jkn pendekatan segitiga kesehatan

7/24/2019 JKN Pendekatan Segitiga Kesehatan

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NAMA : GALUH PRAMESTI

NIM : 142110101180

KELAS : A

MATKUL : PENGANTAR AKK

ANALISIS JAMINAN KESEHATAN NASIONAL

DENGAN PENDEKATAN SEGITIGA KEBIJAKAN KESEHATAN

A. Segitiga Kebijakan Kesehatan

Kebijaka ke!e"a#a $e%&'aka !e(a)a !e!&a#& &k $e$'e(a%&"i *ak#+%,*ak#+%

'ee#& -i !ek#+% ke!e"a#a a(a% -a'a# $ei(ka#ka k&a)i#a! ke!e"a#a $a!.a%aka#/

Kebijaka ke!e"a#a $eja-i !&a#& .a( 'e#i( -i!ebabka ka%ea !ek#+% ke!e"a#a

$e%&'aka ba(ia 'e#i( 'e%ek++$ia -i be%ba(ai e(a%a ke!e"a#a $e$'&.ai '+!i!i

.a( )ebi" i!#i$ea -iba-i( -e(a $a!a)a" !+!ia) .a( )ai.a ke!e"a#a -a'a#

-i'e(a%&"i +)e" !ej&$)a" ke'&!a .a( #i-ak a-a kai#a.a -e(a 'e)a.aa ke!e"a#a

$i!a): ke$i!kia '+)&!i3 -a kebijaka ke!e"a#a j&(a be%'e(a%&" -a)a$ $e$be%i a%a"a

-a)a$ 'e$i)i"a #ek+)+(i ke!e"a#a/ Di!ebabka 'e#i(.a !&a#& kebijaka ke!e"a#a

!e"i((a -ia((a' 'e%)& &k -i)ak&ka aa)i!a kebijaka .a( be%#&j&a &k

$e$'e%+)e" 'eje)a!a $e(eai a'a -a ba(ai$aa "a!i) outcome3 kebijaka aka

-ia'ai -a 'i%a#i &k $e$b&a# $+-e) kebijaka -i $a!a -e'a -a

$e(i$')e$e#a!ika -e(a )ebi" e*ek#i*/

Ga$ba% 1/ Se(i#i(a Kebijaka Ke!e"a#a

Aa)i!a kebijaka ke!e"a#a !a)a" !a#&.a -a'a# -i)ak&ka -e(a $e((&aka

!e(i#a kebijaka ke!e"a#a/ Se(i#a kebijaka ke!e"a#a $e%&'aka !&a#& 'e-eka#a .a(

!&-a" !a(a# -i!e-e%"aaka &k !&a#& #a#aa "&b&(a .a( k+$')ek!/ Se(i#i(a

kebijaka ii $e((a$ba%ka a-a.a e$'a# *ak#+% .a( !e)&%&".a "a%&! -i'e%#i$ba(ka


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-a)a$ !&a#& kebijaka ke!e"a#a/ E$'a# *ak#+% #e%!eb .ai#& k+#ek! ak#+% '%+!e! -a i!i/

Pa%a 'e)ak& -a'a# -i'e(a%&"i !eba(ai !e+%a( i-i5i-& a#a& !e+%a( a((+#a !&a#&

ke)+$'+k a#a& +%(ai!a!i3 -a)a$ k+#ek! -i$aa $e%eka #i((a) -a beke%ja6 k+#ek!

-i'e(a%&"i +)e" ba.ak *ak#+% !e'e%#i: ke#i-ak,!#abi)a a#a& i-e+)+(i -a)a$ "a) !eja%a" -a

