<![CDATA[The National Health Insurance (JKN) program, administered by BPJS Kesehatan, is implemented through cooperation with Community Health Centers (Puskesmas) as Primary Healthcare Facilities. This cooperation is formalized through a Cooperation Agreement, which is normatively intended to ensure the equitable and comprehensive delivery of healthcare services. However, in practice, the PKS between BPJS Kesehatan and Puskesmas demonstrates contractual imbalance, primarily due to the use of standard form contracts unilaterally determined by BPJS Kesehatan. This study aims to analyze the structure and substance of the PKS and to assess its conformity with the principles of justice and proportionality under Indonesian contract law. The research employs an empirical juridical method with a sociological approach, utilizing primary data obtained through interviews and cooperation agreement documents, as well as secondary data derived from statutory regulations and legal literature. The findings reveal that although the PKS satisfies the legal requirements for a valid agreement under Article 1320 of the Indonesian Civil Code, its substantive provisions do not adequately reflect a balanced allocation of rights and obligations between the parties. The dominant position of BPJS Kesehatan in determining contractual clauses, financing mechanisms, and administrative sanctions places Puskesmas in a weaker bargaining position, thereby affecting the implementation of healthcare services. Therefore, a reformulation of the cooperation agreement model is necessary to establish a more equitable, participatory, and sustainable contractual framework that supports the achievement of the objectives of the National Health Insurance (JKN) program.]]>
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