In Indonesia, the national universal health coverage scheme (Jaminan Kesehatan Nasional [JKN]) has consistently overspent against its budget since it was introduced in 2014. In 2017, a new regulation diverted 37.5% of tobacco tax revenue collected at the district and city level to the central government in order to increase government contributions to the JKN. Through a review of policy documents and interviews and focus group discussions with relevant stakeholders, this article explores the history of the JKN and its relationship to local tobacco taxes. Offering an ex-post assessment of the policy and its implementation, we find it negative on three fronts: funding for local anti-smoking initiatives and services was cut, the procedures for implementing the policy were complex and time-consuming, and it did not contribute as much as anticipated to the JKN. These findings underscore potential pitfalls of politically motivated policy that fails to consider implementation and impact. We recommend that the policy be revoked, and local tobacco tax revenue reallocated to its initial purpose, which includes promoting local smoking prevention programs and health service delivery.

中文翻译：

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资助全民医疗保健的政治：转移地方烟草税以补贴印度尼西亚的国家卫生计划

在印度尼西亚，自 2014 年推出以来，国家全民健康覆盖计划 (Jaminan Kesehatan Nasional [JKN]) 一直超支预算。2017 年，一项新法规挪用了 37.5% 的区和市级烟草税收收入中央政府，以增加政府对 JKN 的贡献。通过对政策文件的审查以及与相关利益相关者的访谈和焦点小组讨论，本文探讨了 JKN 的历史及其与地方烟草税的关系。对该政策及其实施进行事后评估，我们发现它在三个方面是负面的：当地反吸烟倡议和服务的资金被削减，实施该政策的程序复杂且耗时，它对 JKN 的贡献没有预期的那么大。这些调查结果强调了政治动机政策的潜在缺陷，即未能考虑实施和影响。我们建议撤销该政策，并将地方烟草税收重新分配到其最初目的，包括促进地方吸烟预防计划和卫生服务提供。