Insurance for All: A Dream Come True

Medical coverage in Africa is very low. Worst still, the underprivileged are excluded even from this very low coverage. For our dream to transform Africa into an island of prosperity to become reality, a number of initiatives such as providing medical coverage for the poor are necessary.

This can be possible through the MC²s, which are actually rural development micro-banks whose mission is to drive the economic growth of the underprivileged, and because the underlying principle of the MC² approach is the pooling together of a community’s material and intellectual resources to promote its welfare. For the purpose of better understanding it is necessary to define micro-insurance and mutual association.

A Mutual Association can be defined as “a not-for-profit-making and non compulsory association of people driven by solidarity and who through their contributions and by their democratic decisions undertake provident funding and mutual help to cover themselves against social risk.” Micro-insurance is a form of insurance requiring very low premiums from subscribers and whose objective is the optimum satisfaction of personal needs.

Principles of A Mutual Association To achieve our objective to provide medical coverage to low and very low income people, we rely on the principle of collecting small amounts from every community member to ensure optimum satisfaction for the individual and the community as a whole. A mutual association is based on the following principles: o Solidarity: “Everybody’s money for everyone’s health.” This saying, which is the underlying principle of mutuality, is clear evidence that healthy members pay for the healthcare of members who fall sick, especially because everybody cannot fall sick at the same time. In African wisdom, this same principle is expressed by the following proverb: “A single hand cannot tie a bundle of wood.” In the area of health insurance this simply implies that in cases where healthcare expenses rise above available financial resources the individual efforts of low income people will not be able to afford the individual appropriate healthcare. o Democracy: We find it unnecessary to discuss the functioning of the MC²s here because we have sufficiently dealt with it in the previous chapters. It suffices at this level to state that MC² AS is a product that aligns with the participatory principle often summed up as one person one vote. o Operating Costs: The mutual association will necessarily function as an arm of the MC² and does not require the extra costs of creating and running a new entity with social services. o Not-for-profit: The MC²’s investment in the healthcare of its members is not a profit-making venture. In fact, the MC² devotes part of its profit to funding the MC²AS account. o Free Membership: Membership is free and open to all MC² members or members of other mutual associations supported directly or indirectly by the micro-banks, the patron or other support institutions. o Welfare: We started on the observation that healthcare is very costly and sometimes extremely costly to low and very low income earners to the extent that when they fall sick they are sometimes compelled to contract loans at usury interest rates, sell their homes, or even pledge their harvest. In many families, children’s education is often jeopardised because the family’s agricultural harvest was pledged for money to pay for healthcare. That’s why the objective of the mutual association is to enable this category of income earners to make affordable contributions and still receive healthcare. We aim at ensuring that even in sickness members do not lose their dignity and honour to unscrupulous people.

Services
Coverage includes to the following: o Mild Diseases: These are diseases that do not pose a threat to the patient’s life, whose treatment is simple and that leave no after-effect if treated in time. They include digestion disorders, headaches, typhoid fever and STDs. o Prophylaxis through major vaccines: BCG, DT-Polio, vaccines against pnomoccocus, whooping cough, haemophilus B, hepatitis B, typhoid fever and meningoccocus meningitis. o Seasonal or Constant Endemies (Conjunctivitis, flu, malaria) o Admissions and minor surgery o Dental Care: Dental Cavity, Odontectomy, Scaling, etc. o Eye Care: Glaucoma, Cataract, o Transportation of patients to advanced medical facilities.
Our analyses of health micro-insurance and conventional health insurance reveal that far from being incompatible, both are complementary. Mutuality is the basis of both types of insurance, the only difference being the amount of the insured’s contribution. Health micro insurance ends where conventional health insurance begins.
For a continent bound to attain a population of 2 billion, there is a need for linkages between health micro-insurance and conventional health insurance to provide patients optimum satisfaction.

Financing MC2 AS
We propose four complementary sources of finance for MC2 AS. 1. A deduction by agreement of a percentage of revenues generated by members’ savings. This type of funding is both sustainable and cannot be affected whenever a member runs into economic difficulty. Besides it does not significantly strain the member’s medical coverage contributions. 2. A deduction by agreement on the guarantee fund of the MC². This allows the mutual association to equitably distribute revenue among its members in keeping with its articles of association. 3. Support from socially responsible entities. The enterprise is the driving force of the economy not only because it generates wealth for the benefit of all stakeholders, but also because it plays a major role by devoting a part of its profit to the welfare of its concentric community. It is from this perspective that we can hope that some entities will likely contribute to health guarantee fund. 4. Subsidies from international partners. For the past two decades, international development cooperation has been contributing significantly to the reduction of poverty within the framework of sustainable development that is beneficial to humanity. A lot of effort has been made, but there is still a long way to go. The OECD estimates that illiteracy, hunger and disease are still the reality of a quarter of the developing world’s population. The MC²AS project effectively aligns with global efforts to improve on the living conditions of rural areas, considering that good health is the basis of all human initiatives.
Easy Access to Services
Ensuring medical coverage for low income earners requires easy access to financial services. That is why it suffices to be a member of an MC² to benefit from MC²AS. Membership in an MC² is charge free and access to healthcare is not subject to a period of observation.
Proximity Coverage
Every MC2 AS will sign partnership agreements with mission and public hospitals located within range of 25km². Such agreements will state that patients bearing insurance tickets or prepaid cards will be given treatment in those health institutions.
Payment Modes
Every MC² will institute two modes of payment: by prepaid card and by insurance ticket both based on the principle of risk sharing. o Prepaid Card: It is an insurance savings scheme that enables the bearer of a card to receive healthcare at partner hospitals. The MC² credits the card on a monthly basis. o Insurance Ticket: The member receives healthcare on the presentation of his or her ticket and the mutual association is in charge of paying the bills by debiting the MC² account amount with the provided for in the contract.

Minimum Savings:
If we consider that the interest rate on savings is 5%, the annual interest will stand at CFAF 7 409 while the amount allocated to the insurance will stand at CFAF 5 927, the total insurance cost will be CFAF 4 650. Therefore, for the scheme to effectively cover the healthcare costs of members, every member must save at least CFAF 300 000.