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Voluntary Health Insurance (Community Based Insurance (evidence (few good…
Voluntary Health Insurance
Evidence
India, Vietnam, Philippines
Community Based Insurance
provider-based health insurance
government-run, community-involved health insurance
community pre-payment health organizations
evidence
performance
characteristics
enrolment challenges
few good evaluations
mixed evidence
problem
missing middle
middle
informal and self-employed
adverse selection problems
low voluntary take-up
bottom covered
tax-financed schemes
top covered
compulsory insurance
policy solution
Thai-style free entitlement?
compulsory premium insurance for informal?
wait for informal sector to formalise?
(RIGHT) increase demand for informal voluntary-based
why low middle take up?
too poor
not willing to pay
lack of info
low benefits
low probability of getting sick
low risk aversion
SO
solution is to
give premium subsidies
give better information
Vietnam and Phillipines experiments: Do subsidies and more info increase uptake?
affordability main reason for low uptake
conclusion for UHC
despite subsidies and info packages, low uptake
need to subsidise almost fully
China and Rwanda examples
strong positive & negative incentives
Thai easy way