Health Care Microinsurance - Case Studies from Uganda, Tanzania, India and Cambodia

This article reports on a study of four health insurance programmes representing:

• Partner-agent model - Found that clients sought care earlier with reports of improved health, includes preventative care and administrator for the plan;
• Community based model - No prevention and permission from group leader required. Found that doctors could not tell between insured and uninsured patients and there were incentives to over prescribe;
• Full-service model - no incentive to be treated early and cover provided only 24 hours after hospitalisation while reimbursement only partially covers costs;
• Provider model - door to door primary care competed with state and it is becoming a clinic service but incentives work at this level. preventative with enrolment examinations.

The article continues by comparing coverage with premiums and sees that the key is to provide broad coverage at a premium level that the poor are willing to pay coupled with a mechanism to minimise the negative impact of the premium payment while efficiencies are improved. Preliminary conclusions indicate that:

• A separate entity should provide the insurance;
• There should be incentives to obtain and maintain client health;
• The uninsured report a preference for complete coverage;
• There was a poor understanding of risk pooling;
• How clients save for the premiums was important;
• Properly testing these products was advantageous.