Paper
Brief Technical Report on Swasthyapurna Mutual Health Fund
How can health insurance be provided to the slum dwellers of Pune city?
Download13 pages
Using the case study of Swasthyapurna Mutual Health Fund, this paper explores the evolving health micro insurance scheme in Pune, India. The paper presents important characteristics of the Swasthyapurna scheme:
- Offered by Annapurna Pariwar, Pune, and supported by the French NGO, Inter Aide;
- Targets urban slum dwellers in Pune city;
- Annual premium is Rs.50 per member, if all members of a family join;
- Annual premium is Rs.100, if all family members do not join;
- Up to 80% of the costs of a hospitalization due to most prevalent diseases are covered with a ceiling of Rs.5,000 per year and person.
The scheme is organized in the three levels while a fourth one is being planned:
- Group level;
- Cluster level;
- NGO level: Swasthyapurna staff together with Inter Aide and cluster representatives;
- Federation level as reinsurance (planned).
Using Strengths-Weakness-Opportunities and Threat (SWOT) analysis, the authors make the following recommendations for the scheme:
- Quickly building up a federation of mutual health funds to act as a kind of reinsurance for avoiding a financial collapse;
- Negotiating special offers with mainstream insurance companies;
- Introducing some kind of scholarship or a saving instrument for educational expenditure of clients' households;
- Formalizing premium collections;
- Fixing rules for claim settlements.
About this Publication
Published
