Paper
Brief Technical Report on Swasthyapurna Mutual Health Fund
How can health insurance be provided to the slum dwellers of Pune city?
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Using the case study of Swasthyapurna Mutual Health Fund, this paper explores the evolving health micro insurance scheme in Pune, India. The paper presents important characteristics of the Swasthyapurna scheme:
- Offered by Annapurna Pariwar, Pune, and supported by the French NGO, Inter Aide;
- Targets urban slum dwellers in Pune city;
- Annual premium is Rs.50 per member, if all members of a family join;
- Annual premium is Rs.100, if all family members do not join;
- Up to 80% of the costs of a hospitalization due to most prevalent diseases are covered with a ceiling of Rs.5,000 per year and person.
The scheme is organized in the three levels while a fourth one is being planned:
- Group level;
- Cluster level;
- NGO level: Swasthyapurna staff together with Inter Aide and cluster representatives;
- Federation level as reinsurance (planned).
Using Strengths-Weakness-Opportunities and Threat (SWOT) analysis, the authors make the following recommendations for the scheme:
- Quickly building up a federation of mutual health funds to act as a kind of reinsurance for avoiding a financial collapse;
- Negotiating special offers with mainstream insurance companies;
- Introducing some kind of scholarship or a saving instrument for educational expenditure of clients' households;
- Formalizing premium collections;
- Fixing rules for claim settlements.
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