Micro Health Insurance: The Quest for a Balance between Different Interests of Healthcare Providers, Clients and Insurers

Abstract

The three partners in the equation of health insurance are the clients, the providers of care and the insurers. Each of the stakeholders aims at different objectives: providers of healthcare seek to deliver health services, and each provider focuses on those services that it has capacity to deliver. The objective of insurers is to ensure that expenditure levels will not exceed the income. And the objective of clients is to obtain affordable and good quality services that are relevant in their context, through a process that they consider as fair. In the face of potential conflicts of interest between insurers, providers and clients, micro health insurance units that enjoyed sufficient autonomy to adapt the insurance solution to the specific conditions of the client-group served (mostly organized as community-based mutual schemes) have demonstrated coherent capacity to find a balance between the three sets of interests. This is the unique strength of micro health insurance units in the rapidly changing conditions that prevail in low-income India.

Keywords: Micro health insurance, India, the mutual model