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The Demand for (Micro) Health Insurance in the Informal Sector

Author

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  • David M Dror

    (1] Micro Insurance Academy, 52-B, Okhla Industrial Estate phase III, New Delhi 110020, India. E-mails: daviddror@socialre.org; Lucy.firth1@gmail.com[2] Erasmus University Rotterdam (Institute of Health Policy and Management), PO Box 1738, Rotterdam 3000DR, The Netherlands)

  • Lucy A Firth

    (Micro Insurance Academy, 52-B, Okhla Industrial Estate phase III, New Delhi 110020, India. E-mails: daviddror@socialre.org; Lucy.firth1@gmail.com)

Abstract

We identify the need for a theory of demand for health insurance suited to the informal sector in low- and middle income countries (LMIC) where some 3 billion people lack health cover. Excluded from formal governance structures, they rely on informal arrangements by which rules-in-use shape choices, behaviours and decisions. We explore the fundamental assumptions of standard economic theories of demand for health insurance in the light of arguments from the literature and field evidence. We show that the assumptions are largely inconsistent with the context of poverty and informality. And we propose a new theory based on assumptions better suited to the context of informality and poverty. Our major conclusion is that, in order to grow the demand for health insurance in the informal sector in LMIC, it is first necessary to strengthen ground-up governance consistent with group-based decision-making under local conditions.

Suggested Citation

  • David M Dror & Lucy A Firth, 2014. "The Demand for (Micro) Health Insurance in the Informal Sector," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 39(4), pages 693-711, October.
    • Handle: RePEc:pal:gpprii:v:39:y:2014:i:4:p:693-711
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    Cited by:

    1. Xiaoqi Zhang & Yi Chen & Yi Yao, 2021. "Dynamic information asymmetry in micro health insurance: implications for sustainability," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 46(3), pages 468-507, July.
    2. Isaac Akomea-Frimpong & Caleb Boadi & Roger Owusu-Boafo, 2021. "Determinants and challenges of supplying microlife insurance in Ghana," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 46(3), pages 331-357, July.
    3. Fischer, Torben & Frölich, Markus & Landmann, Andreas, 2018. "Adverse Selection in Low-Income Health Insurance Markets: Evidence from a RCT in Pakistan," IZA Discussion Papers 11751, Institute of Labor Economics (IZA).
    4. David Mark Dror, 2018. "Systematic Review of Willingness to Pay for Health Insurance in Low and Middle Income Countries," World Scientific Book Chapters, in: Financing Micro Health Insurance Theory, Methods and Evidence, chapter 8, pages 151-168, World Scientific Publishing Co. Pte. Ltd..
    5. Maia Sieverding & Cynthia Onyango & Lauren Suchman, 2018. "Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-22, February.
    6. Rajneesh Chowdhury & Nihar Jangle, 2018. "Critical Systems Thinking Towards Enhancing Community Engagement in Micro-insurance," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 19(3), pages 209-224, September.
    7. Muttaqien Muttaqien & Hermawati Setiyaningsih & Vini Aristianti & Harry Laurence Selby Coleman & Muhammad Syamsu Hidayat & Erzan Dhanalvin & Dedy Revelino Siregar & Ali Ghufron Mukti & Maarten Olivier, 2021. "Why did informal sector workers stop paying for health insurance in Indonesia? Exploring enrollees’ ability and willingness to pay," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-19, June.
    8. David M. Dror & Atanu Majumdar & Nihar Jangle, 2019. "Estimating capital requirements to scale health microinsurance serving rural poor populations," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(3), pages 410-444, July.
    9. Levi Ng’ang’a Mbugua & John Odhiambo Magambo, 2022. "Repositioning Health Microinsurance Products for the Informal Sector Groups," Businesses, MDPI, vol. 3(1), pages 1-17, December.

    More about this item

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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