This book contains a health insurance model that aims to provide affordable premiums for low-income populations in countries with different levels of development and economy. The model proposes three strategies for developing a large cost-sharing capacity that covers at least 10 million members. The economy of scale boosts businesses constructed with lower prices to obtain many clients. The idea of the model is to say, “Let us focus on a limited number of expensive healthcare services, as the prevalence is usually low and cost sharing should work. The proposed attractive benefits include major surgeries, complicated birth deliveries, and cancer treatment. The services include medical consultations, diagnostic exams and drugs. To make the model more attractive and sustainable, the quality and efficiency of healthcare services and the efficiency of the health insurance administration were added. The model is proposed as a profitable social business that aims to attract investments for the reduction or prevention of the impoverishment of low-income populations due to expensive healthcare services.
Dr. Claude Sekabaraga is a medical doctor and senior public health and health-financing specialist. Over 20 years, he has been a hospital director, director of quality healthcare, director of health services, and director of policy and planning in Rwanda Ministry of Health. He was a senior results-based financing specialist of the World Bank and founder and managing director of Quality & Equity Healthcare and International Doctor Booking (www.internationaldoctorbooking.com).
The book “One Health Insurance” is a work of passion and reason and outlines the vision to provide realistic and effective access to quality healthcare services to low-income populations to prevent impoverishment due to catastrophic healthcare expenses
How to Engage Health Insurances to Provide a Protective Product and Get Profits
One Dollar Health Insurance
The model of “One Dollar Health Insurance” is to offer the lowest possible health insurance premium to those with a low income focusing only on covering a limited number of expensive healthcare risks (strategic purchasing) and the highest financing value of healthcare services. It is a social business model based on the postulation that “I need insurance to rescue me when I’m sick and when my revenue is not able to do so.” This is theoretically the usual concept and objective of all social protection and health insurance schemes, but the reality is different. The classic benefits package of healthcare services includes the “essential package of healthcare services” that requires a high premium that is unaffordable to those with a low income. This is why many types of private health insurance essentially have the employed middle class subsidized by the employer and a high income or rich people. In countries where social security with a health or medical scheme exists (national compulsory pool) or in the case of the United States’ Affordable Care Act, those with a low-income receive cross subsidies from a high income or government tax subsidies. Few countries have social protection systems providing coverage of financial healthcare risks to those with a low income, especially those in informal sectors of the economy.