b&-a.a6 !e%#a '%+!e! 'e.&!&a kebijaka 7 ba(ai$aa i!& -a'a# $eja-i !&a#& a(e-a

kebijaka -a ba(ai$aa i!& #e%!eb -a'a# be%"a%(a 7 -i'e(a%&"i +)e" 'e)ak!aa

ke-&-&ka $e%eka -a)a$ !#%&% kek&a#a +%$a -a "a%a'a $e%eka !e-i%i/ Da i!i -a%i

kebijaka $e&j&ka !eba(ia a#a& !e)&%&" ba(ia ii/ Se(i#i(a kebijaka ke!e"a#a -a'a#

be%!i*a# i3 Re#%+!'ek#i* $e)i'i e5a)&a!i -a $+i#+%i( kebijaka3 -a ii3 '%+!'ek#i*

Me$be%i 'e$iki%a !#%a#e(i! a-5+ka!i -a )+bi kebijaka3/

B. Kebijakan KesehatanKebijaka !ea%a !e-e%"aa -a'a# -i-e*ei!ika !eba(ai !&a#& '%+!e! a#a& !e%a(kaia

#i-aka .a( -i#e#a'ka -a -i)ak!aaka a#a& #i-ak -i)ak!aaka +)e" 'e$e%i#a" .a(

$e$'&.ai #&j&a a#a& be%+%ie#a!i 'a-a #&j&a #e%#e#& -e$i ke'e#i(a !e)&%&" %ak.a#/

Me&% UU N+/ 9 #a"& 200 #e#a( Ke!e"a#a -i!ebka ba"a ke!e"a#a a-a)a"

kea-aa !e"a# baik !ea%a *i!ik $e#a) !'%i#&a) $a&'& !+!ia) .a( $e$&(kika !e#ia'

+%a( &k "i-&' '%+-&k#i* !ea%a !+!ia) -a ek++$i!/ O)e" !ebab i#& Kebijaka Ke!e"a#a

-a'a# -i-e*ei!ika !eba(ai '%+!e! #i-aka .a( -i#e#a'ka -a -i)ak!aaka a#a& #i-ak

-i)ak!aaka 'e$e%i#a" .a( $e$'&.ai #&j&a #e%a'ai.a kea-aa !e"a# baik !ea%a

*i!ik $e#a) !'%i#&a) $a&'& !+!ia) .a( $e$&(kika !e)&%&" %ak.a# &k "i-&'

'%+-&k#i* !ea%a !+!ia) -a ek++$i/

C. Kebijakan Jaminan Kesehatan Nasional (JKN)

Kebijaka JKN $e%&'aka !&a#& kebijaka .a( -i#e#a'ka -a -i)ak!aaka +)e"

'e$e%i#a" -e(a #&j&a #e%a'ai.a kea-aa !e"a# !eba(ai$aa -e*ei!i ke!e"a#a -i a#a!

-e(a a!'ek i#e%5e!i 'a-a 'e$bia.aa 'e)a.aa ke!e"a#a k"&!&!.a ja$ia 'e)a.aa

ke!e"a#a/ O)e" !ebab i#& JKN $e%&'aka !a)a" !a#& be#&k Kebijaka Ke!e"a#a/

Seba(ai !&a#& kebijaka ke!e"a#a kebijaka JKN $e$i)iki ka%ak#e%i!#ik !eba(ai

be%ik:

1/ Be%#&j&a &k $ei(ka#ka -e%aja# ke!e"a#a $a!.a%aka# $e)a)&i 'e.e-iaa ja$ia

'e)a.aa ke!e"a#a

2/ Me%&'aka kebijaka .a( be%i!i #i-aka a#a& '+)a #i-aka 'e$e%i#a" -i bi-a(

ke!e"a#a


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/ Me%&'aka kebijaka .a( bea%,bea% -i)ak&ka +)e" 'e$e%i#a" be%!a$a a'a%a#&%.a

#e%a$a +%(ai!a!i 'e)a.aa ke!e"a#a

4/ Be%!i*a# '+!i!#i* -a)a$ a%#i ba"a JKN -i)ak&ka !e$a#a,$a#a &k $e$be%i $a*aa#

ba(i !e)&%&" 'e-&-&k &k $e$'e%+)e" "ak .a( !a$a -a)a$ 'e)a.aa ke!e"a#a

;/ Kebijaka JKN -i-a!a%ka 'a-a 'e%a#&%a a#a& 'e%&-a(,&-a(a .a( be%!i*a#

$e(ika#/

Kebijaka JKN $e%&'aka '%+(%a$ e(a%a .a( be%#&j&a $e$be%ika ke'a!#ia

'e%)i-&(a -a ke!e"a#a ba(i !e)&%&" %ak.a#/ U#&k $e&j&-ka #&j&a #e%!eb

-ibe#&k)a" ba-a 'e.e)e((a%a .a( be%be#&k ba-a "&k&$ be%-a!a%ka '%i!i'

ke(+#+(%+.+(a i%)aba ke#e%b&kaa ke"a#i,"a#ia akabi)i#a! '+%#abi)i#a!

