Micro-Insurance: Extending Health Insurance to the Excluded

The paper proposes a concept for group-based health inurance or 'micro-insurance' and proposes a strategy to implement it.

It explains that micro-insurance is more than just an activity at the level of single communities and that it foresees setting up networks to link multiple small area- and occupation-based units into larger structures:

• "Micro" refers to the level of society where the interaction is located, i.e. smaller than national schemes;
• "Insurance" refers to the economic instrument.

A more accurate descriptor of the proposed concept might perhaps be: voluntary group self-help schemes for social health insurance. These units and networks can enhance:

• The insurance function through a wider pooling of risks;
• Support structures needed for improved governance through training, data banks and research facilities.

The paper concludes with a review of the future of micro-insurance finding that:

• Test and pilot studies suggest that hwlth insurance, adapted to the specific conditions of small groups of people, is possible;
• There are threats from domination of elites, organisation into larger risk pools and co-ordination with government health systems;
• Cohesion and participation bond individuals in the collective goal of risk sharing;
• Micro-insurance units can introduce multiple controls of risk through group interaction/peer monitoring of personal health and as units for targeted health promotion;
• In combination, there is a better bargaining position that empowers the demand side as purchasers of services.