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- W2254236709 abstract "The main insight gained from this study is that community-based health schemes can be helped to function as micro health insurance units (MIUs), which can reduce the exposure of poor population segments, living and working in the informal economy and the rural sector, to health-related financial risk. However, MIUs cannot succeed if they operate as isolated entities. Their efficiency and survival can be greatly improved by pooling the risks of many such schemes. Furthermore, pooling poor schemes only with other poor schemes may not produce the desired positive effects unless such a pool enjoys some measure of corrective deficit financing through subsidies. In the absence of guaranteed deficit financing, reinsurance seems the only viable option. The social reinsurer, introducing risk management technology and information-based risk assessment and control of the flow of funds, can offer to limit the financial responsibility of MIUs (and consequently their members) to the average cost of the benefit package; this benefit package can be designed to meet the level of members' ability to pay. The main advantages that the reinsurer can provide to MIUs are Fnancing of surplus needed to cover worst case outlier situations; Determining the capacity of MIUs to accumulate risk; Reducing year-to-year fluctuations in risk/loss exposure; Insuring against catastrophic loss that can endanger the MIU's very existence; and Providing underwriting and managerial assistance. These services can allow MIUs to better design their benefit package; operate a system to register, analyze, and transfer data on their utilization and cost experience; and improve their social marketing to their catchment population as well as their negotiating capacity vis-a-vis providers of care." @default.
- W2254236709 created "2016-06-24" @default.
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- W2254236709 date "2007-10-18" @default.
- W2254236709 modified "2023-09-26" @default.
- W2254236709 title "Health Insurance for the Poor Through Community Schemes is it Viable" @default.
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