ke'e!e%#aa be%!i*a# ajib -aa a$aa# -a "a!i) 'e(e)+)aa -aa ja$ia ke!e"a#a

!e)&%&".a &k 'e(e$ba(a '%+(%a$ ke!e"a#a -a &k !ebe!a%,be!a% ke'e#i(a

'e!e%#a/

P%+(%a$ JKN $e%&'aka !a)a" !a#& '%+(%a$ -a)a$ Si!#e$ Ja$ia S+!ia) Na!i+a)

.ai#& !eb&a" !i!#e$ Ja$ia S+!ia) .a( -ibe%)ak&ka -i I-+e!ia/ Ja$ia !+!ia) ii a-a)a"

!a)a" !a#& be#&k 'e%)i-&(a !+!ia) .a( -i!e)e((a%aka +)e" e(a%a Re'&b)ik I-+e!ia

(&a $eja$i a%(a e(a%a.a &k $e$e&"i keb&"a "i-&' -a!a% .a( )a.ak/

D. Pendekatan Segitiga Kebijakan Jaminan Kesehatan Nasional1/ Ak#+%

Pe)ak!aa JKN #e%-i%i -a%i 'e$e%i#a" '&!a# -a -ae%a"3 +%(ai!a!i i#e%a!i+a) LSM

a!i+a) -a i#e%a!i+a) ke)+$'+k 'eeka -a ke)+$'+k ke'e#i(a )e$ba(a,

)e$ba(a bi)a#e%a) '%+*e!i -a )ai,)ai/

Pe)ak& a#a& ak#+% -i -a)a$ kebijaka ii -ia#a%a.a .ai#& :

a/ Pe)ak& .a( #e%)iba# -a)a$ 'e.&!&a kebijaka -a *&(!i %e(&)a!i/ A-a be%a(a$

+%(ai!a!i .a( -a'a# -i(a$ba%ka !eba(ai !ek#+% ke!e"a#a/ Pe.&!&a kebijaka

!ek#+% ke!e"a#a -a 'e%a#&%a -i!e)e((a%aka +)e" Ke$e#%ia Ke!e"a#a -i #i(ka#

a!i+a) a#a& 'e$e%i#a" '&!a# -a Dia! Ke!e"a#a -i #i(ka# '%+5i!i -a

kab&'a#e


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!e-i%i3/ Si!#e$ ja$ia ke!e"a#a .a( -ibia.ai +)e" 'e$e%i#a" ba%& -i'e%kea)ka

'a-a 18 !e#e)a" k%i!i! ek++$i/

Pa-a 2008 '%+(%a$ ja$ia ke!e"a#a a!i+a) .a( #e%ak"i% Ja$ke!$a!3

-ib&a# be%#&j&a &k $e.e-iaka ak!e! ke'a-a 'e)a.aa ke!e"a#a &k +%a(

$i!ki -a a(ak $i!ki -e(a $e$beba!ka $e%eka -a%i bia.a,bia.a .a(

-ike)&a%ka !aa# $e((&aka 'e)a.aa ke!e"a#a/

b/ =ak#+% !#%&k#&%a)

