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Submitted by Rob Yates on

Time to stop flogging the CBHI dead horse

These dismally low coverage rates for community based health insurance in Maharastra are not at all unusual. In fact they are typical of CBHI schemes across Africa. Over the last 30 years there have been hundreds of schemes like this and many have tried to up their coverage rates with intensive efforts to "sensitise the community" But the impact has been minimal.

Therefore wouldn't it be better if we all stopped flogging the dead horse of CBHI because it suffers the fatal flaw of all voluntary insurance schemes - adverse selection. The only way to force the healthy wealthy to cross-subsidise the sick and the poor is through compulsory publicly-governed health finanicng systems. In other words tax finaning or social health insurance or a combination of the two. As even the world's largest economy has shown you can't reach UHC using private insurance as your primary mechanism. Public health finanicng is the key to UHC.