Social Reassurance - A new approach to sustainable Community Health Financing

Publication proposée par Bruno Galland


This study aims at showing that reinsurance can improve the financial viability of community-financed health scheme. It shows how the idea of social assurance can be made operational in countries without the capacity to finance or organize large scale systems, thus making it possible to improve access to health care for poor people in poor countries.
It provides complete analysis about social reassurance for promoters who are looking for solution to strengthen health insurance scheme.

Executive summary

The book is divided in four parts :

1) The first part deals with the development challenges in health care financing. The study identifies the origins of poor/rich differences in health care financing and key obstacles in extending financial protection trough formal arrangements. It defines origins of social exclusion from formal health care financing and the role and strength of communities in providing social protection against illness.

2) The second part is about Insurance, microinsurance and reassurance. The book provides explanation on principles governing a reinsurance program, and identifies needs of a community based health insurance fund. It explains different mechanisms of reinsurance contract, and among them, how a reinsurance program can work.
It provides a definition of microfinance and brings lessons from microfinance which can be use for microinsurance.
Then, the book provides reflections on the limits of Insurability and proposes a model of microinsurance and reinsurance. It provides solutions to typical challenges of microinsurers.

3) The third part deals with implementation issues. Main information is the following :
Presentation of some experiences in scheme design and implementation and the role of reinsurance in capacity building for microinsurance scheme.
Analysis on the role of central government to further social goals through microinsurance units.
Measures to apply for regulating environnement for microinsurance and reinsurance.
Explanation of the role of subsidies to close the recovery gap.
Highlighting on the role that willingness to pay studies in determining contribution levels for microinsurance.
Definition of the cluster of data required to operate the reinsurance model.

4) The fourth part is a case study of the Philippines. It provides information about epidemiological data on health risks, structuring demand and supply in community health in Philippines insurance, assessment of piloting social reinsurance in the Philippines.