Keb&"a bia.a 'e)a.aa ke!e"a#a e-e%&( #e%&! $e(a)a$i keaika

!e"i((a ke$a$'&a -a.a be)i ke!e"a#a $a!.a%aka# e-e%&( $e&%&/ Ha) ii

$e.ebabka jika ja#&" !aki# 'e("a!i)a.a aka "abi! &k bia.a ke!e"a#a -a

#e%a$'a! ke!eja"#e%aa $ii$&$/ U#&k i#&)a" -i'e%)&ka !i!#e$ .a( $eja$i

ke!e"a#a $a!.a%aka# $i!ki 'a-a k"&!&!.a -a !e)&%&" $a!.a%aka# 'a-a &$$.a/

Me)a)&i ja$ia ke!e"a#a $a!.a%aka# ke#e%ba#a!a k"&!&!.a ak!e! -a ke$a$'&a

$e$ba.a% aka -a'a# be%k&%a( !e"i((a !#a#&! ke!e"a#a aka $ei(ka#/

U#&k $eja$i ak!e! 'e-&-&k $i!ki #e%"a-a' 'e)a.aa ke!e"a#a !ejak

#a"& 18 'e$e%i#a" $e)ak!aaka be%ba(ai &'a.a 'e$e)i"a%aa ke!e"a#a

'e-&-&k $i!ki/ K%i!i! $+e#e% .a( #e%ja-i 'a-a #a"& 18 $eja-ika ke!e"a#a

!eba(ai !e!&a#& .a( !a(a# $a"a)/ Ha) ii $e.ebabka a%(a $i!ki $e(a)a$i

ke!&)i#a &k $e(ak!e! ke!e"a#a/ P%+(%a$ Ja%i( Pe(a$a S+!ia) Bi-a(

Ke!e"a#a JPS,BK3 $e%&'aka '%+(%a$ #e%+b+!a -a%i 'e$e%i#a" &k $e+)+(

%ak.a# $i!ki -a%i ke!aki#a/ Pa-a #a"& 200; 'e)a.aa ke!e"a#a ba(i $a!.a%aka#

$i!ki -i!e)e((a%aka -a)a$ $ekai!$e a!&%a!i ke!e"a#a .a( -ikea) -e(a

P%+(%a$ A!&%a!i Ke!e"a#a ba(i Ma!.a%aka# Mi!ki A!ke!ki3/ A#a! 'e%#i$ba(a

'e(e-a)ia bia.a ke!e"a#a 'ei(ka#a $& #%a!'a%a!i -a akabi)i#a!

-i)ak&ka 'e%&ba"a $ekai!$e 'a-a #a"& 2008 .a( -ikea) -e(a Ja$ia

Ke!e"a#a Ma!.a%aka# Ja$ke!$a!3/

/ =ak#+% b&-a.a

-/ =ak#+% i#e%a!i+a) S#a#&! ke!e"a#a 'e-&-&k I-+e!ia -a 'e%ba-i(a.a -e(a e(a%a )ai/

La'+%a >+%)- Hea)#" O%(ai?a#i+ >HO3 #a"& 200; $e&j&kka ba"a

a(ka ke$a#ia ba.i -i I-+e!ia $a!i" 49 'e% 1/000 ke)a"i%a "i-&' !e$e#a%a -i

M&a(#ai 2 =i)i'ia 9 S%i)aka 18 -a Ma)a.!ia 11 'e% 1/000 ke)a"i%a "i-&'/

K+%e)a!i !#a#&! ke!e"a#a -e(a kie%ja !i!#e$ ke!e"a#a k"&!&!.a 'e-aaa

ke!e"a#a/ A((a%a ke!e"a#a !e"a%&!.a $ii$a) ; 'e%!e -a%i APBN/

Seki#a% 10@ %&$a" #a((a #e%$i!ki "a%&! $e("abi!ka 20@ 'e("a!i)a.a

!eb&)a &k $e$bia.ai !eka)i %aa# ia' a((+#a ke)&a%(a.a/ Se$e#a%a


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ke)&a%(a 10@ #e%ka.a "a.a $e("abi!ka 120@ 'e("a!i)a ke)&a%(a !eb&)a

&k $e$bia.ai !a#& ka)i %aa# ia' a((+#a ke)&a%(a.a/ Akiba#.a ak!e!

#e%"a-a' 'e)a.aa %&$a" !aki# $eja-i !a(a# #i-ak a-i) ka%ea 'e-&-&k $i!ki

#i-ak $a$'& $e$bia.ai 'e%aa#a/

Seki#a% 8@ %&$a" #a((a $e(a)a$i 'e$ba.a%a ka#a!#%+'ik ke#ika !a#& a((+#a

%&$a" #a((a $e$b&"ka %aa# ia'/ A%#i.a !eb&a" %&$a" #a((a aka ja#&"

$i!ki !a-iki !aki# !e-iki# ja-i $i!ki3 ka%ea "a%&! be%"a( a#a& $ej&a)

