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Beyond Financial Protection: A Comprehensive Framework for Value for Money in Health Insurance for Informal Sector Populations

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  • Dror, David Mark

Abstract

Background: Traditional conceptions of "value for money" in health insurance are narrowly framed around financial metrics, inadequately capturing the multidimensional nature of value for informal sector populations. Objectives: This paper develops a theoretical framework conceptualizing value for money beyond financial protection to include preference alignment and social capital formation. Methods: We examine trust as a core mathematical variable rather than an environmental factor by analyzing generalizations from community-based health insurance schemes in India, the Philippines, Uganda, Cambodia, Bangladesh, Rwanda, and South Africa. Results: Our framework reveals trust exhibits specific properties including asymmetric response and critical thresholds, and that the Collaborative and Contributive (C&C) model generates distinctive value propositions yielding superior sustainability and willingness-to-pay metrics compared to conventional approaches. Conclusions: This framework reconceptualizes value for vulnerable populations and provides actionable design principles for optimizing insurance value across three dimensions: financial protection, preference alignment, and social capital formation.

Suggested Citation

  • Dror, David Mark, 2025. "Beyond Financial Protection: A Comprehensive Framework for Value for Money in Health Insurance for Informal Sector Populations," EconStor Preprints 316219, ZBW - Leibniz Information Centre for Economics.
  • Handle: RePEc:zbw:esprep:316219
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    File URL: https://www.econstor.eu/bitstream/10419/316219/8/Dror-Beyond-Financial-Protection.pdf
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    References listed on IDEAS

    as
    1. Dror, David Mark & Radermacher, Ralf & Koren, Ruth, 2007. "Willingness to pay for health insurance among rural and poor persons: Field evidence from seven micro health insurance units in India," Health Policy, Elsevier, vol. 82(1), pages 12-27, June.
    2. Arnab Acharya & Sukumar Vellakkal & Fiona Taylor & Edoardo Masset & Ambika Satija & Margaret Burke & Shah Ebrahim, 2013. "The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review," The World Bank Research Observer, World Bank, vol. 28(2), pages 236-266, August.
    3. David M. Dror & Christian Jacquier, 1999. "Micro‐insurance: Extending Health Insurance to the Excluded," International Social Security Review, John Wiley & Sons, vol. 52(1), pages 71-97.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    Health insurance; informal sector; Trust; social capital; financial protection; community participation; health financing;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • O17 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Formal and Informal Sectors; Shadow Economy; Institutional Arrangements
    • D91 - Microeconomics - - Micro-Based Behavioral Economics - - - Role and Effects of Psychological, Emotional, Social, and Cognitive Factors on Decision Making
    • Z13 - Other Special Topics - - Cultural Economics - - - Economic Sociology; Economic Anthropology; Language; Social and Economic Stratification
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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