Regulation and Implementation Mismatch: A Critique of Existing Health Law Policies

Abstract

This study critically examines the inconsistencies between regulation and implementation in health law policy in Indonesia, and how these gaps hinder the fulfillment of constitutional rights to health. Although Indonesia has a comprehensive legal framework rooted in Article 28H of the 1945 Constitution and supported by the Health Law and the National Health Insurance (JKN) program the reality of implementation in the field is still far from expectations. This study uses a qualitative approach with empirical legal research, combining primary data from interviews and field observations with secondary data in the form of regulatory documents, institutional reports, and academic literature. The results of the study show a clear gap between normative expectations and practice, such as unequal access to services, concentration of medical personnel in urban areas, limited infrastructure, and regulatory fragmentation between central and local governments. Case studies in Surakarta and Boyolali show that local capacity, technology adoption, and institutional coordination greatly influence the effectiveness of implementation. Surakarta has been relatively successful in integrating JKN and utilizing health information systems, while Boyolali still faces major challenges through manual referral systems, limited facilities, and uneven distribution of medical personnel. These findings confirm that effective health policies require not only comprehensive regulations, but also harmonization, institutional synergy, fiscal redistribution, and consistent law enforcement. The novelty of this study lies in its attempt to link normative constitutional principles with practical implementation challenges, thereby offering improvement strategies for realizing fairer, more effective, and sustainable health governance.