Editor’s Note

Mutuality Maters – September 2014

Dear Readers,

Greetings from People Mutuals !

Risks are prevalent throughout the life and invariably across the globe. The foremost thing in risk management is recognition of the risks and practicing measures for its avoidance, prevention and reduction by self. For instance with respect to health risks, it is appropriate to take measures for good health rather than health insurance cover and benefits. The health insurance would provide financial compensation if the covered health risk arises, but it would not prevent the risk and the consequent loss. Thus it is apt to follow risk mitigation practices before risk financing efforts, which is very lucidly explained in Simon Kadijk’s article – “The future of mutual insurance companies.”

Health care and insurance are two sides of the coin and they coexist. A health insurance contract between the insurer and insured is towards indemnification of health care expenses on account of illness or injury. The existence of an universal health care system for all the citizens of a country that ensures health care for any health risk is a reality in countries like The Netherlands is indeed a eye opener for many developing countries. Such a good, universal Dutch health care system is well covered in the article by Jennifer Op’t Hoog and Wim Niesing, which is a valuable article to read.

However in India, the state is increasingly focusing on subsidized health insurance schemes for poor towards reducing poverty and they are well narrated in the article on “Towards Health for All: State run Health Insurance Programs of India” by Vasimalai and Gayathri.

Apart from the government, the mainstream insurers are gearing their efforts of health risk protection of under privileged sections of the society by appropriately designed health insurance products like Samporna Suraksha, which has accessed health insurance to over 300,000 poor through the community organizations of Shree Kshethra Dharmasthala Rural Development Project. The article by Abraham details this elaborately. However the government programs as well as the mainstream insurance products on health insurance are unable to cover the health risks in its entirety and there are significant gaps in cover and processes. These are normally left to the fate of the poor population but however there are remarkable efforts by Uplift India and DHAN Foundation by appropriately evolved and designed community health insurance programs. The community based mutual health insurance program of Uplift India is shaping into a model of an inclusive insurance program with people centered approach involving sound technical platforms. The article by Kumar Shailabh well depicts these.

Similarly the DHAN’s initiative of Insurance to the vulnerable People Living with HIV is a novel model of ensuring risk cover to these vulnerable sections of the population as they are excluded under the mainstream insurance products of life and health. The concept of distribution and sharing of risks among different risk pools towards an affordable and sustainable insurance product is focused in the article on Insurance to vulnerable PLHIV by Balasubramanian.

As mentioned earlier, risk management includes the measures of risk avoidance, risk prevention and risk reduction apart from the risk financing / insurance. Thus it is more appropriate to practice the measures that would mitigate risks apart from risk financing. How the poor communities are practicing an integrated system of health care and insurance is not known much. The article on “Integrated Health care and Insurance – A community model” by Rajapandian and Sivarani reveals this and provides valuable learnings.

I look forward to your valuable feed back to enrich the magazine.

S. Balasubramanian
Email: pm@dhan.org

Leave a Reply

Your email address will not be published. Required fields are marked *

Time limit is exhausted. Please reload CAPTCHA.