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Social reinsurance. A new approach to sustainable community health financing
  1. Gabriel A Picone

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    Edited by D M Dror, A S Preker. International Labour Office, and World Bank, 2002, pp 518, US$50 (paperback). ISBN 92-2-112711-7

    Financing the health care needs of rural and informal sector workers in low and middle income countries has always been a great challenge for policy makers in these countries. Because of government and market failures, traditional methods of financing health care do not work well and 1.3 billion poor people must rely on out of pocket expenditures to pay for the little health care that they receive.

    This book looks into community based microinsurance schemes to overcome the problems of financing health care for informal workers in these countries. Their central idea is to enhance existing community institutions to organise access to basic health care for the at risk populations along the lines of microinsurance. Because each of these institutions will only cover a small group of people, the authors emphasise the importance of reinsurance to enlarge the risk pool and spread the risks across populations. The role of the government is to subsidise and regulate these microinsurance schemes.

    The volume is a compilation of 22 articles by different authors and it comprehensively covers all of the issues related to community based microinsurance schemes in low and middle income countries. The volume is divided into four parts. The first part is devoted to the challenges facing microinsurance schemes in these countries, the second part analyses the theory behind insurance, microinsurance, and reinsurance, the third part is devoted to issues related to the implementation of community based microinsurance mechanisms, and the fourth part describes a pilot programme in the Philippines.

    In summary, this volume is a very valuable contribution to the discussion regarding access to health care and financing in poor and middle income countries. I highly recommend this book to any reader interested in health financing policies in developing countries.