"a%#a be-a &k bia.a be%+ba# -i RS ba"ka -i %&$a" !aki# '&b)ik/

/ P%+!e!

a/ I-e#i*ika!i $a!a)a" -a i!&

Si!#e$ Ke!e"a#a I-+e!ia "a%&! $e$i"ak %ak.a#/ Saa# ii !i!#e$ 'e$ba.a%a

ja!a 'e% 'e)a.aa fee for service3 .a( -i#e%a'ka I-+e!ia $e!ki'& 'e)a.aa

#e%!eb -i!e-iaka -i RS '&b)ik/ Rak.a# .a( $e$ba.a% )ebi" ba.ak $e-a'a#

'e)a.aa .a( )ebi" ba.ak a#a& )ebi" baik $&.a you get what you pay for/

Pa-a"a) -i !e)&%&" -&ia '%i!i' kea-i)a .a( $e%a#a !e#a%a3 a#a& e&i#. .a(

-i(&aka a-a)a" e&i#. e(a)i#a%ia .a( 'a-a '%i!i'.a $eja$i ba"a !e#ia'

'e-&-&k $e-a'a# 'e)a.aa !e!&ai -e(a keb&"a $e-i!.a you get what you

need3 -a b&ka !e!&ai ke$a$'&a.a $e$ba.a%/

b/ Pe%&$&!a kebijaka

Ke)&a%.a TAP MPR RI N+/


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#e%ak"i% 14 Ja&a%i 2004 #e%-i%i -a%i 12 -&a be)a!3 bab -a C4 #&j&" '&)&" e$'a#3

'a!a) .a( -i!e%a"ka +)e" Ti$ SJSN ke'a-a Pe$e%i#a" !e#e)a" $e(a)a$i ;2

)i$a '&)&" -&a3 ka)i 'e%&ba"a -a 'e.e$'&%aa/

Ke$&-ia Pe$e%i#a" $e.e%a"ka RUU SJSN .a( #e%-i%i -a%i 12 -&a be)a!3

bab -a 80 -e)a'a '&)&"3 'a!a) ke'a-a DPR RI 'a-a #a((a) 29 Ja&a%i 2004/

Se)a$a 'e$ba"a!a Pe$e%i#a" -e(a Pa!&! RUU SJSN DPR RI RUU SJSN

"i((a -i#e%bi#ka.a UU SJSN #e)a" $e(a)a$i #i(a3 ka)i 'e%&ba"a/ Se"i((a

-a)a$ 'e%ja)aa.a k+!e' RUU SJSN "i((a -i#e%bi#ka $eja-i UU SJSN

#e)a" $e(a)a$i 'e%&ba"a -a 'e.e$'&%aa !eba.ak ;9 )i$a '&)&" ea$3

ka)i/ UU SJSN #e%!eb !ea%a %e!$i -i#e%bi#ka $eja-i UU N+/ 40 Ta"& 2004

#e#a( SJSN 'a-a #a((a) 1 Ok#+be% Ta"& 2004 #e%-i%i -a%i bab -a ; )i$a

'&)&" #i(a3 'a!a)/

UU N+$+% 40 #a"& 2004 #e#a( SJSN $e((a#ika '%+(%a$,'%+(%a$

ja$ia !+!ia) .a( a-a !ebe)&$.a A!ke! Ja$!+!#ek Ta!'e -a A!ab%i3 .a(

-ii)ai k&%a( be%"a!i) $e$be%ika $a*aa# .a( be%a%#i ke'a-a 'e((&a.a ka%ea

j&$)a" 'e!e%#a.a be)&$ $eak&' !e)&%&" 'e-&-&k j&$)a" i)ai $a*aa# '%+(%a$

k&%a( $e$a-ai -a k&%a( baik.a #a#a ke)+)a $aaje$e '%+(%a$ #e%!eb/

U-a( N+$+% 40 Ta"& 2004 #e#a( Si!#i$ Ja$ia S+!ia) Na!i+a) SJSN3

#e)a" -i#i-ak)aji -e(a -i#e#a'ka.a U-a(, U-a( Re'&b)ik I-+e!iaN+$+% 24 Ta"& 2011 Te#a( Ba-a Pe.e)e((a%a Ja$ia S+!ia) Pe%a#&%a

