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Health Micro Insurance in Cameroon: The Need for a Legal Framework and the Possibility of Unfulfilled Expectations
In most low income countries like Cameroon, severe inequalities exist between citizens as they attempt to meet their health care financing needs. The World Health Organization estimates that, about 100 million people are pushed into poverty each year because of medical bills (WHO 2005). Due to a limited tax base, the state in these Countries cannot provide health social security for its denizens. As a result, people rely on out-of-pocket payments at the point of service with catastrophic consequences. To address this health financing inequalities, Cameroon embraced health micro insurance (HMI) in 2005.
In a mixed method (quantitative and qualitative) research I conducted in Cameroon in January 2011, I discovered that, there is no legal framework regulating the functioning of HMI. All key informants for the study extolled the benefits that an eventual legal framework will bring to HMI. From the quantitative data it emerged that, the absence of a legal framework is causing citizens to be skeptical about joining the scheme. This lethargy by the state is interpreted by potential adherents as tacit disapproval. A legal framework will make HMI obligatory. Saving to prevent future health risk is not part of the Cameroonian culture. The National values theory argues that, the cultural and ideological conditions inherited from each country’s past, either facilitate or delay governmental actions to promote social security. A legal framework will subsidize premiums, thus making HMI accessible to the very poor. It will equally provide a legal instrument to check moral hazards. However, a legal framework isn’t a panacea for all health financing challenges in Cameroon. For instance, in Rwanda and Tanzania where it exist problems as adverse selection and abuse abound.
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Learning Objectives: Participants will acquire information about the gross inequalities that exist in Cameroon's health care financing and how these can be addressed via health micro insurance. The importance of a legal framework for such a scheme will be discussed. At the end of my presentation, participants should be able to analyze objectively the role of a legal framework in an important health policy sector as micro insurance for health financing. With the help of theories as the national values approach and the institutional theories of politics, participants should be able to recognize and identify challenges in enacting a legal framework for health micro insurance. Participants will understand that, despite its obvious advantages, a legal framework for health micro insurance is not a magic wand for all of Cameroon's health financing challenges. They should be able to assess for themselves whether, Cameroon government's target of 40% coverage by 2015 will be met.