Social Reinsurance: A New Approach to Sustainable Community Health Financing

Traditional sources of health care financing are often inadequate leaving many of the 1.3 billion poor people in low- and middle-income countries without access to the most basic health services. Governments in these countries have tried to reach these excluded populations through public clinics and hospitals. To help pay for these services, governments often use a combination of broad-based general revenues, contributions from the formal labor force, and user fees, similar to the financing mechanisms used by Western industrial countries. However, these mechanisms are not always effective in many developing countries, leaving many of the poor without essential health care or financial protection against the cost of illness.

'Social Reinsurance' details community-based approaches to insuring people against medical risk not based on individual risk rating as in private insurance, but rather using decentralized social insurance based on the average risk. This book shows how the concept of social insurance can be implemented in countries that do not have the capacity to finance or organize large-scale systems. It also details the strategies and public policies that countries can use to mitigate the shortcomings of community-financing plans designed along the lines of micro-insurance. Reinsurance is stressed as a tool for enlarging the risk pool and spreading risks across larger population groups, which no single micro-insurance scheme can do on its own. Social Reinsurance also discusses other measures to strengthen micro-insurance-based community-financing programs.

This volume provides an important review of health-financing policy for rural and informal-sector workers in low- and middle-income countries.