Pe$e%i#a" Re'&b)ik I-+e!ia N+$+% 101 Ta"& 2012 Te#a( Pee%i$a Ba#&a

I&%a Ja$ia Ke!e"a#a Pe%a#&%a P%e!i-e RI N+$+% 12 Ta"& 201 #e#a(

Ja$ia Ke!e"a#a -a Pe%a#&%a Me#e%i Ke!e"a#a RI N+$+% C1 Ta"& 201 #e#a(

Pe)a.aa Ke!e"a#a 'a-a Ja$ia Ke!e"a#a Na!i+a)/

/ Pe)ak!aaa Kebijaka

-/ E5a)&a!i

4/ I!iBa-a Pe.e)e((a%a Ja$ia S+!ia) Ke!e"a#a .a( !e)aj.a -i!eb BPJS

Ke!e"a#a a-a)a" ba-a "&k&$ .a( -ibe#&k &k $e.e)e((a%aka '%+(%a$ Ja$ia

Ke!e"a#a/ =a!i)i#a! Ke!e"a#a a-a)a" *a!i)i#a! 'e)a.aa ke!e"a#a .a( -i(&aka &k

$e.e)e((a%aka &'a.a 'e)a.aa ke!e"a#a 'e%+%a(a baik '%+$+#i* '%e5e#i* k&%a#i*

$a&'& %e"abi)i#a#i* .a( -i)ak&ka +)e" Pe$e%i#a" Pe$e%i#a" Dae%a" -a


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b/ i&%a ke'e!e%#aa6

/ 'e.e)e((a%a 'e)a.aa ke!e"a#a6

-/ ke-a)i $& -a ke-a)i bia.a6 -a

e/ 'e)a'+%a -a i)i?a#i+ %e5ie

Li$a ;3 e!e!i -a%i JKN .ai#& :

K+!e' JKN $e%&'aka &'a.a $e$b&a# ')a#*+%$ .a( !a$a ba(i 'e(aai e(e%i

'e(aai !a!#a -a 'eke%ja -i !ek#+% i*+%$a) -a)a$ $e("a-a'i %i!ik+ !+ia) ek++$i

-i $a!a -e'a/ U-a(,&-a( SJSN $e(a#&% a(a% !e#ia' 'e-&-&k $e$i)iki ja$ia

"a%i #&a a#a& 'e!i& #e%$a!&k !eak#& $e-e%i#a -i!abi)i#. a#a&'& ja$ia ba(i a")i

a%i! jika !e!e+%a( 'ea%i a*ka" $ei((a) -&ia

Da)a$ k+!e' JKN $e(&ba" !#a#&! ba-a "&k&$ Ba-a Pe.e)e((a%a .a( a-a

!eka%a( PT/ Ta!'e PT/ A!ab%i PT/ A!ke! -a PT/ Ja$!+!#ek $eja-i Ba-a

Pe.e)e((a%a Ja$ia S+!ia) BPJS3 .a( #i-ak be%#&j&a $ea%i )aba &k ka!

Ne(a%a/

JKN $e$a!#ika ba"a -aa .a( #e%k&$'&) -a%i i&%a -a "a!i) 'e(e$ba(a.a

-ike)+)a "a.a &k ke'e#i(a 'e!e%#a/ I&%a ak&$&)a!i i&%a -a "a!i)

'e(e$ba(a.a a-a)a" -aa #i#i'a 'e!e%#a -a b&ka 'ee%i$aa a#a& a!!e# ba-a

'e.e)e((a%a/

JKN $e$a!#ika a(a% 'i"ak +#%ib+% a#a& 'e(i&% a#a& #%i'a%#i#e .ai#& #ea(a ke%ja

$ajika -a 'e$e%i#a"3 $e$i)iki ke-a)i kebijaka #e%#i((i .a( -i&j&-ka -a)a$

be#&k Dea Ja$ia S+!ia) Na!i+a) DJSN3 .a( -iaki)i 2 +%a( !e%ika# 'eke%ja 2

+%a( !e%ika# 'e$be%i 'eke%ja ; +%a( aki) 'e$e%i#a" -a 9 +%a( aki) #+k+"

$a!.a%aka#


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