[Subgroup-health] 1st discussion of the CGAP Health sub-group - Mission statement
Iddo Dror
iddo at mia.org.in
Sun Apr 6 06:01:04 CEST 2008
Dear Valerie and all,
Thanks for starting the discussion on this important topic, and for the
draft mission statement document.
I have a couple of suggestions and a few comments to share with the
subgroup:
*_Suggestions for inclusion in the mission statement_* and research
areas to explore with reference to micro health insurance:
*1.* Relevance: The relative importance of health in the hierarchy of
perceived insurance needs (e.g why do the vast majority of the poor rank
health as their top microinsurance need? Is the industry responding to
this adequately? )
*2.* Complexity: Specificities of micro health insurance as opposed to
other risks (e.g. greater information asymmetries and related risks) and
mechanisms available to address these.
A few *_comments on the key questions outlined in the draft mission
statement_*:
*3.* If we wish to have an inclusive debate, we should not have
preconceived conclusions about provision models that are not generally
accepted by all players in the sector (unless we have sufficient
evidence to support it). Therefore, rather than looking at “The
comparative advantages of mutual health organizations and the importance
of the community based aspects”, could we maybe look at different
options of delivering micro health insurance and see what our research
yields on this front? We may indeed find out that mutuals have
comparative advantages for provision of micro health insurance, but let
us take a scientific, rigorous approach to it, get relevant data to test
this assumption, and see what comes out.
*4*. In a similar vein, the issue of subsidies should be approached
without preconceived notions. Therefore, rather than deciding that
subsidies are necessary (what evidence base research do we have to
support this?) let us look at this complex, and highly political issue
carefully and methodically. Most subsidies tend to focus directly on
demand size (e.g. payment of a large part of the premium) or supply side
(e.g. payment of a large portion of supplier’s costs) but there has been
little evidence that either of these offers an optimal use of fund and
delivers most benefit to the poor, and the use of subsidies could also
have adverse effects such as distorting effective microinsurance markets
(e.g. once withdrawn, the clients may have a lower willingness to pay
making the system unsustainable). It could be very interesting to focus
on precisely this issue – the optimal use of subsidies in micro health
insurance - and see what options offer most value, and include in our
discussions elements that often get left out such as reinsurance
(outlier cases) and capacity building measures.
*5*. The design of an essential cost effective benefit package -
Benefit package design is indeed a key issue to look at, and I certainly
support placing this towards the top of the list. I assume that the
singular extends to the plural here – as “an essential cost effective
benefit package “would effectively mean many different packages for many
different groups. I feel there simply can not be a “one size fits all”
approach given the vast differences in the needs and priorities
(economically and socially) of different groups - even within the same
region or country – let alone on different continents. The need for
context specific solutions should be kept in mind in our discussions,
for else we may need to restrict ourselves to very broad level
observations that might not be useful in leading the way for better
action on the ground – which I believe should be an objective of the
research we conduct.
*6.* Finally, while it is good to direct the group to previous published
work (notably from the compendium) that deals with the issue of micro
health insurance, I am surprised that a few other chapters that deal
with the topic directly and explicitly have been omitted, and am listing
these below in case some want to have a look ahead of our discussions
Chapter 2.1 Challenges and strategies to extend health insurance to the
poor
<http://www.munichre-foundation.org/NR/rdonlyres/AF8FD93E-7483-4AE5-B68F-CC17CBF4DF83/0/Part2Microinsuranceproductsandservices.pdf>
* *
*Chapter 4.3 The community-based model: Mutual health organizations in
Africa
<http://www.munichre-foundation.org/NR/rdonlyres/000BDF9A-33A3-4D02-A7F1-2F779DA5ACB4/0/Part4Institutionaloptions.pdf>*
* *
Chapter 4.4 Institutional options for delivering health microinsurance
<http://www.munichre-foundation.org/NR/rdonlyres/000BDF9A-33A3-4D02-A7F1-2F779DA5ACB4/0/Part4Institutionaloptions.pdf>
* *
Best wishes,
Iddo
--
Iddo Dror
Director of Operations
Micro Insurance Academy
D-127, Panchsheel Enclave
New Delhi 110017
India
Tel: +91 11 4174 9101
Fax: +91 11 4174 9102
www.microinsuranceacademy.org
Valérie Schmitt-Diabate wrote:
> **
> Dear members of the CGAP health sub-group,
>
> We, Harrie and I, discussed the best way of starting activities within
> the health subgroup
>
> In order to have some clarity about the role of the sub-group (what do
> we stand for? what is our purpose? what is our strategy?) and to
> facilitate the development of a work plan, we came to the conclusion
> that it was necessary to produce first a *mission statement (including
> a strategy) of the subgroup*.
>
> We have put our ideas on paper ; here is a proposal that we would like
> to share with you (attached document).
> Could you please comment it by the 18th April ? You may send your
> comments by answering to the present e-mail. We will then be able to
> produce a consolidated and revised version of the document.
>
> Once the mission statement has been clearly defined, we will be in a
> position to work on:
> 1. the definition of a clear focus of the subgroup for the next 12
> months (leading to one or more activities).
> 2. the subgroup's contribution to the 2008 microinsurance conference,
> in Cartagena.
>
> Best regards,
>
> Valerie Schmitt Diabaté (ILO / STEP, Geneva)
> & Harrie Oostingh (Oxfam Novib, Netherlands)
>
>
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--
Iddo Dror
Director of Operations
Micro Insurance Academy
D-127, Panchsheel Enclave
New Delhi 110017
India
Tel: +91 11 4174 9101
Fax: +91 11 4174 9102
www.microinsuranceacademy.org
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