E Learning

Electronic Commerce

INDONESIAN PRESIDENTIAL REGULATION - NUMBER 74 OF 2017 ON

ROADMAP FOR THE NATIONAL ELECTRONIC COMMERCE SYSTEM FOR 2017

• Funding

• Taxation

• Consumers protection

• Education and human resources

• Communication infrastructure

• Logistics

• Cyber security; and

• Establishment of Implementing Management for Roadmap for National E-Commerce for 2017 – 2019

• E-Commerce system, start-ups, business development, and logistic acceleration

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Electronic Apps & Health Care

Google is also bringing its data-friendly YouTube Go app -Indonesia.

2016 report co-authored by Google projected that Southeast ASIA Internet economy - grow 6.5-fold to $197 billion by 2025

*Indonesia expected to represent around half, including key categories: e-commerce & ride-hailing

(Source: http://www.amcham.or.id/fe/5626-internet-for-all-Indonesians)

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Health Care Data Explosion

Explosion Infor Technology : AI & Robotics provide medicine down to personal level

Democratization of Access: AI tools embedded in Android & iOS – individuals access - own basic health information.

Public Willingness : care anywhere anytime

(Source: PwC Global 2017 & Journal of Public Health Research 2013 (Technology) 26

Digital Technology = Health Appts 165,000

Assist Integration Of Service With Government

(Source: Source: Digitial Health Austrade Feb 2016) 27

• MyHealth Record

• Clinical Analaysis of Patient

data

• Medical Imaging

• Prescribing – e prescription

• Telehealth, Telemedicine &

remote delivery of health

solution

• Management systems

• Patient flow, demand &

operation management

• Medical training & simulation

• Clinical Programs:

o Cancer CareZone:

o CareZone GI Hepatitis

o CareZone Mental Health

Royal Flying Doctor Service

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▪ Waiting room 7.69 million sq. Km

▪ 24-hour aeromedical emergency services

▪ Combined with telehealth consultations, fly-in fly-out GP and Nurse clinics, mobile dental services, patient transfers…..

Cyber Security Consideration

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▪ NHS cyber attack

▪ Security standards

▪ Assessment of threats

(Source: PwC Global 2017)

Australian RSD Services

✓ HICMR

✓ Riskman

✓ Mercury E Credentialing

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Joint Commission International Accreditation

Bintaro (Jan 2017)

RSDHC Indonesian Success Stories

AON Best Employers Award

(Oct 2017)

IN CONCLUSION:

(Source: https://en.wikipedia.org/wiki/Demographics_of_Indonesia)

“Indonesia's total median age is 28.2 years (2011 estimate). This indicates that one half of the population is older than 28.2 years,

while the other half is younger than this number”

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