MR Microinsurance_2012_03_29.indd - International Labour ...

128 Health insurance
Box 5.3 Mobile technology to connect doctors with rural patients
Based in Hyderabad, India, CARE Foundation is piloting a rural health delivery
and microinsurance scheme that focuses focuses on the provision of outpatient care care in
the village setting. Community members are trained to be village health champions
(VHCs) who provide “health care on the village doorstep”. For routine diagnoses,
VHCs use a hand-held terminal with a built-in clinical decision support system
to provide appropriate medical advice and order prescriptions. In less routine
cases, they liaise with a remote CARE doctor who recommends treatment
through a text message. Final testing of the technology, training of health workers,
and product design are currently being completed.
5.4 Th e way forward
Th is chapter suggests ways in which HMI programmes can become more valuable
to clients and more sustainable over time. Specifi cally, some strategies are
highlighted to respond to market demand, to address supply gaps by improving
product design, delivery, and operations, and to integrate public- and privatesector
eff orts.
5.4.1 Expanding member benefi ts to respond to market demand
Member benefi ts should extend beyond hospitalization. Minor health shocks are
a pressing concern for most low-income households, and meeting this demand
can increase enrolment and stabilize risk pools. Furthermore, enhancing outpatient
benefi ts encourages regular health check-ups, earlier diagnoses, and
timely care for minor illnesses. Th ese changes should reduce overall treatment
costs and lower claims for in-patient care, thus improving the overall viability of
HMI programmes.
HMI programmes must simultaneously educate clients in the benefi ts of
health insurance products and respond to client needs. Currently, lack of understanding
of HMI is a key reason for the low renewal rates of many HMI programmes
– clients often feel that insurance is a wasted purchase if they did not
fall sick during the year. Few programmes have devoted adequate resources to
segment-specifi c market research, education and marketing, limiting understanding
and acceptance of HMI products on the part of clients and even practitioners.
Compounding these issues is the fact that the poor, by defi nition, lack the
capacity to pay. As a result, stimulating demand for HMI will require careful
design of optimum benefi t packages, ideally through a participatory process