Is Health Microinsurance Sustainable? An Analysis of Five South Asian Schemes

Can health microinsurance (HMI) schemes achieve sustainability? As with many seemingly simple questions, there is no simple answer. The answer to this question is of interest to a variety of parties. Insurance providers seek to understand if there is a viable business case for offering an HMI product. Health-care providers and pharmaceutical companies are interested in whether or not HMI can be a means for broadening coverage. Donors and other funding organizations want to know if HMI is a viable investment as a means to improve health-care access, health outcomes and financial protection for the low-income population. Governments consider how to use HMI schemes as a step towards universal health coverage.

This paper seeks to answer this simple yet crucial question based on the experiences of five schemes in India, Bangladesh and Pakistan. The schemes are run by a range of types of organization: for-profit insurance companies, not-for-profit organizations and intermediaries. One scheme is an example of a public–private partnership between the government and a private insurer. The schemes use subsidies, include both mandatory and voluntary enrolment, and provide comprehensive as well as limited health benefits.