Inaugural Professorial Address of Prof. Dr. drg. Julita Hendrartini, M.Kes., FISDPH., FISPD. in the Field of Dental Policy, Management, and Financing at FKG UGM
Amid Indonesia’s grand ambitions for national healthcare development, one fundamental issue still escapes serious attention: inequality in dental and oral healthcare services. In her professorial inaugural speech at Universitas Gadjah Mada, Prof. Dr. drg. Julita Hendrartini revealed a striking reality: the expansion of health insurance coverage has not automatically resulted in equitable access to healthcare services. (Tuesday, April 7, 2026)
Throughout a decade of implementing the National Health Insurance system (JKN), the government has indeed succeeded in expanding financial protection coverage. However, behind this achievement lies a paradox: possessing insurance coverage does not necessarily correlate with real access to dental healthcare services.
National data reveal a wide gap between healthcare needs and actual utilization of services. This is not merely a technical service issue, but a reflection of systemic failure.
The Root of the Problem: Structured Inequality
Prof. Julita emphasized that inequality in dental healthcare services is not a singular phenomenon, but rather the result of complex interactions among multiple structural factors:
Unequal Distribution of Dentists
The main issue is not the shortage of dentists, but their distribution. Thousands of dentists graduate every year, yet most remain concentrated in major cities. As a result, more than a quarter of community health centers (puskesmas) in Indonesia do not even have a dentist.
This phenomenon reflects policy failure in regulating incentives and workforce placement strategies. Remote regions remain unattractive due to limited career guarantees, inadequate facilities, and lack of professional development opportunities.
Layered Geographic Barriers
As an archipelagic nation, Indonesia faces serious geographic challenges. Healthcare access is determined not only by the existence of facilities, but also by distance, transportation, and infrastructure.
Communities in remote regions experience “layered inequality”: far from facilities, lacking healthcare workers, and economically disadvantaged.
Financing Schemes Insufficiently Focused on Equity
The financing design within JKN is considered insufficient in promoting equitable healthcare distribution. Imbalanced financial incentives can influence healthcare worker behavior, including decisions regarding treatment types and referrals.
Furthermore, dental services are more frequently utilized by wealthier population groups—strong evidence that the system has not fully prioritized vulnerable communities.
Policies That Are Too Curative
Dental healthcare services remain heavily oriented toward curative rather than preventive approaches. As a consequence, the system becomes reactive and more expensive in the long term.
Preventive interventions such as education and early detection are actually far more effective in reducing disease burdens.
Limitations in Specialist Education
Among dozens of dental faculties in Indonesia, only a small number are capable of producing specialist dentists. As a result, referral services in hospitals remain far from adequate.
Adding More Dentists Is Not the Solution
One of the most critical points in the speech was Prof. Julita’s rejection of the “instant” solution of simply increasing the number of dentists.
According to her, such an approach is overly simplistic and ignores the root causes of the problem. Without reforms in incentives, distribution systems, and policy structures, adding more healthcare personnel will only worsen inequality because they will continue concentrating in the same regions.
The Way Forward: Systemic Reform, Not Patchwork Solutions
The speech did not stop at criticism. Several strategic solutions were proposed through a more structural approach, including: reforming healthcare workforce distribution based on actual regional needs, equity-based incentives for remote regions, performance-based payments encouraging preventive services, strengthening strategic purchasingby BPJS Kesehatan to map regional needs, integrating dental healthcare into primary healthcare systems, utilizing technologies such as tele-dentistry, implementing task shifting to other healthcare workers in areas without dentists, and developing a national dashboard to monitor inequality in real time. Most fundamentally, the proposed paradigm shift moves healthcare from a curative system toward prevention-based justice and equity.
A Reflection of Structural Inequality in Indonesia’s Healthcare System
What Prof. Julita revealed was not merely about dental healthcare. It reflects a broader portrait of Indonesia’s healthcare system: structural inequality. Although revolutionary in expanding coverage, JKN has not fully addressed the dimension of equitable distribution. The system still tends to “follow the market,” where services develop primarily in already advanced regions. Without strong policy intervention, this inequality risks widening further, especially as Indonesia moves toward its vision of Golden Indonesia 2045.
A Momentum for Reform
Healthcare access is not merely about financing—it is about whether the system truly takes sides with justice. Inequality in dental services proves that healthcare development in Indonesia is still not fully inclusive. If an issue that appears relatively “small” remains unresolved, then the challenges across the broader healthcare sector are undoubtedly far greater.
The lingering question is this: after the existence of such scientific studies, will there be sufficient political courage to fundamentally reform Indonesia’s healthcare system? Hopefully.
(Reporter: Andri Wicaksono | Photography: Dody Hendro Wibowo)
