Habtom GebreMichael Kibreab, Ruys Pieter
Tilburg University, Development Research Institute, The Netherlands.
Health Policy. 2007 Jan;80(1):218-35. doi: 10.1016/j.healthpol.2006.02.013. Epub 2006 Apr 24.
In Eritrea neither the state nor the market is effective in providing health insurance to low-income people (in rural and informal job sector). Schemes intended for the informal sector are confronted with low and irregular incomes of target populations and consequently negligible potential for profit making. Because of this there, are no formal health insurance systems in Eritrea that cover people in the traditional (or informal) sector of the economy. In the absence of formal safety nets traditional Eritrean societies use their local social capital to alleviate unexpected social costs. In Eritrea traditional risk-sharing arrangements are made within extended families and mutual aid community associations. This study reveals that in a situation where the state no longer provides free public health services any more and access to private insurance is denied, the extension of the voluntary mutual aid community associations to Mahber-based health insurance schemes at the local level is a viable way for providing modern health services.
在厄立特里亚，无论是国家还是市场，在为低收入人群（农村和非正规就业部门）提供医疗保险方面都效率低下。针对非正规部门的计划面临目标人群收入低且不稳定的问题，因此盈利潜力微乎其微。正因如此，厄立特里亚没有覆盖经济传统（或非正规）部门人群的正式医疗保险制度。在缺乏正式安全网的情况下，厄立特里亚传统社会利用其当地社会资本来减轻意外的社会成本。在厄立特里亚，传统的风险分担安排是在大家庭和互助社区协会内部进行的。这项研究表明，在国家不再提供免费公共卫生服务且无法获得私人保险的情况下，将自愿互助社区协会扩展为地方层面基于Mahber的医疗保险计划是提供现代卫生服务的一种可行方式。
